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What is endometriosis?

Get information on what endometriosis is and what causes it.

Endometriosis often carries with it serious abdominal pains. [©Shutterstock, 2010]
©Shutterstock, 2010
Endometriosis often carries with it serious abdominal pains.

Endometriosis is a chronic disease that occurs when tissue that lines the uterus, called endometrium, implants on other organs such as the ovaries, bowel and bladder. Endometrium also may grow behind the uterus and in rare cases, it migrates to distant areas like the lungs, breasts, arms, legs and brain. The transplanted tissue acts like the original, building up and shedding every month when pregnancy does not occur. This is problematic because, unlike blood and tissue from the uterus, the transplanted tissue has nowhere to exit the body, which can cause internal bleeding, scar tissue formation and other complications. 

More than 5 million women in the United States are affected by endometriosis, according to the U.S. Department of Health and Human Services. There is no cure for the disease, and it’s a leading cause of infertility among women of child-bearing age. Endometriosis has a very real physiological origin, though the underlying cause of the disease has not been positively identified.

Symptoms of Endometriosis

Some women do not experience any pain as a result of endometriosis, while others suffer from excruciating pain every month when they menstruate. Beyond pain during menses, other common symptoms include:

  • Painful sexual intercourse
  • Infertility
  • Spotting between periods
  • Lower back and pelvis pain
  • Unusually heavy or long menstrual periods
  • Pain urinating or defecating during menstruation
  • Intestinal pain


Because the endometrial tissue attaches to other organs, it can affect their functioning as well. Gastrointestinal problems like irritable bowel syndrome and constipation or diarrhea during the menstrual period are common.

Endometriosis Diagnosis

Endometriosis is diagnosed in several steps. After a thorough discussion of the patient’s medical history, a pelvic exam will be conducted during which the gynecologist may find signs of endometriosis. An ultrasound or MRI of the patient’s abdomen may also be conducted. The diagnosis of endometriosis can be confirmed only through laparoscopic surgery.

Causes of Endometriosis

There are several theories about the cause of endometriosis, but none has been scientifically confirmed. Because the condition occurs more frequently among women whose relatives have endometriosis, there is likely some genetic component to the disease. Some theories include retrograde menstruation theory, which posits that endometrium backs up into the abdomen during menstruation and implants itself. The “transplantation” theory that endometrium is carried to other areas by the lymph or blood system. Finally, the “coelomic metaplasia” theory argues that cells may change types under certain circumstances. Environmental pollutants called dioxins also have been linked to endometriosis.

Treatment of Endometriosis

Common treatments for endometriosis include hormone therapy (birth control pills, progestin, Gonadotropin releasing hormone agonists and Danazol) and surgery (laparoscopy, laparotomy and hysterectomy).

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