What Is Endometriosis?

Endometriosis is a chronic condition in which tissue similar to the lining of the uterus grows outside the uterus. These growths most commonly affect the ovaries, fallopian tubes, and pelvic lining, though they may also develop in other parts of the body. Like the tissue inside the uterus, endometriosis tissue outside the uterus responds to monthly hormonal changes. During the monthly menstrual cycle, the tissue can swell with blood and irritate nearby structures, contributing to inflammation, pain, and scar tissue formation. Over time, scar tissue may create abnormal connections between organs.

Understanding what endometriosis is can help patients recognize symptoms earlier and seek appropriate care. At M Health Fairview, our OB-GYN specialists provide personalized evaluation and treatment for endometriosis at every stage of care. Schedule an appointment with an OB-GYN specialist to discuss symptoms and treatment options. Additional information is available through the MedlinePlus endometriosis overview.
 

What Are Endometriosis Symptoms? 

Symptoms of endometriosis can vary widely and may change over time. Because symptoms often overlap with conditions such as irritable bowel syndrome (IBS) or general menstrual discomfort, endometriosis may sometimes go undiagnosed for years. Some common symptoms associated with endometriosis include:

•  Pelvic pain, especially during periods: Pelvic pain and cramping are among the most common endometriosis symptoms. Tissue growth outside the uterus responds to hormonal changes during menstruation, causing inflammation and irritation in surrounding pelvic tissues.
• Pain during intercourse: Pain during intercourse may occur when endometriosis lesions or scar tissue affect nearby nerves, muscles, or organs within the pelvis. Symptoms may range from mild discomfort to persistent deep pelvic pain.
• Heavy or irregular periods: Hormonal changes and abnormal tissue growth may contribute to heavy menstrual bleeding, prolonged periods, or bleeding between menstrual cycles in some individuals with endometriosis.
• Pain with bowel movements or urination: When tissue growth develops near the bladder or bowel, it can cause pain during urination or bowel movements, especially during menstruation when inflammation increases.
• Infertility or difficulty getting pregnant: Endometriosis may reduce the chances of becoming pregnant. Pelvic adhesions, chronic inflammation, and changes to reproductive structures can interfere with ovulation, fertilization, or implantation.
• Lower back pain, fatigue, bloating, or nausea: Some individuals experience lower back pain, intestinal discomfort, fatigue, bloating, or nausea related to chronic inflammation and irritation caused by endometriosis.

What Causes Endometriosis?

Although the exact cause of endometriosis remains unclear, researchers believe several hormonal, immune, genetic, and anatomical factors may contribute to its development.

Retrograde Menstruation

Retrograde menstruation occurs when menstrual blood flows backward through the fallopian tubes into the pelvic cavity instead of leaving the body. Research suggests this may allow endometrial-like cells to implant and grow outside the uterus. Although retrograde menstruation is relatively common, only some individuals develop endometriosis, suggesting additional hormonal, genetic, or immune-related factors may also contribute to disease development. 

Immune System Dysfunction

Some studies indicate that immune system dysfunction may contribute to endometriosis by allowing abnormal tissue to persist outside the uterus instead of being removed naturally by the body. Certain immune cells involved in inflammation, tissue growth, and blood vessel formation may help support the survival and spread of endometriosis lesions, contributing to ongoing symptoms and chronic inflammation. 

Genetics and Family History

Individuals with a parent, sibling, or close relative diagnosed with endometriosis may have a higher risk of developing it themselves, suggesting a genetic component to the condition. Researchers are currently studying how inherited genetic traits may influence inflammation, hormone activity, immune response, and overall susceptibility to endometriosis.

Hormonal Factors

Estrogen plays a key role in the growth and activity of endometrial tissue. Hormonal imbalances may contribute to inflammation, lesion growth, and the persistence of symptoms over time. Because endometriosis is closely linked to hormonal cycling, many treatment approaches focus on regulating estrogen levels or suppressing hormonal stimulation that can worsen symptoms.

Surgical or Tissue Transfer

In rare cases, endometrial-like cells may attach to surgical incisions after procedures such as cesarean delivery or other pelvic surgeries. Once transferred, these cells may continue growing outside the uterus and respond to hormonal changes during the menstrual cycle. This can lead to localized pain, inflammation, or scar tissue formation near the surgical site over time.

How Is Endometriosis Diagnosed? 

Diagnosis for endometriosis involves reviewing your medical history, physical examination, and imaging. That said, the only way to confirm the diagnosis is through a minimally invasive surgical procedure called laparoscopy. During this procedure, a surgeon inserts a small camera through a tiny incision to visually inspect the pelvic organs. If needed, they also take a tissue sample (biopsy) for laboratory confirmation.

Before recommending surgery, your doctor may first use tools like pelvic ultrasound or MRI to assess symptoms and rule out other conditions, though these imaging tests alone cannot definitively diagnose endometriosis.

How is Endometriosis Treated? 

Endometriosis is a chronic condition, but it can often be effectively managed with appropriate treatment and ongoing care. While there is no universal cure for endometriosis, many treatment options can help control symptoms, slow disease progression, and support quality of life.

Endometriosis treatment options may include:

• Pain management: Anti-inflammatory medications and other therapies may help reduce pelvic pain, cramping, and inflammation.
• Hormonal therapies: Hormone-based treatments may help slow the growth and activity of abnormal tissue associated with endometriosis.
• Surgical options: Minimally invasive procedures may be used to diagnose endometriosis, remove abnormal tissue, and reduce scar tissue.

Treatment recommendations depend on factors such as symptom severity, age, overall health, and fertility goals. At M Health Fairview, our specialists provide individualized care designed to support long-term symptom management and quality of life. Learn more about available endometriosis treatments and services.

What are the Benefits of Endometriosis Treatment?

Endometriosis treatment focuses on reducing pain, slowing disease progression, and improving overall quality of life through personalized, evidence-based care.

• Pain relief and symptom management: Treatment options may help reduce inflammation, relieve pelvic pain and cramping, and improve comfort during daily activities, exercise, work, sleep, and other routine tasks.
• Improved fertility outcomes: Early diagnosis and treatment may help support reproductive health by addressing inflammation, scar tissue, and other factors that can interfere with conception or implantation.
• Reduced disease progression: Managing hormonal and inflammatory factors may help slow the growth and spread of endometriosis tissue while reducing long-term complications related to scarring and chronic pain.
• Personalized treatment options: Care plans may include medication, hormonal therapy, lifestyle recommendations, fertility-focused care, or minimally invasive surgical procedures tailored to each patient’s symptoms and goals.
• Comprehensive, long-term care: Ongoing follow-up care helps patients monitor symptoms, adjust treatment plans as needed, and receive continued support for long-term symptom management and quality of life.