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Endometriosis

Endometriosis is when the type of cells that would normally line your uterus are found outside of your uterus. This may cause pain in your abdominal and pelvic areas, especially during your period. Patients also may have bladder pain, and pain during sex. Endometriosis can make it harder to get pregnant, too.

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  • What Is Endometriosis?
  • What Are the Symptoms of Endometriosis?
  • How Do You Diagnose Endometriosis?
  • How Do You Treat Endometriosis?

What Is Endometriosis?

Endometriosis occurs when cells that you would normally find in the lining of the uterus grow outside of your uterus wall. Those cells can form growths (endometrial tissues) in parts of your belly and pelvic areas, including your:

  • Bowels
  • Bladder
  • Bowels
  • Fallopian tubes
  • Intestines
  • Ovaries

Although these growths aren’t cancerous, they can cause inflammation and scar tissue.

Hormones make endometrial tissues swell and bleed during your period, the same way your uterus does. Endometriosis can be very painful. It can also make getting pregnant more difficult.

There’s no cure for endometriosis. But diagnosing and treating it can reduce pain and may keep it from becoming severe. Doctors can treat symptoms with over-the-counter medicine, hormones, and surgery.

How common is endometriosis?

One in 10 people with a uterus will have endometriosis.

What causes endometriosis? 

We don’t know what causes endometriosis; there are many theories, which include:

  • Retrograde menstruation — This is when blood from your uterus goes into your fallopian tubes during your period.
  • Genetic factors — Inheriting certain genes from your parents may make you more likely to develop endometriosis. 
  • Surgical complications — Endometrial cells may attach to scar tissue after an abdominal surgery, like a cesarean section.
  • Cellular changes — For instance, when embryonic cells turn into endometrial cells during puberty.

Some health conditions may increase your odds of having endometriosis. These include:

  • Allergies and asthma.
  • Autoimmune diseases like lupus and multiple sclerosis.
  • Chronic fatigue syndrome and fibromyalgia.
  • Ehler Danlos syndrome.

What are endometriosis risk factors and complications?

Your health history may play a role in whether you get endometriosis.

Endometriosis risk factors

You’re more likely to get endometriosis if you:

  • Have never been pregnant or are unable to get pregnant (infertility).
  • Have periods that last longer than seven days or a menstrual cycle shorter than 27 days.
  • Have a close relative who has endometriosis, like your sister or mother.
  • Are underweight or have low body fat levels (body mass index, or BMI).

Complications of endometriosis

The two biggest issues endometriosis causes are painful periods and difficulty getting pregnant. About half of people with endometriosis have a hard time getting pregnant.

Endometriosis may also increase your risk of ovarian cancer a little bit. However, the odds of developing ovarian cancer during your lifetime are still very low.

How can I prevent endometriosis?

There’s no way to prevent endometriosis.

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What Are the Signs and Symptoms of Endometriosis?

Endometriosis doesn’t always cause symptoms. But most people with endometriosis have pelvic pain that's usually worse during their period.

If you have endometriosis, you might also experience:

  • Bloating, constipation, diarrhea, and/or nausea, especially during your period.
  • Feelings of depression or anxiety.
  • Heavy periods.
  • Pain during sex.
  • Pain when you urinate.
  • Painful bowel movements.
  • Severe cramping right before and during your period.

Endometriosis symptoms can show up any time after you start having your period. Many women will have symptoms for several decades. Your symptoms may ease or stop around menopause, but menopause doesn’t guarantee an end to endometriosis issues.

When should I see a doctor about my endometriosis symptoms?

There is currently no screening test for endometriosis. However, doctors may ask you questions about symptoms linked to endometriosis during a check-up. Make an appointment to see an OB-GYN (obstetrician-gynecologist) if:

  • Sex is painful.
  • You’ve been trying to get pregnant for more than 12 months.
  • You’re finding it hard to do daily activities or enjoy life because of cramping or pain.
  • Your periods are painful and/or very heavy.

See a doctor right away if:

  • It's painful to pee or poop.
  • You notice blood in your urine or stool.

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How Do You Diagnose Endometriosis?

If your OB-GYN suspects you may have endometriosis, they'll do a pelvic exam to check your vagina and pelvic area for lumps and painful spots.

