Diseases and Disorders > Endometriosis > Endometriosis - Overview

The Facts About Endometriosis

Find out how endometriosis affects your sexual health.

A woman lays on a sofa holding her abdomen in pain.

Endometriosis mimics several other illnesses that affect the female reproductive system and surrounding organs. The complicated nature of endometriosis often results in a misdiagnosis of other conditions with similar symptoms.

What is endometriosis? What does the medical community know about it? How does it manifest? What are a patient's treatment options?

What is endometriosis?

Endometriosis is defined as a disease wherein tissues similar in composition to the endometrium—the lining of the inside of the uterus—grow outside of it, especially on other organs or even muscles, according to the Mayo Clinic.

This disease causes various symptoms that closely mimic those of other conditions, including several potentially life-threatening diseases.

Conditions sometimes mistaken for endometriosis include:

  • Primary dysmenorrhea
  • Adenomyosis
  • Fibroids
  • Ovarian cycles
  • Pelvic adhesions
  • Fibromyalgia
  • Pelvic inflammatory disease (PID)
  • Polycystic ovary syndrome (PCOS)
  • Pelvic floor dysfunction

Mostly, endometriosis affects nearby organs such as the external surface of the uterus, the tissues holding the womb in place, the ovaries and even the fallopian tubes. Endometrial tissue may attach to the colon, urinary bladder and other organs in extreme cases.

This condition is challenging for women who have it because these tissues behave in the same way as the uterine lining—with painful consequences.

When women with endometriosis get their period, the endometrial cells that are outside of the uterus build up and break down if the egg released by the ovary is not fertilized.

Unlike the uterine lining, which gets flushed out of the body through the vaginal canal, the broken-down endometrial tissues have no means of escape, leading to pain and discomfort. Some women experience pain during their periods but also during or after sex or while using the bathroom (urination or bowel movements typically during the menstrual cycle).

Some women do not experience pain. This lack of pain may be due to a large affected area or scar tissue, according to the Illinois Department of Public Health.

What are the signs and symptoms of endometriosis?

Many women experience pelvic pain ranging from manageable twinges to something so severe as to warrant a trip to the emergency room.

Here are the potential symptoms of endometriosis:

  • Painful dysmenorrhea throughout one's period
  • Warning cramps for one or two weeks before menstruation
  • Discomfort or difficulty with one's bowel movements
  • Menorrhagia (heavy menstrual bleeding or flooding)
  • Moderate bleeding (not spotting) between periods
  • Moderate to severe lower back pain anytime during one's cycle
  • Infertility, which affects between 25 percent and 50 percent of people living with endometriosis

Who is prone to endometriosis?

Globally, about 190 million women (approximately 10 percent of the global female reproductive age population) of varying ages, races and social brackets are affected by this disease, according to the World Health Organization (WHO).

Any girl or woman currently having periods may have endometriosis. However, the average age of women when they are diagnosed with the condition is between 30 and 40, according to the Office on Women's Health of the U.S. Department of Health and Human Services.

Because endometriosis resembles other diseases or health conditions, it can take a long time for someone to receive the correct diagnosis. It takes from four to 11 years from the onset of symptoms to a clinical diagnosis, a 2019 study noted.

The following conditions and factors may put someone at a higher risk for endometriosis:

  • They began menstruation (menarche) at a young age.
  • They have never given birth.
  • Their menstrual periods last longer than seven days.
  • Their menstrual cycles run for less than the 28-day average.
  • They have family members with endometriosis, especially female relatives on the maternal side.
  • They have health conditions that prevent the normal flow of menstrual blood during a period.

Diagnosing endometriosis

The more common method of endometrial diagnosis is through laparoscopic surgery, followed by a biopsy to check for the presence of malignant tissue. In 2020, DotLab began a study to determine if biomarkers could check for the presence of endometriosis. More research is needed to determine if blood or saliva analysis yields a positive result.

