Endometriosis

What are Causes of Endometriosis?

Endometriosis occurs when the lining of the uterus, called the endometrium, grows in places it shouldn’t. During a woman’s menstrual cycle, the tissue sheds, causing pelvic pain and sometimes heavy periods. All the above can lead to inflammation and, eventually, infertility and other complications.

Is Endometriosis Genetic?

While the science isn’t fully understood, endometriosis does seem to be genetic. Meaning, it runs in families.

Signs and Symptoms of Endometriosis

While endometriosis feels different for everyone, pelvic pain is the most frequent complaint. It might be severe or a dull ache. It gets worse before and during your period. Other signs include:

• Abdominal pain
• Back pain
• Bloating
• Bowel movement pain
• Constipation
• Diarrhea
• Discomfort while urinating
• Heavy periods
• Infertility
• Painful cramps
• Pain during sex
• Spotting

You can have endometriosis without any noticeable symptoms. Sometimes, it’s only discovered when you have trouble getting pregnant.

Does Endometriosis Cause Weight Gain?

No, but endometriosis can cause bloating and fluid retention, which can be mistaken for weight gain. However, it doesn’t cause weight gain directly.

Does Endometriosis Cause Infertility?

Yes, it’s a leading cause of infertility. This is because the tissue that grows outside the uterus can block the fallopian tubes, which are the pathways for eggs, or create scar tissue, both of which make it harder to get pregnant.

However, you can still get pregnant with endometriosis. Laparoscopic surgery or fertility treatments may be recommended.

What Does Endometriosis Look Like?

Endometriosis can implant anywhere in the abdomen, including the pelvic walls, bladder, bowel and diaphragm. Due to the typically small and flat nature of these implants or lesions, they’re hard to see on imaging.

Endometriosis can also cause ovarian cysts. While the presence of an endometrioma, a cyst filled with old blood on the ovary, is a strong indicator of the condition, its absence doesn’t mean you don’t have endometriosis.

Endometriosis Stages

Doctors use a system from the American Society of Reproductive Medicine to understand how serious endometriosis is. It's based on how much the tissue has spread and how deep it grows.

• Stage 1 endometriosis (minimal): A few superficial implants with minimal scarring.
• Stage 2 endometriosis (mild): More implants that penetrate deeper, potentially including some scar tissue.
• Stage 3 endometriosis (moderate): Numerous deep implants, potential ovarian cysts and adhesions.
• Stage 4 endometriosis (severe): Widespread deep implants, significant adhesions and large ovarian cysts.

It’s important to remember endometriosis staging doesn't always match the pain you feel. It can be an unpredictable condition. Pain may stay the same, worsen or even improve on its own without treatment.

Is Endometriosis an Autoimmune Disorder?

Chronic inflammation is a major component of endometriosis, similar to autoimmune disorders, but they’re two separate conditions.

Adenomyosis vs Endometriosis

Adenomyosis occurs when the endometrium, the lining of the uterus, grows within the uterine muscle layer itself. Instead of shedding and exiting during menstruation, this tissue bleeds within the uterine wall, leading to an enlarged uterus and often increased pain during menstrual cycles. While it shares a similar process with endometriosis, adenomyosis is distinct in that the endometrial tissue is confined to the uterine muscle wall.

Can Endometriosis Cause Cancer?

Endometriosis doesn't usually raise your chances of getting cancer.

Rarely, some ovarian cancers are a little more common in women with endometriosis. Even then, the risk is less than 1%.

How to Diagnose Endometriosis

An accurate diagnosis relies heavily on patient symptoms versus imaging, as endometriosis is often not visible on ultrasound, computed tomography scan (CT) or magnetic resonance imaging (MRI).

The only sure way to know if someone has endometriosis is through a medical procedure called laparoscopic surgery. This is when doctors make small cuts and use a camera to look inside the belly to find the endometrial tissue.

Even though this tissue can grow anywhere in the abdomen, it's usually found on the pelvic walls, near the uterus and on the ligaments that hold the uterus and cervix in place. Where this tissue grows often explains the type and location of a person's pain. However, the amount of tissue present doesn't always match the severity of symptoms. Some people have minimal lesions, or tissue, and lot of pain. Others have numerous lesions with less pain.

Treatment for Endometriosis

While endometriosis can't be cured, and won’t go away on its own, there are ways to manage it. This is usually with medicine or surgery. Finding the right treatment takes some trial and error.

For endometriosis pain relief, over-the-counter pain relievers like ibuprofen or naproxen can be beneficial. If those don't work, talk to your doctor about other pain management options.

Hormone treatments can lower estrogen levels and stop your periods, which can reduce bleeding, inflammation, scarring and cysts. Common options include:

• Birth control pills, patches or rings
• Gn-RH agonists and antagonists that lower estrogen levels in the body
• Progestin-only birth control
• Steroids

Surgery can remove endometriosis tissue, which can lessen symptoms and improve fertility. Sometimes, the pain returns after surgery. In severe cases, a hysterectomy for endometriosis is necessary. This removes the uterus, ovaries and cervix. However, pregnancy isn’t possible afterward.

Your provider will create a personalized treatment plan for you based on a few things, like the severity of the condition, plans for getting pregnant in the future, your age and the intensity of your pain.

Natural Ways to Treat Endometriosis

Self-care is important when managing any chronic condition. Your doctor may recommend some natural remedies to manage pain and other symptoms from endometriosis, including:

• Anti-inflammatory foods, like fish and nuts
• Heating pads
• Massage
• Rest
• Supplements, like omega-3 fatty acids or magnesium
• Warm baths

When to Talk to Your Doctor About Endometriosis

Endometriosis is notoriously difficult to diagnose, often mimicking other conditions. Tell your doctor if you have constant pelvic pain, especially if it’s worse during menstruation, you have unusually heavy or painful periods, pain during or after sex, discomfort with bowel movements or urination or difficulty conceiving.

Even if your symptoms are mild, being persistently uncomfortable warrants a conversation with your healthcare provider. Early intervention can help manage symptoms and prevent complications.