Endometriosis: Causes, Symptoms Diagnosis and Treatment

It is a painful medical condition in which endometrial implants, composed of tissue usually found inside the uterus, are present in other body areas.

This becomes problematic as the tissue continues to act as if it were inside the uterine cavity and thickens, decomposes, and bleeding during a woman’s menstrual cycle, becoming trapped within the affected body area.

Scar tissue and adhesions are formed when the irritation of the surrounding tissues occurs, causing organ fusion and anatomical changes.

Data on endometriosis

Worldwide, 176 million women are affected by the disease, with 5 million women involved in the United States.

The data show that endometriosis may be present in a developing fetus; It is believed that the levels of pubertal estrogen trigger the disease.

Symptoms of endometriosis are usually present during the reproductive years, most commonly during a woman’s 30s-40s, and may occur with the onset of a girl’s menses.

Most women are not diagnosed, taking approximately ten years to receive a diagnosis in the United States.


Endometriosis is not contagious.

Allergies, asthma, chemical sensitivities, autoimmune diseases, chronic fatigue syndrome, fibromyalgia, and breast and ovarian cancer are related to women and families with endometriosis.

What is endometriosis?

Endometrial implants can be found in various body areas, including the vagina, vulva, cervix, uterus, fallopian tubes, ovaries, uterosacral ligaments, peritoneum, pelvic cavity, bladder, intestine, intestines, appendix, and rectum.

In rare situations, endometrial implants may also be present in the lungs, brain, and skin.

The disease causes physical symptoms such as pain, but it can also affect other areas of a woman’s life, including her professional and financial life, relationships, and quality of life.


The exact cause of endometriosis is not entirely understood. However, there are some explanations for the development of the disease and including:

Retrograde menstruation:

This condition causes menstrual blood to back up into the fallopian tubes and pelvis instead of normal expulsion.

Additional research is needed to determine why only some women manifest endometriosis during retrograde menstruation.

Embryonic cell growth:

Sometimes, the abdomen and pelvis embryonic cells become endometrial tissue inside those cavities.

Fetal development:

The data show that endometriosis may be present in a developing fetus; It is believed that the levels of pubertal estrogen trigger the disease.

Surgical scar: the endometrial cells can be attached to an incision made for a procedure such as a hysterectomy or a cesarean section.

Transport of endometrial cells:

The lymphatic system can transport endometrial cells to various parts of the body.


There may be a hereditary component of endometriosis. There is an increased risk that a girl will develop endometriosis if she has a close relative of the woman with the disease.


When the hormone estrogen stimulates endometriosis.

Immune system:

Problems with the immune system can prohibit the destruction of extrauterine endometrial tissue.


Other medical conditions such as pelvic inflammatory disease (PID), ovarian cysts, and irritable bowel syndrome (IBS) can mimic the symptoms of endometriosis.

As for the symptoms, they must be evaluated by your health care provider to make an accurate diagnosis.

Symptoms of endometriosis include:

  • Severe menstrual cramps not relieved by NSAIDs.
  • Long-term pelvic and back pain.
  • Periods more extended than the average last more than seven days.
  • Heavy menstrual bleeding causes the need to change your pad or tampon every 1-2 hours.
  • Intestinal and urinary problems include pain, diarrhea, constipation, and swelling.
  • Blood in the stool or urine.
  • Nausea and vomiting.
  • Fatigue.
  • Painful sex.
  • Intermenstrual staining/hemorrhage.

Infertility can be experienced in 30-40% of those with endometriosis.

While pain is the most common indication of endometriosis, the severity of the pain itself does not always correlate with the extent of the disease since some women experience excruciating pain and only show mild illness or vice versa.

Often, the pain resolves after menopause when estrogen production is over; however, if hormone therapy is used during menopause, the symptoms may persist. Pregnancy can provide temporary relief of symptoms.

Tests and diagnosis of endometriosis

The diagnosis of endometriosis can be a challenge for health providers because there is no single test used for the evaluation; The only way to confirm endometriosis is by surgical laparoscopy.

Most women are not diagnosed, and it takes approximately ten years to receive a diagnosis in the United States.

Other methods of evaluating the presence of endometriosis include the pelvic exam.

But also the radiological image with ultrasound or magnetic resonance and the use of certain medications, including birth control or agonists of the gonadotropin-releasing hormone (GnRH).


Conservative administration is preferred when initially treating endometriosis with surgery, reserving as a last resort. However, there are several options in the treatment of the disease.

The options include:

Medications for pain: non-steroidal anti-inflammatory drugs (NSAIDs) such as ibuprofen (Advil, Motrin, others) or naproxen (Aleve, others) for the treatment of painful menstruation.

Hormones: treatment with hormonal therapies such as hormonal contraceptives, agonists, and antagonists of gonadotropin-releasing hormone (Gn-RH), Medroxyprogesterone (Depo-Provera), or Danazol. The placement of an intrauterine device (IUD) can also be recommended.

Surgery: a conservative approach is initially taken, eliminating areas of endometriosis; however, hysterectomy with removal of both ovaries may be necessary.

Fertility treatments: pregnancy can be recommended by in vitro fertilization.

Alternative modalities: acupuncture, chiropractic, and treatment with certain herbs and vitamins can also be considered.