Endometriosis is a condition where tissue similar to the lining of your uterus grows on other parts of your body. When this tissue grows in the wrong places, it can cause you to experience uncomfortable symptoms that can impact your daily life. Some people with this also have issues getting pregnant.
The endometrium is the inner lining of your uterus. This tissue is what you shed during a menstrual period. Think of endometrium as layers of tissue that build up along the inside lining of your uterus. When you have a period, these layers fall away from the walls of your uterus and leave your body. If you get pregnant, the endometrium helps support the early phases of development.
When you have endometriosis, endometrial-like tissue grows on other organs or structures. This tissue can grow within your abdomen, pelvis or even chest. This tissue is hormonally sensitive and can become inflamed during your menstrual cycle. These areas of endometrial-like tissue can cause ovarian cysts, superficial lesions, deeper nodules, adhesions (tissue that connects your organs and binds them together) and scar tissue within your body.
A few places you can develop endometriosis include the:
- Outside and back of your uterus.
- Fallopian tubes.
- Peritoneum (the lining of your abdomen and pelvis).
- Bladder and ureters.
- Diaphragm (a muscle near the bottom of your chest that plays an important role in breathing).
It is a common condition that can interfere with your everyday life. It can cause long-term pain, disruptions to your menstrual cycle and fertility issues. The symptoms are often manageable with treatment.
The cause of endometriosis is unknown. When you have it, tissue similar to the lining of your uterus grows in the wrong places. When it develops in places like the outside of your uterus, fallopian tubes, ovaries, intestine and within your pelvic cavity, it can cause painful symptoms. This pain is related to increased inflammation and often fibrosis and adhesions.
When endometrial-like tissue grows outside of your uterus, it can cause scar tissue (adhesions). These sections of scar tissue can fuse your organs — creating connections between them that normally wouldn’t be there. This can lead to discomfort and pain.
Symptoms of endometriosis
There are many symptoms connected with endometriosis. The main symptom is pain. This pain can be intense or mild. It can typically be felt in your abdomen, pelvic region and lower back. Although endometriosis is a common condition, not all people will experience symptoms. Sometimes, you can have endometriosis and not know until it’s found during another procedure or investigation of infertility.
People who do experience symptoms of endometriosis may have:
- Very painful menstrual cramps.
- Abdominal pain or back pain during your period or in between periods.
- Pain during sex.
- Heavy bleeding during periods or spotting (light bleeding) between periods.
- Infertility (difficulty becoming pregnant).
- Painful bowel movements.
There’s no connection between the symptoms of endometriosis and the severity of the condition. Some people may have very few patches of endometriosis and still experience severe pain. Other people might have severe endometriosis, but not experience a great deal of pain.
Diagnosis and Tests
In many cases, an endometriosis diagnosis will start with your symptoms. Painful and heavy periods might cause you to reach out to your healthcare provider. Once at an appointment, your provider (typically an Ob-Gyn) may start by asking you for your personal medical history, about any previous pregnancies and if any other people in your family have endometriosis. Your provider may do a pelvic exam. If your healthcare provider needs more information they’ll likely perform pelvic imaging starting with an ultrasound.
Depending on your symptoms, physical exam and ultrasound results, an MRI may also be ordered for further endometriosis mapping. A laparoscopy may be offered for both definitive diagnosis and treatment. It can be a useful way to confirm endometriosis because your surgeon doing the procedure can use a small camera (laparoscope) to look inside your body. A biopsy (small tissue sample) might be taken during this procedure. The biopsy will be sent to a lab to confirm the diagnosis.
Sometimes, you find endometriosis by accident. Not all people who have endometriosis will experience symptoms. In these cases, your provider might discover the condition during a different procedure.
- The severity of your problem
- Your plans for future pregnancies.
- Your age.
- The severity of your symptoms (often pain).
In many cases, your treatment plan will focus primarily on managing your pain and improving fertility issues (if you are planning on a future pregnancy). This can be done through medications and surgery.
Medications are often used to help control the symptoms. These can include pain medications and hormone therapies.