Endometriosis is a chronic condition in which tissue similar to the lining of the uterus (endometrium) grows outside the uterus. These growths are commonly found on the ovaries, fallopian tubes, pelvic lining, and, less commonly, on the bowel or bladder. The misplaced tissue responds to hormonal changes during the menstrual cycle, causing inflammation, pain, and scar tissue.
Common Symptoms
- Severe menstrual cramps that may worsen over time
- Chronic pelvic pain
- Pain during or after sexual intercourse
- Pain while passing urine or stool, especially during menstruation
- Heavy menstrual bleeding or bleeding between periods
- Difficulty becoming pregnant (infertility)
- Fatigue, bloating, constipation, diarrhea, or nausea during periods
Causes
The exact cause of endometriosis is unknown, but possible factors include:
- Retrograde menstruation (menstrual blood flowing backward into the pelvis)
- Genetic predisposition
- Immune system abnormalities
- Hormonal influences
- Transformation of certain cells into endometriosis-like tissue
Risk Factors
- Family history of endometriosis
- Starting menstruation at a young age
- Short menstrual cycles
- Heavy or prolonged menstrual bleeding
- Never having been pregnant
How It Is Diagnosed
A healthcare professional may recommend:
- Medical history and pelvic examination
- Pelvic ultrasound (helps identify ovarian endometriomas)
- MRI in selected cases
- Laparoscopy, a minimally invasive surgery, is the most accurate way to confirm the diagnosis.
Treatment Options
Treatment depends on symptoms, age, and whether pregnancy is desired.
Pain relief
- Nonsteroidal anti-inflammatory drugs (NSAIDs), such as ibuprofen, may help reduce pain.
Hormonal therapy
- Birth control pills
- Progestin-only medications
- Hormonal intrauterine devices (IUDs)
- GnRH agonists or antagonists
Surgery
- Laparoscopic removal of endometriosis lesions while preserving fertility when possible.
- In severe cases, hysterectomy may be considered if other treatments have failed and pregnancy is not desired.
Can Endometriosis Affect Fertility?
Yes. Endometriosis can make it harder to conceive by affecting the ovaries, fallopian tubes, or pelvic environment. However, many women with endometriosis become pregnant naturally or with fertility treatments.
Lifestyle Tips
- Exercise regularly.
- Eat a balanced diet rich in fruits, vegetables, and whole grains.
- Use a heating pad to relieve cramps.
- Practice stress-reduction techniques such as yoga or meditation.
- Get adequate sleep and maintain a healthy weight.
When to See a Doctor
Seek medical evaluation if you have:
- Severe menstrual pain that interferes with daily life
- Persistent pelvic pain
- Pain during sex
- Difficulty getting pregnant after trying for 12 months (or 6 months if age 35 or older)
- Heavy menstrual bleeding or unusual bleeding