The only way to confirm you have endometriosis is through laparoscopic surgery. During laparoscopy, a doctor makes a small incision in your belly. They use a laparoscope tool to look for endometriosis growths in your abdominal and pelvic areas. They may take a small tissue sample (biopsy) to confirm the growth is endometriosis.

Tests to diagnose endometriosis

Your doctor may suggest an ultrasound, which uses sound waves to look at your pelvic area. An ultrasound won't find superficial/early-stage endometriosis, but it can find endometriomas, the blood-filled cysts that indicate more advanced disease.

Endometriomas are usually located in the ovaries and are one form of endometriosis that can be seen on ultrasound.  Even though you may have a normal-looking ultrasound, this does not mean that you don’t have endometriosis.

Your doctor may also recommend an MRI to help with laparoscopy or surgery.

Endometriosis outlook

Although endometriosis isn't fatal, it is a long-term condition. It can have a negative impact on your mood and mental health, sex life, relationships, and career. 

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How Do You Treat Endometriosis? 

There’s no cure for endometriosis, but treating it can ease your symptoms and improve your quality of life.

Lifestyle changes for endometriosis

Your doctor may recommend pain management treatments, including:

  • Acupuncture.
  • Mindfulness practices.
  • Physical therapy.
  • Talk therapy.

Pain medications for endometriosis

Over-the-counter pain medicine called nonsteroidal anti-inflammatories (NSAIDs) can relieve endometriosis-related pain and cramping.

NSAIDs used for endometriosis include:  

  • Ibuprofen (Motrin or Advil).
  • Naproxen (Aleve).

Hormone therapy for endometriosis

Hormone levels rise and fall during menstrual cycles, which can cause endometriosis tissue to thicken, break down, and bleed. Hormone treatments reduce the fluctuation of these hormones.

Hormone therapy doesn’t cure endometriosis. You'll have to keep using it to continue treating your symptoms.

Hormone therapies for endometriosis include:

  • Aromatase inhibitors which reduce your estrogen levels.
  • Birth control shots, patches, rings, or intrauterine devices (IUDs).
  • Gonadotropic-releasing hormone (Gn-RH) agonists and antagonists. These medicines stop you from having a period and lower your estrogen levels.
  • Oral contraceptives (birth control pills) containing estrogen and progestin or just progestin.

Fertility treatment for endometriosis

When you plan to have children will impact the type of treatment your doctor recommends. For example, you wouldn’t use most hormone therapies if you were trying to get pregnant.

If you’re having a lot of trouble getting pregnant, your doctor may recommend surgery. Removing endometriosis lesions can sometimes improve fertility. They may also refer you to a reproductive endocrinologist, a specialist who treats infertility.

Surgery for endometriosis

Your doctor may recommend surgery to remove endometrial tissue if:

  • Medicine isn’t enough to ease your endometriosis symptoms.
  • You haven't been able to get pregnant. 

The length of your surgery depends on how severe your endometriosis is. If doctors remove a lot of tissue, you may need to stay overnight at the hospital. However, most surgeries for endometriosis are same-day procedures.

Laparoscopic surgery for endometriosis

Most of the time, doctors use laparoscopic surgery to treat endometriosis. With laparoscopic surgery, a doctor makes small cuts in your belly and uses a laparoscope and surgical tools to remove tissue.

How long does it take to recover?

Recovery from surgery for endometriosis can take several days to more than a month.

How effective is treatment?

If you have endometriosis symptoms, you’ll probably need ongoing treatment. Pain medicine and hormone therapy are usually effective if you keep taking them.

Surgery eases pain for most women with endometriosis.


By UPMC Editorial Staff. Last reviewed on 2024-09-05.

  • American College of Obstetricians and Gynecologists, Endometriosis.
  • Human Reproduction, Fruit and vegetable consumption and endometriosis.
  • International Journal of Environmental Research and Public Health, The Burden of Endometriosis on Women’s Lifespan: A Narrative on Quality of Life and Psychosocial Wellbeing.
  • National Institutes of Health, National Institute of Child Health and Human Development, What are the risk factors for endometriosis.
  • Obstetrics & Gynecology Science, What is the link between endometriosis and adiposity?
  • Stat Pearls, Endometriosis.
  • PMC, Endometriosis symptoms, Risks, and Treatments.
  • World Health Organization, Endometriosis.
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