Other measures used to diagnose gynecological conditions, such as ultrasound or magnetic resonance imaging (MRI), are ineffective when finding endometrial tissue beyond the uterus. It is only visible if it is particularly severe.

Sometimes women don't experience pain. The disease may be discovered during a different procedure.

Treating endometriosis

There is no cure for endometriosis. However, treatment options are available to help ease the pain of endometriosis. They may be used alone or after surgery to help end the growth and spread of these cells to parts of the body.

Pain medication

To help reduce the discomfort of period cramps, your healthcare professional may recommend over-the-counter pain medication, such as nonsteroidal anti-inflammatory drugs (NSAIDs), such as ibuprofen or naproxen sodium.

Hormone therapy

The ebb and flow of hormones during a woman's period can cause the tissue to thicken, break down and bleed. For women not trying to conceive, the birth control pill can stop periods and help suppress mild to moderate endometriosis, according to Yale Medicine.

Gonadotropin-releasing hormone (Gn-RH) agonists and antagonists stop or limit ovarian hormone production in the body. Progesterone-only medications are other viable options to stop periods and endometrial tissue growth.


To help relieve pain or discomfort and increase the efficiency of any affected organs, surgery is sometimes required. Surgery can remove excess endometrial tissue, a solution commonly implemented for those who want to get pregnant, because it can help improve fertility.

Endometriosis can return soon after surgery, according to Cleveland Clinic.

Two kinds of surgery are available:

  • Laparoscopy. This surgical option is minimally invasive and involves a small cut or multiple cuts to the abdomen to insert a small tube with a laparoscope, or camera. It is used for mild to severe cases of endometriosis.
  • Laparotomy. It's a more invasive option involving one large incision across the abdomen. It is used when someone has severe endometriosis and laparoscopy isn't possible.

Doctors once performed a hysterectomy to remove the uterus or an oophorectomy to remove the ovaries, but doing so leads to the onset of early menopause, which could lead to other health conditions. These conditions could include premature death, cardiovascular disease, neurologic disease, osteoporosis, psychosexual dysfunction and mood disorders, according to a 2009 study.

The remaining endometrium-like tissue could continue to cause pain or discomfort even after a hysterectomy or oophorectomy, which is why continued hormonal treatment may be necessary.

Living with endometriosis

While endometriosis can cause minimal discomfort or severe pain, it is possible to live your best life. Treatment options such as fertility preservation and in vitro fertilization (IVF) can help women with endometriosis become pregnant. Roughly 25 percent to 50 percent of women with endometriosis have fertility problems, according to a 2009 study.

Here are some tips for living with endometriosis:

  • Take medications for endometriosis pain as your doctor recommends.
  • Eat a fiber-rich and more plant-based diet with minimally processed foods.
  • Consider hormonal birth control to help manage symptoms.
  • Exercise regularly.
  • Consider stress management measures, along with those for dealing with chronic pain.
  • Discuss measures like surgery, especially if you're hoping to get pregnant and endometriosis has adversely impacted your fertility.


What happens when a woman has endometriosis?

With endometriosis, tissues similar in composition to the endometrium—the lining of the inside of the uterus—grow outside of it, especially on other organs or even muscles. This disease causes various symptoms that closely mimic those of other conditions, such as severe primary dysmenorrhea, menstrual flooding, lower back pain and infertility.

How does a woman get endometriosis?

In most cases, a condition called retrograde menstruation is to blame. During each period, menstrual blood that carries endometrial cells flows backward via fallopian tubes and toward the pelvic cavity instead of flowing out of the woman's body.

What are three common causes of endometriosis?

Numerous factors could cause endometriosis. Three common causes include a hereditary predisposition to the condition, issues with a woman's immune system that affect her reproductive organs or a hormonal imbalance.

What are the complications of endometriosis?

Roughly 25 percent to 50 percent of women with endometriosis will have a more difficult time getting pregnant, according to the Gynecology and Obstetrics Medical Group. There are treatment options to help promote a healthy pregnancy and a healthy baby. Speak with your doctor.