Endometriosis is a disorder where endometrium-like tissue grows outside the uterus in areas like the ovaries, fallopian tubes, bowel, and other pelvic organs. About 7 million people in the United States have endometriosis, but this number could actually be much higher.

Pelvic pain is the most common symptom. But people with endometriosis report a range of other symptoms, including weight gain.

Doctors have differing opinions on whether weight gain may be directly associated with endometriosis. There isn’t any formal research linking this symptom to the disorder, but anecdotal evidence persists. Keep reading to learn more.

The tissue lining the inside of the uterus is called the endometrium. When endometrial tissue grows outside of the uterus, there are a number of symptoms you may experience, including:

Weight gain may not be a direct symptom of endometriosis, but certain aspects of the disorder and its treatments may cause you to add on weight. These include:

  • hormonal imbalances
  • certain medications
  • a hysterectomy

Endometriosis has been linked to high levels of the hormone estrogen. This hormone is responsible for the thickening of the endometrium with your monthly menstrual cycle.

Too much estrogen or unopposed estrogen, when there is more estrogen than progesterone to balance it out, in the body can lead to a number of symptoms, including:

Weight gain is another symptom of a hormonal imbalance, which can affect your metabolism and your ability to lose weight. You may specifically notice fat accumulating around your abdomen and on the tops of your thighs.

Your doctor may prescribe hormone medications, like birth control pills, the vaginal ring, or an intrauterine device (IUD) to help treat your symptoms.

During your normal menstrual cycle, your hormones thicken and then break down the endometrial lining.

Hormone medications may slow tissue growth and prevent tissue from implanting elsewhere in the body. They may also make your menstrual cycles lighter and less frequent.

Some people report weight gain with oral contraceptives and other hormone medications. The synthetic version of progesterone — progestin — is likely the culprit.

Although researchers have concluded that hormonal birth control doesn’t directly cause weight gain, they do agree that certain side effects may be to blame. This includes fluid retention and increased appetite.

A hysterectomy is a surgical treatment for endometriosis. It can involve the removal of your uterus.

The type of hysterectomy performed determines which parts of your reproductive system are removed. For example, a total hysterectomy involves the removal of the uterus and cervix.

Removing just the uterus may not be effective, as the ovaries produce the estrogen and can create pain in tissue throughout the body. This intervention is usually saved for the most extensive cases of the disorder.

A hysterectomy means you can no longer get pregnant. If your ovaries are removed, your body enters menopause.

You may experience a range of symptoms that result from the lack of the hormones estrogen and progesterone. Symptoms may include:

Other common symptoms of menopause include:

It’s important to understand that a hysterectomy will stop your periods from happening. But if your ovaries are not removed then they’ll continue to make hormones. People generally experience more abrupt symptoms of menopause when the ovaries are removed.

Again, research is mixed on whether endometriosis directly or indirectly contributes to weight gain.

If you believe you’re gaining weight as a result of the disorder, there are some lifestyle changes that may help.

These include:

The foods you choose have an impact on your weight.

Consider shopping the perimeter of your grocery store because that’s where the whole foods are. Whole foods are unprocessed and unrefined, such as whole grains, fruits, and vegetables.

Eating whole foods gives your body the nutrients it needs to thrive. Processed and packaged foods, on the other hand, contain empty calories, such as added sugars, that contribute to weight gain.

Remember to:

  • Include plenty of fresh fruits and vegetables into your diet. Other healthy foods include whole grains, low-fat dairy, lean proteins, and healthy fats.
  • Choose cooking methods like baking, grilling, or sautéing.
  • Read labels on packaged foods to evaluate their salt, sugar, and fat content.
  • Pack your own snacks so you aren’t tempted by convenience foods when you’re out and about.
  • Talk with your doctor or dietitian for specifics about how many calories you should eat each day, as well as other advice specific to you and your unique needs.
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Adults are recommended to get 150 minutes of moderate physical exercise per week.

Moderate activity includes exercises like:

  • walking
  • dancing
  • hiking

Vigorous activity includes exercises like:

  • running
  • cycling
  • swimming

Remember to:

  • Stretch. Flexibility in your muscles and joints will increase your range of motion and help you avoid injury.
  • Start slow. A gentle walk in your neighborhood is a solid first step. Try increasing your distance over time or incorporating intervals as you feel more aerobically fit.
  • Look into strength training. Lifting weights regularly will tone your muscles and help you burn more fat. If you belong to a gym, consider asking a personal trainer for tips on proper form.
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Hormone medications and surgical treatments, such as a hysterectomy, may cause weight gain. If you’re concerned about these options, talk with your doctor.

There are other treatments available, like taking pain relievers as needed. Over-the-counter (OTC) nonsteroidal anti-inflammatory drugs, such as ibuprofen (Advil) and naproxen (Aleve), may help with menstrual cramping.

Lifestyle changes may also help. For example, taking warm baths or using heating pads may reduce your cramps and pain. Regular exercise may also ease your symptoms and aid in your weight loss efforts.

If you have endometriosis and feel it may be contributing to weight gain, talk with your doctor. Take note of any additional symptoms you’ve been experiencing.

Your doctor may discuss alternative treatment options, as well as lifestyle changes that can help you feel better and stay in a moderate weight range.

It’s always a good idea to contact your doctor before making significant changes to your diet and exercise routines. Your doctor may have suggestions or refer you to a specialist, such as a dietitian, for additional support.