Decoding Endometriosis: Understanding the signs, symptoms, and treatments

Endometriosis is one of the more common female reproductive issues medical professionals see. There are about 200,000 cases in the United States every year, making it fairly common but there are a lot of things women don’t know about endometriosis and sometimes it can be overlooked. Since it’s not very often talked about unlike issues like PCOS, we’re going to break down what it is, the signs and symptoms, and how to bring it up to your healthcare provider if you think it might be something you’re suffering from. 

What is endometriosis?

Endometriosis is the disorder that occurs when tissue that normally lines the inside of your uterus grows outside of your uterus. The tissue does what it normally does and thickens, breaks down and bleeds with each menstrual cycle but since the tissue has no way to exit your body, it becomes trapped. When endometriosis occurs, it’s most common for the endometrial tissue to grow on your ovaries and other areas of the pelvic region and typically doesn’t go beyond that region but it’s not impossible for that to happen.  

About 10% of reproductive-aged women have been diagnosed with endometriosis but the true statistic is unknown due to the difficulty in diagnosing. To diagnose endometriosis a doctor must perform a laparoscopy, which is a surgery involving looking into the abdomen with a camera to see if there are endometriosis lesions. According to UCLA Health, endometriosis is seen in 12-32% of women having surgery for pelvic pain and in up to 50% of women having surgery for infertility. 

Causes and risk factors of endometriosis 

Unfortunately, the cause of endometriosis is still unclear. However, there are a few working theories. 

  • During menstruation, some of the tissue backs up through the fallopian tubes into the abdomen where it attaches and grows (also called “reverse menstruation”)
  • Endometrial tissue may travel and implant via blood or lymphatic channels 
  • Cells in any location may transform into endometrial cells 

Since the cause is still somewhat unknown, exact risk factors aren’t certain either but so far there are women who have been shown to be in higher risk groups for developing the disease. 

  • 30+ year-old women giving birth for the first time
  • Women with an abnormal uterus 
  • Women who have a close relative with the disease 
  • Starting your period at an early age 
  • Higher levels of estrogen
  • Going through menopause at an early age 
  • Low BMI 

What are the symptoms of endometriosis?

pelvic pain from endometriosis

Like many diseases, the symptoms vary greatly for every person. Some women experience no symptoms at all, while others can experience severe symptoms. The symptom severity also doesn’t equate to the severity or stage of endometriosis. The most common symptom endometriosis is associated with is pelvic and abdominal pain. Since abdominal pain can be linked to a huge variety of issues, endometriosis can be easily overlooked. Some of the other common symptoms are 

  • Painful periods 
  • Infertility
  • Pain after sex
  • Pain in the pelvic region during periods
  • Uncomfortable bowel movements 
  • Excessive bleeding 
  • Pain while peeing during periods 
  • Fatigue 
  • Bloating or constipation during periods 

It can be really difficult to decode the symptoms of endometriosis since some of them are common with PMS and having periods in general but always listen to your body. If things aren’t feeling right, and especially if you’re having pelvic pain paired with any symptoms above, talk to your doctor. 

How is endometriosis treated? 

birth control pills

Unfortunately, there isn’t a known cure to endometriosis. However, there are some options for treating the symptoms and managing pain. Working with your healthcare provider to find what works best for you is critical. Most doctors prefer to start with more mild treatment options to see how your body will react and escalate options from there if things aren’t improving. The most common treatment options are

  • Pain medications - over-the-counter pain medications such as ibuprofen are a typical recommendation for managing the pain 
  • Hormone therapy - taking supplemental hormones can sometimes relieve pain and stop the progression of endometriosis. It helps your body regulate the monthly hormonal changes that promote the tissue growth that happens when you have endometriosis
  • Hormonal contraceptives - contraceptives like birth control pills or patches can reduce pain in less severe cases of endometriosis 
  • Laparotomy - in more severe cases doctors will opt to perform a surgery to remove as much of the displaced endometrium as possible without damaging healthy tissue in the region 
  • Hysterectomy - as a last resort, doctors will perform a hysterectomy to remove the uterus all together 

If you’re struggling with any of the symptoms of endometriosis, talk with your doctor and voice your concerns. Work closely with them to develop the right path forward and know that you’re not alone and that science is always pushing forward to develop a better understanding of the disease and its treatment options.