The cause of endometriosis is unknown, but it occurs when endometrial-like tissue grows outside of the uterine cavity. It can cause painful symptoms that may get worse with hormone fluctuations.

Endometriosis is a disorder in which tissue similar to the lining of your uterus grows outside of your uterine cavityTrusted Source.

The lining of your uterus is called the endometriumTrusted Source. In endometriosis, endometrial-like tissue can growTrusted Source on the:

  • ovaries
  • fallopian tubes
  • tissues holding the uterus in place
  • outer surface of the uterus

The hormonal changes of your menstrual cycle affectTrusted Source the misplaced endometrial-like tissue, causing the area to become inflamed and painful. This tissue cannot easily get out of your body.

This tisssue may also continue to expand, which can cause problems such asTrusted Source:

  • irritation
  • cysts
  • scar formation
  • adhesions, in which tissue binds your pelvic organs together
  • bladder and intestine problems

The symptoms of endometriosis vary. Some people experience mild symptoms, but others can have moderate to severe symptoms.

The severity of your pain does not indicate the degree or stage of the condition. You may have a mild form of the disease yet experience agonizing pain. It’s also possible to have a severe form and have very little discomfort.

It’s also important to note that you may not experience any symptoms.

Pelvic pain is the most common symptom of endometriosis. You may also have the following symptomsTrusted Source:

It is important that you get regular gynecological exams, which will allow your gynecologist to monitor any changes. This is particularly important if you have two or more symptoms.

If you need an OBGYN

If you don’t already have an OBGYN, you can browse doctors in your area through the Healthline FindCare tool.

Endometriosis has no cure, but its symptoms can be managed.

Medical and surgical options are available to help reduce your symptoms and manage any potential complications. Your doctor may first try conservative treatments. They may then recommend surgery if your condition does not improve.

Everyone reacts differently to these treatment options. Your doctor will help you find the one that works best for you.

Pain medications

Pain medications for endometriosis can include non-steroidal anti-inflammatory drugs (NSAIDs) and over-the-counter pain medicationsTrusted Source such as ibuprofen.

You should always check with your doctor before starting any new medications, even if they are OTC.

Hormone therapy

Taking supplemental hormones can relieve painTrusted Source and stop the progression of endometriosis.

Hormone therapy helps your body regulate the monthly hormonal changes that promote the tissue growth that occurs with endometriosis.

Keep in mind that some forms of hormone therapy may not be suitableTrusted Source if you are planning to get pregnant.

Hormonal contraceptives

Hormonal contraceptives decrease fertility by preventing the monthly growth and buildup of endometrial-like tissue. They may decrease pain and bleeding.

The medroxyprogesterone (Depo-Provera) injection is also effective in stopping menstruation. It stops the growth of endometrial implants. It relieves pain and other symptoms.

This may not be your first choice, however, due to side effects such asTrusted Source:

  • weight gain
  • decreased bone mineral density
  • vaginal cysts

Gonadotropin-releasing hormone (GnRH) agonists and antagonists

Gonadotropin-releasing hormone (GnRH) agonists and antagonists blockTrusted Source the menstrual cycle and lower the amount of estrogen your body makes.

Estrogen is the hormone that’s mainly responsible for the development of sexual characteristics in people assigned female at birth. Blocking the production of estrogen prevents menstruation and creates artificial menopause.

GnRH therapy has side effectsTrusted Source like hot flashes and weight gain. Taking small doses of estrogen and progesterone at the same time can help to limit or prevent these symptoms.

Danazol

Danazol is another medication used to stop menstruation and help reduce symptoms of endometriosis. However, it does not prevent disease progression.

Danazol can cause side effectsTrusted Source, including acne and hirsutism. Hirsutism is excessive hair growth on your face and body.

Other drugs are being studied that may improve symptoms and slow disease progression.

Conservative surgery

Conservative surgery is typically used for people who want to get pregnant or who experience severe pain and hormonal treatments are not working.

The goal of conservative surgery is to remove or destroy endometrial growths without damaging the reproductive organs.

Laparoscopy, a minimally invasive surgery, is used to both visualize and diagnose endometriosis. It is also used to remove the abnormal or displaced endometrial-like tissue.

A surgeon makes small incisions in the abdomen to surgically remove the growths or to burn or vaporize them. Lasers are now commonly used to destroy this “out of place” tissue.

Last-resort surgery (hysterectomy)

Your doctor may recommend a total hysterectomy as a last resort if your condition does not improve with other treatments.

During a total hysterectomy, a surgeon removesTrusted Source the uterus and cervix. They also remove the ovaries because these organs make estrogen, and estrogen can cause the growth of endometrial-like tissue.

Additionally, the surgeon removes visible implant lesions.

Two other types of hysterectomies are performed based on the condition a person is being treated for.

A subtotalTrusted Source — also referred to as partial or supracervical — hysterectomy removes the upper part of the uterus, leaving the cervix in place.

A radical hysterectomyTrusted Source is typically performed when cancer is present. It removes the entire uterus, cervix, and the top part of the vagina.

You’ll be unable to get pregnant after a hysterectomy. If you’re thinking about starting a family, get a second medical opinion before agreeing to surgery.

Keep in mind that you may still feel painTrusted Source associated with endometriosis after a hysterectomy.

Your mental health matters

Getting a diagnosis and starting treatment options early in the disease can be challenging. Thinking about — or coping with — symptoms like fertility issues and pain coupled with fear possibly setting in about getting relief can be stressful.

In addition to your treatments, it’s important to address your mental wellness. You may consider finding a support group or starting therapy. Taking these steps can help you create a well-balanced approach to managing your condition.

