Endometriosis

Many people have painful periods from time to time. But if your pain is severe, ongoing or affecting your daily life, it could be a sign of endometriosis. 

Endometriosis is a common condition that can cause chronic pelvic pain, heavy periods and fertility challenges. It often goes undiagnosed for years. 

The good news: With the right care, symptoms can be managed and quality of life can improve. 

What is endometriosis? 

Endometriosis is a condition where tissue similar to the lining of the uterus grows outside the uterus. 

This tissue can grow on the: 

• Ovaries 
• Fallopian tubes 
• Bladder 
• Bowel 
• Pelvic lining 

Like the uterine lining, it responds to hormones during your menstrual cycle. But because it has no way to leave the body, it can cause: 

• Inflammation 
• Scarring 
• Pain 

Endometriosis affects about 1 in 10 women of reproductive age. 

What are the symptoms of endometriosis? 

Symptoms can vary widely. Some people have severe pain, while others have mild or no symptoms. 

Common symptoms of endometriosis include: 

• Pelvic pain, especially before or during periods 
• Severe menstrual cramps that worsen over time 
• Heavy or prolonged periods 
• Bleeding between periods 
• Pain during sex 
• Pain with urination or bowel movements 
• Bloating, nausea, diarrhea or constipation 
• Fatigue 
• Difficulty getting pregnant 

A key sign: Pain that interferes with daily life is not normal and should be evaluated. 

When should you see a doctor for endometriosis? 

Talk to a health care provider if you: 

• Have severe or worsening pelvic pain 
• Miss work, school or activities due to period pain 
• Experience pain during sex, urination or bowel movements 
• Have heavy or irregular bleeding 
• Are having trouble getting pregnant 

Early evaluation can help reduce long-term complications and protect fertility. 

What causes endometriosis? 

The exact cause isn’t fully understood, but several theories exist. 

Possible causes include: 

• Retrograde menstruation (blood flowing backward into the pelvis) 
• Hormonal and immune system factors 
• Cell transformation in the abdomen 
• Spread of endometrial-like cells through blood or lymphatic systems 

Risk factors include: 

• Family history of endometriosis 
• Immune system conditions 
• Prior pelvic surgeries such as C-section 

Endometriosis likely develops from a combination of genetic, hormonal and immune factors. 

Types of endometriosis 

Endometriosis can appear in different forms: 

• Peritoneal (superficial): Small lesions on pelvic surfaces 
• Ovarian (endometriomas): Cysts on the ovaries 
• Deep infiltrating endometriosis: Growths that extend into organs like the bowel or bladder 

Why is endometriosis often hard to diagnose? 

Endometriosis is often misdiagnosed because symptoms overlap with other conditions such as: 

• Irritable bowel syndrome (IBS) 
• Uterine fibroids 
• Pelvic inflammatory disease (PID) 

On average, diagnosis can take years, making early awareness important. 

How is endometriosis diagnosed? 

Your provider may use several steps to diagnose endometriosis: 

• Review your symptoms and medical history 
• Perform a pelvic exam 
• Order imaging tests such as ultrasound or MRI 

In some cases, laparoscopic surgery may be used to confirm the diagnosis and remove tissue. 

How is endometriosis treated? 

Endometriosis is a chronic condition, but treatment can help manage symptoms and improve fertility. 

Treatment options include: 

Medications: 

• Pain relievers 
• Hormonal therapy or birth control 

Surgery: 

• Minimally invasive procedures to remove or destroy endometrial tissue 

Lifestyle support: 

• Physical therapy 
• Stress management 
• Nutrition changes 

Fertility treatment: 

• IVF or IUI for those trying to conceive 

In severe cases, a hysterectomy may be considered if other treatments have not worked and pregnancy is not planned. 

Endometriosis and fertility 

Endometriosis can make it harder to get pregnant, but many people still have successful pregnancies. 

Fertility depends on: 

• Severity of the condition 
• Location of tissue growth 
• Overall reproductive health 

Early treatment and working with a specialist can improve outcomes. 

Long-term outlook 

Without treatment, endometriosis can worsen over time and lead to: 

• Chronic pelvic pain 
• Scar tissue and adhesions 
• Ovarian cysts 
• Fertility challenges 

With the right care, many people find significant relief and maintain a good quality of life. 

Care you can trust 

At Banner Health, our gynecology specialists use advanced imaging and minimally invasive techniques to diagnose and treat endometriosis. 

We create personalized care plans to help manage pain, support fertility and improve your daily life. 

Find a Banner Health specialist near you to get started. 

Frequently asked questions about endometriosis 

Is endometriosis curable? 

There is no cure, but treatment can help control symptoms and improve quality of life. 

Can endometriosis get worse over time? 

Yes. Without treatment, symptoms and complications may increase. 

Does endometriosis always cause pain? 

No. Some people have little or no pain but may still have fertility issues. 

Can you get pregnant with endometriosis? 

Yes. Many people with endometriosis can become pregnant, especially with the right care. 

Bottom line 

Endometriosis is a common but often overlooked condition that can cause significant pain and impact fertility. If your symptoms are affecting your daily life, getting evaluated early can help you find relief and protect your long-term health.