Endometriosis: Causes, Symptoms and Treatment

Endometriosis is a chronic disease that affects millions of women worldwide. Despite being a common condition, it is often misunderstood and underdiagnosed. In this article, we’ll explore in depth what endometriosis is, what its causes are, the symptoms it causes, and the treatment options available.

What is endometriosis?

Endometriosis is a disease in which tissue similar to the lining of the uterus, known as the endometrium, grows outside the uterus. Normally, the endometrium is broken down and eliminated during the menstrual cycle, leading to menstruation. However, in people with endometriosis, this tissue attaches to nearby organs, such as the ovaries, fallopian tubes, intestines, or bladder. Throughout the menstrual cycle, this tissue also becomes inflamed and bleeds, but since it cannot be removed from the body, it can cause pain, inflammation and the formation of scar tissue (adhesions).

Causes of endometriosis

Although researchers have been studying endometriosis for decades, its causes are still not fully understood. However, there are several theories that attempt to explain why this condition develops:

Retrograde menstruation theory

One of the most accepted theories is retrograde menstruation. This theory suggests that during menstruation, some endometrial cells flow through the fallopian tubes into the abdominal cavity instead of leaving the body. These cells can implant in nearby organs and begin to grow.

Genetic theory

Endometriosis also appears to have a genetic component. People who have first-degree relatives with the disease have a higher risk of developing it. This suggests that there might be certain genes that predispose someone to endometriosis.

Immune System and Inflammation Theory

Some researchers believe that the immune system plays an important role in the development of endometriosis. A dysfunctional immune system could allow endometrial cells to grow and spread rather than eliminate them.

Symptoms of endometriosis

The symptoms of endometriosis vary widely from person to person and do not necessarily correlate with the severity of the disease. Some people may have mild endometriosis but experience severe symptoms, while others with more severe cases may have mild symptoms. Common symptoms include:

Pelvic pain

Pelvic pain is one of the most characteristic symptoms of endometriosis. It can be constant or intermittent and vary in intensity. The pain may get worse during menstruation, sex, or bowel movements.

Painful menstruation

Dysmenorrhea, or painful menstruation, is another common symptom of endometriosis. People with endometriosis often experience more intense menstrual cramps than normal.


About 30-50% of people diagnosed with endometriosis may have fertility problems. The presence of endometrial tissue outside the uterus can affect the function of the ovaries, fallopian tubes, and other reproductive organs, making conception difficult.

Other symptoms

In addition to the main symptoms, endometriosis can also cause fatigue, pain during sex, bleeding between periods, and bowel problems such as diarrhea, constipation, and painful bowel movements.

Diagnosis of endometriosis

Diagnosing endometriosis can be challenging, as symptoms can be mistaken for other conditions and vary in severity. The typical diagnostic process includes:

Medical history and symptoms

Your doctor will begin by gathering information about your symptoms, menstrual history, and any family history of endometriosis.

Physical exam

A pelvic exam can help your doctor detect masses or abnormal tissue in your pelvic organs.

Medical Imaging

Pelvic ultrasound and MRI can help visualize internal organs and detect the presence of endometrial tissue outside the uterus.


The only definitive method of diagnosing endometriosis is through a laparoscopy. During this procedure, a small tube with a camera is inserted into the abdomen to directly look at the organs and tissues.

Treatment of endometriosis

Treatment of endometriosis is based on several factors, such as the severity of symptoms, desire for fertility, and the person’s age. Treatment options include:

Pain management

Over-the-counter or prescription pain relievers, nonsteroidal anti-inflammatory drugs (NSAIDs), and in some cases, opioid medications may be used for pain relief.

Hormone therapy

Hormone therapy is a common option for managing the symptoms of endometriosis. This may include oral contraceptives, patches, hormone-releasing intrauterine devices (IUDs), hormone injections, and medications that temporarily stop ovarian hormone production.

Conservative surgery

If symptoms are severe or affect quality of life, laparoscopic surgery may be done to remove endometrial tissue and adhesions. Importantly, this surgery is performed conservatively to preserve fertility as much as possible.


In extreme cases where other treatments have not been successful and the symptoms are debilitating, a hysterectomy, which is the removal of the uterus, may be considered. However, this option is irreversible and is only recommended when other methods have failed.


Fertility is a crucial aspect of many people’s lives, and understanding the factors that can influence it is essential to making informed decisions. Tobacco and alcohol, despite being widely consumed substances, can have significant negative effects on the ability to conceive in both men and women. From alterations in sperm and egg quality to menstrual irregularities and ovarian dysfunction, these substances can hinder the conception process and increase the risk of complications during pregnancy.

If you’re considering starting a family in the future, it’s important to take steps to reduce or eliminate tobacco and alcohol use. Seeking medical support and adopting a healthy lifestyle can make a big difference in your ability to conceive and have a successful pregnancy. Remember that every decision you make regarding your health can influence your fertility and the health of your future baby.

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