The exact cause of endometriosis isn’t known. There are several theoriesTrusted Source regarding the cause, although no one theory has been scientifically proven.

One of the most likely theoriesTrusted Source is that endometriosis occurs due to a process called retrograde menstruation. This occurs when menstrual blood flows back through your fallopian tubes into your pelvic cavity instead of leaving your body through the vagina.

Another theory is that the immune system may fail to find and destroyTrusted Source endometrial-like tissue growing outside of the uterus.

It’s also possible that endometrial-like tissue may be picked up and moved by mistakeTrusted Source during surgery, such as after a cesarean delivery, also commonly called a C-section.

Some believe endometriosis might start in the fetal period with misplaced cell tissue that begins to respond to the hormones of puberty. This is often called Mullerian theory.

The development of endometriosis might also be linked to geneticsTrusted Source or even environmental toxins.

Endometriosis has four stages or types:

  • minimal
  • mild
  • moderate
  • severe

Different factors determine the stage of the disorder. These factors can include the location, number, size, and depth of endometrial implants.

Stage 1: Minimal

In minimal endometriosis, there are small lesions or wounds and shallow endometrial implants on your ovaries.

Stage 2: Mild

Mild endometriosis involves more and deeper implants on the ovaries and the pelvic lining compared to the minimal stage.

Stage 3: Moderate

Moderate endometriosis involves many deep implants on your ovaries and pelvic lining. There can also be adhesions or small cysts.

Stage 4: Severe

The most severe stage of endometriosis involves many deep implants and dense adhesions on your pelvic lining and ovaries. There can also be cysts on one or both of your ovaries.

The symptoms of endometriosis can be similar to the symptoms of other conditions, such as ovarian cysts and pelvic inflammatory disease. The condition also shares similar symptoms with irritable bowel syndrome (IBS), which can prolong diagnosis.

At the core of treating your pain is getting an accurate diagnosis. It’s important to note that the diagnosis process may vary. In some situations, it can take 4 to 11 years from the onset of symptoms to diagnosis.

Try to be patient with yourself and the process as you work with your healthcare team. Your doctor will perform one or more of the following tests:

Detailed history

Your doctor will note your symptoms and personal or family history of endometriosis. A general health assessment may also be performed to determine if there are any other signs of a long-term disorder.

Physical exam

During a pelvic exam, your doctor will use a speculum and light to see inside of the vagina and cervix. They will also manually feel your abdomen for cysts or scars behind the uterus.

Ultrasound

Your doctor may use a transvaginal ultrasound or an abdominal ultrasound. In a transvaginal ultrasound, a probe is inserted into your vagina.

Both types of ultrasound provide images of your reproductive organs. They can help your doctor identify cysts associated with endometriosis, but they aren’t effective in ruling out the disease.

Laparoscopy

The only certain method for identifying endometriosis is by viewing it directly. This is done by a minor surgical procedure known as laparoscopy. Once diagnosed, the tissue can be removed in the same procedure.

Although there are medications used to treat endometriosis, they do not improve fertility.

You may be able to conceive after having endometrial-like tissue surgically removed. If this does not work in your case, you may want to consider fertility treatments or in vitro fertilization to help improve your chances of having a baby.

Talk with your doctor to better understand your options, such as if endometriosis will affect your timeline for starting a family. They may advise you to start sooner or delay the pregnancy.

With endometriosis, your symptoms may worsen over time, which can make it difficult to naturally conceive. Your doctor will need to do an assessment before and during your pregnancy.

Moreover, if you have endometriosis, you may be at an increased risk of various pregnancy complications.

Endometriosis can develop anytime after the startTrusted Source of your menstrual cycle.

Understanding its risk factors can help you determine whether you’re more likely to develop this condition and when you should talk with your doctor.

Age

Women of all ages are at risk for endometriosis. It most commonly affects womenTrusted Source in their 30s and 40s, but symptoms can begin at puberty.

Family history

Talk with your doctor if you have a family member who has endometriosis. You may have a higher riskTrusted Source of developing the disease.

Pregnancy history

Pregnancy may temporarily decrease the symptoms of endometriosis, but it is not a cure.

Women who have not had children are at an increased riskTrusted Source of developing the disorder. However, endometriosis can still occur in women who’ve had children.

Menstrual history

You may be at a higher riskTrusted Source for developing endometriosis if you have short menstrual cycles (27 days or fewer) or periods that last for more than seven days.

While endometriosis affects about 11 percent of AmericanTrusted Source women between 15 and 44 years old, a 2019 studyTrusted Source found that race and ethnicity may influence its prevalence.

When compared with white women, Hispanic and Black women are less likely to receive a diagnosis for endometriosis.

Alternately, Asian women were 50 percent more likely to receive a diagnosis when compared with white women.

However, a review published in 2019Trusted Source found that when results were limited to women with infertility, disparities for Black women were reduced; there was no statistical significance between Black, white, and Asian patients. The researchers argued that it is unknown if previous associations were made based on diagnostic biases or other factors.

Additionally, there is a lack of research that examines prevalence and outcomes in American IndianTrusted Source or Alaskan Native women.

Overall, more inclusive research that factors in environmental and socioeconomic factors and access to healthcare is necessary to better understand the disease.

Endometriosis is a chronic condition. Its cause has yet to be determined, and currently, it does not have a cure.

However, effective treatments, such as medications, hormone therapy, and surgery, are available to help manage its side effects and complications like pain and fertility issues.

It’s important to immediately contact your doctor if you feel you might have endometriosis. They can begin the process of getting an accurate diagnosis and eventually creating a plan based on your specific situation.