Endometriosis: Causes, Symptoms, Types & Tests

Endometriosis is a chronic, often painful condition that affects millions of women and people assigned female at birth around the world. It happens when tissue similar to the lining inside the uterus (called the endometrium) grows outside the uterus. This misplaced tissue can cause inflammation, scarring, and severe pain, particularly during menstruation. Though it is a benign (non-cancerous) condition, endometriosis can significantly impact daily life, fertility, and emotional well-being. Awareness, early diagnosis, and proper treatment can greatly reduce complications and help those affected lead more comfortable lives.

Endometriosis

Endometriosis is defined as the presence of endometrial-like tissue outside the uterus, most commonly on the ovaries, fallopian tubes, pelvic lining, and, less frequently, in distant organs like the bladder or intestines. This tissue behaves like normal uterine lining—it thickens, breaks down, and bleeds with each menstrual cycle. But because it has no way to exit the body, it becomes trapped, leading to inflammation, scar tissue, and adhesions that can bind pelvic organs together. It often develops during reproductive years (usually between ages 25–40) but can begin as early as adolescence.

Causes of Endometriosis

The exact cause of endometriosis isn’t fully understood, but several theories and risk factors exist:

• Retrograde menstruation: Menstrual blood flows backward into the pelvic cavity instead of leaving the body.
• Immune system disorders: A faulty immune response may fail to recognize and destroy misplaced endometrial-like tissue.
• Genetics: A family history increases the risk, suggesting a hereditary component.
• Surgical scar implantation: Endometrial cells may attach to surgical incisions after procedures like cesarean sections.
• Hormonal factors: High levels of estrogen can stimulate growth of endometrial tissue.
• Embryonic cell transformation: Hormones may turn peritoneal cells into endometrial-like cells during development.

Though these theories explain some cases, endometriosis likely results from a combination of genetic, hormonal, immune, and environmental factors.

Symptoms of Endometriosis

Symptoms vary greatly—some people experience severe pain, while others may have mild or no symptoms. Common signs include:

• Pelvic pain: Often worse during menstruation and sometimes chronic.
• Painful periods (dysmenorrhea): Cramping that may begin before and extend after the menstrual period.
• Pain during intercourse (dyspareunia): Discomfort or sharp pain during or after sex.
• Pain with bowel movements or urination: Especially noticeable during menstrual periods.
• Excessive menstrual bleeding: Heavy periods (menorrhagia) or bleeding between periods.
• Infertility: Difficulty becoming pregnant is sometimes the first sign.
• Other symptoms: Fatigue, diarrhea, constipation, bloating, or nausea during menstruation.

The severity of pain doesn’t necessarily correlate with the extent of the disease.

Types of Endometriosis

Endometriosis can appear in different forms, often grouped by location or appearance:

1. Superficial peritoneal endometriosis

• Small, flat lesions on the pelvic peritoneum (lining).

2. Ovarian endometriomas (chocolate cysts):

• Fluid-filled cysts that form on the ovaries.

3. Deep infiltrating endometriosis (DIE):

• Lesions that penetrate deeply into pelvic organs or ligaments, sometimes causing severe pain and organ dysfunction.

Doctors may also describe endometriosis based on its stage (I–IV) using the American Society for Reproductive Medicine classification, which considers the size, location, and depth of lesions.

Tests Used to Detect Endometriosis

Endometriosis can be challenging to diagnose because symptoms often overlap with other conditions. Common tests include:

• Pelvic exam: A doctor checks for cysts or scar tissue through manual examination.
• Ultrasound: Especially transvaginal ultrasound can help identify ovarian cysts.
• Magnetic resonance imaging (MRI): Provides detailed images of pelvic organs and is useful in complex cases.
• Laparoscopy: The gold standard for diagnosis; a surgeon uses a camera inserted into the abdomen to view and sometimes biopsy lesions.
• Histopathology: Analysis of biopsied tissue to confirm endometriosis.
• Other tests: Blood tests like CA-125 may be elevated but are not specific to endometriosis.

Conclusion

Endometriosis is a complex disorder that extends beyond painful periods—it can deeply impact physical health, emotional well-being, and fertility. While the cause remains unclear, growing awareness has led to earlier diagnosis and better treatment options, including medications, hormone therapy, surgery, and lifestyle management. If you suspect you might have endometriosis, seeking medical advice is crucial for proper evaluation and care. With the right support and treatment plan, many people with endometriosis find significant relief and lead fulfilling lives.

Frequently Asked Questions (FAQ’s)

1. What is endometriosis?
Endometriosis is a condition where tissue similar to the uterine lining grows outside the uterus.

2. What causes endometriosis?
The exact cause isn’t known, but theories include retrograde menstruation, immune dysfunction, and genetics.

3. Can endometriosis be cured?
There’s no cure, but symptoms can often be managed with medication, surgery, or lifestyle changes.

4. Does endometriosis cause infertility?
Yes, it can make it harder to become pregnant, but many people with endometriosis still conceive.

5. How is endometriosis diagnosed?
Diagnosis usually involves pelvic exams, imaging (like ultrasound or MRI), and sometimes laparoscopy.

6. What are common symptoms of endometriosis?
Pelvic pain, painful periods, heavy bleeding, pain during intercourse, and sometimes infertility.

7. At what age does endometriosis start?
It often begins in adolescence but can affect anyone during their reproductive years.

8. Is endometriosis the same as fibroids?
No; fibroids are benign muscle tumors in the uterus, while endometriosis is tissue growth outside the uterus.