Endometriosis: Symptoms, Causes, Diagnosis & Treatment
Learn about endometriosis, its symptoms and possible causes, how it is diagnosed, and the medical and lifestyle approaches that may help manage symptoms and support quality of life.
Endometriosis is a long-term condition in which tissue similar to the lining of the uterus grows outside the uterus. It can affect areas of the pelvis and, in some cases, other parts of the body.
Endometriosis can cause pain, menstrual symptoms, bowel or bladder symptoms, and difficulties with fertility. However, symptoms vary greatly from person to person, and the amount of tissue involved does not always correspond to the severity of symptoms.
What Is Endometriosis?
Endometriosis is a chronic condition involving tissue that is similar to the endometrium, the tissue lining the inside of the uterus. This tissue can grow outside the uterus and may cause inflammation, scarring, and pain.
Endometriosis commonly affects the pelvis. It can involve the ovaries, fallopian tubes, pelvic lining, or areas around the bowel and bladder. The location and extent of disease vary from person to person.
Common Symptoms of Endometriosis
Symptoms can range from mild to severe, and some people with endometriosis may have few or no noticeable symptoms.
Pelvic Pain
Pain in the lower abdomen or pelvis may occur before or during menstruation and can sometimes continue outside the menstrual period.
Painful Periods
Menstrual pain may be severe enough to interfere with school, work, exercise, social activities, or everyday life.
Bowel or Bladder Symptoms
Some people experience pain with bowel movements or urination, particularly around menstruation.
Fertility Difficulties
Endometriosis can be associated with difficulties becoming pregnant for some people.
Other Possible Symptoms
- Pelvic pain that occurs outside menstruation
- Pain during or after sexual activity
- Heavy menstrual bleeding in some individuals
- Bloating or abdominal discomfort
- Fatigue
- Digestive symptoms such as diarrhea or constipation
- Lower back or pelvic discomfort
These symptoms are not specific to endometriosis. Conditions such as fibroids, adenomyosis, pelvic infections, irritable bowel syndrome, and other health problems can cause similar symptoms.
What Causes Endometriosis?
The exact cause of endometriosis is not fully understood. Researchers believe that several biological, hormonal, immune, cellular, and genetic factors may contribute to its development.
Possible Contributing Factors
- Genetic factors: Endometriosis can occur more often in some families.
- Immune and inflammatory processes: Changes in immune and inflammatory responses may contribute to the development and persistence of endometriosis.
- Hormonal influences: Estrogen and other reproductive hormones influence the growth and activity of endometriosis tissue.
- Cellular changes: Researchers are studying how certain cells can develop into tissue resembling endometrium outside the uterus.
Retrograde menstruation, in which menstrual fluid flows backward through the fallopian tubes into the pelvic cavity, is one proposed explanation for how endometriosis may develop. However, it does not fully explain every case, and researchers believe that multiple mechanisms may be involved.
Risk Factors
Having a close family member with endometriosis may increase the likelihood of developing the condition. Other reproductive and menstrual factors may also be associated with risk.
Importantly, endometriosis is not caused simply by poor diet, lack of exercise, stress, or
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