Endometriosis: Causes, Symptoms, and Treatment

Endometriosis: Causes, Symptoms, and Treatment Options

Endometriosis Introduction

Endometriosis is a chronic and often painful condition that affects millions of women worldwide. It occurs when the tissue lining the uterus (endometrium) grows outside the uterus, commonly in the pelvic region. Endometriosis can cause various symptoms, complications, and fertility issues, impacting a woman’s quality of life. In this article, we will explore the risk factors, causes, types, signs and symptoms, investigations, treatment options, prevention measures, and lifestyle changes recommended by the World Health Organization (WHO).

Risk Factors

Several factors can increase the risk of developing endometriosis, including:

  1. Family history: Women with a close relative, such as a mother or sister, who has endometriosis, are at a higher risk.
  2. Early menstruation: Starting menstruation at an early age (before 11 years) may increase the likelihood of endometriosis.
  3. Short menstrual cycles: Having menstrual cycles shorter than 27 days may be a risk factor.
  4. Long-term exposure to estrogen: Women with prolonged exposure to estrogen, such as those with late menopause or never having given birth, may have a higher risk.
  5. Reproductive abnormalities: Certain conditions, such as a uterus with an abnormal shape or a blocked fallopian tube, can contribute to endometriosis.


The exact cause of endometriosis is not fully understood, but several theories exist, including:

  1. Retrograde menstruation: This theory suggests that during menstruation, some of the menstrual blood flows backward through the fallopian tubes, allowing the endometrial tissue to implant and grow outside the uterus.
  2. Embryonic cell transformation: This proposes that embryonic cells outside the uterus can develop into endometrial-like tissue.
  3. Immune system dysfunction: Issues with the immune system may prevent the elimination of endometrial tissue growing outside the uterus.
  4. Hormonal imbalance: Disruptions in hormone levels, particularly estrogen, can contribute to endometriosis development.

Signs and Symptoms

The signs and symptoms of endometriosis can vary, but common ones include:

  1. Pelvic pain: Chronic pelvic pain, particularly during menstruation, is a hallmark symptom.
  2. Painful intercourse: Dyspareunia, or pain during sexual intercourse, can be experienced.
  3. Heavy or irregular periods: Menstrual cycles may be longer, heavier, or accompanied by severe cramping.
  4. Infertility: Difficulty conceiving or experiencing recurrent miscarriages can be associated with endometriosis.
  5. Gastrointestinal issues: Bowel problems, such as diarrhea, constipation, or bloating, may occur, especially during menstruation.


To diagnose endometriosis, various investigations may be conducted:

  1. Medical history and symptom assessment: A detailed discussion with the doctor about symptoms, medical history, and family history is crucial.
  2. Pelvic examination: The doctor may perform a physical examination to check for abnormalities, tenderness, or the presence of masses.
  3. Imaging tests: Ultrasound, magnetic resonance imaging (MRI), or computed tomography (CT) scans can help identify endometriotic implants.
  4. Laparoscopy: This minimally invasive surgical procedure involves inserting a thin tube with a camera (laparoscope) into the abdomen to view and biopsy the endometrial tissue.


The treatment options for endometriosis aim to manage symptoms, preserve fertility, and improve the quality of life. WHO recommends the following approaches:

  1. Pain management: Over-the-counter pain relievers, such as nonsteroidal anti-inflammatory drugs (NSAIDs), can help alleviate pain and cramping.
  2. Hormonal therapy: Various hormonal treatments, including combined oral contraceptives, progestins, and gonadotropin-releasing hormone (GnRH) analogs, can help control endometriosis progression and reduce symptoms.
  3. Surgery: Laparoscopic surgery can remove endometrial implants, adhesions, and cysts. In severe cases, a hysterectomy may be considered.
  4. Fertility treatment: Assisted reproductive techniques, such as in vitro fertilization (IVF), may be recommended for women experiencing infertility due to endometriosis.

Prevention and Lifestyle Changes

While endometriosis cannot be completely prevented, certain measures can reduce the risk and manage symptoms:

  1. Regular exercise: Engaging in regular physical activity can help regulate hormone levels and reduce pain.
  2. Healthy diet: Consuming a balanced diet rich in fruits, vegetables, whole grains, and omega-3 fatty acids may help reduce inflammation and manage symptoms.
  3. Stress management: Stress reduction techniques, such as meditation, yoga, or counseling, can alleviate symptoms and improve overall well-being.
  4. Avoiding exposure to environmental toxins: Limiting exposure to toxic chemicals found in some household products and pollutants may be beneficial.

Endometriosis is a complex condition that can significantly impact a woman’s life. Understanding the risk factors, causes, types, signs and symptoms, investigations, treatment options, and prevention measures outlined by the World Health Organization can help women seek timely diagnosis and appropriate management. By adopting lifestyle changes and receiving appropriate medical care, women with endometriosis can better manage their symptoms and improve their quality of life. It is crucial to consult healthcare professionals for accurate diagnosis and personalized treatment plans.

Author: Dr. Rabia
Dr Rabia Akhtar, MBBS(Bachelor of Medicine and Bachelor of Surgery), has perceived her graduation from India. Special Interest: Surgery, Chronic disease, Emergency Medicine, Paediatrics, Women's Health.
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