What is endometriosis

Surrounding tissue can become irritated, eventually developing scar tissue and adhesions — bands of fibrous tissue that can cause pelvic tissues and organs to stick to each other. Endometriosis can cause pain — sometimes severe — especially during menstrual periods. Fertility problems also may develop. Fortunately, effective treatments are available. The primary symptom of endometriosis is pelvic pain, often associated with menstrual periods. Although many experience cramping during their menstrual periods, those with endometriosis typically describe menstrual pain that's far worse than usual.

Pain also may increase over time. The severity of your pain may not be a reliable indicator of the extent of your condition. You could have mild endometriosis with severe pain, or you could have advanced endometriosis with little or no pain.

Endometriosis is sometimes mistaken for other conditions that can cause pelvic pain, such as pelvic inflammatory disease PID or ovarian cysts. It may be confused with irritable bowel syndrome IBS , a condition that causes bouts of diarrhea, constipation and abdominal cramping. IBS can accompany endometriosis, which can complicate the diagnosis. Endometriosis can be a challenging condition to manage.

An early diagnosis, a multidisciplinary medical team and an understanding of your diagnosis may result in better management of your symptoms. Endometriosis usually develops several years after the onset of menstruation menarche. Signs and symptoms of endometriosis may temporarily improve with pregnancy and may go away completely with menopause, unless you're taking estrogen. During fertilization, the sperm and egg unite in one of the fallopian tubes to form a zygote.

Then the zygote travels down the fallopian tube, where it becomes a morula. Once it reaches the uterus, the morula becomes a blastocyst. The blastocyst then burrows into the uterine lining — a process called implantation. The main complication of endometriosis is impaired fertility. Approximately one-third to one-half of women with endometriosis have difficulty getting pregnant.

Symptoms include pain and unusual bleeding. It is most common among those in their 30s and 40s. Endometrosis occurs when tissue, similar to the lining of the endometrium, grows outside the uterus. The tissue that grows outside the uterus in endometriosis is not the same as endometrial tissue, but they have some features in common.

Endometrial tissue can also develop in other areas , including the digestive tract, the lungs, and around the heart. The body usually expels this type of tissue during menstruation, but the tissue that forms in endometriosis may remain in the body, which can lead to inflammation.

As tissue decomposes, scar tissue can form. In addition to the pain, they may experience pressures relating to:. A report notes that it can take an average of 6. During this time, people lose an average of Pain is the most common indication of endometriosis, but the severity of the pain does not always correlate with the extent of the disease. Pain often disappears after menopause , when the body stops producing estrogen.

However, if a person uses hormone therapy during menopause, symptoms may persist. What are endometriosis adhesions? Endometriosis can be difficult to diagnose. One reason for this is that other medical conditions have similar symptoms. These include:. Monitoring symptoms and seeking help may help prevent long-term complications. People should let their doctor know if they experience severe pain or unexpected bleeding.

There is currently no cure for endometriosis, but various treatment options may help manage symptoms. They include:. Medications can help manage pain. They include nonsteroidal anti-inflammatory drugs such as ibuprofen Advil, Motrin IB, others and drugs to relieve painful menstruation.

A doctor may recommend birth control pills or other hormonal methods of birth control, such as the Mirena device. For many women, simply having a diagnosis of endometriosis brings relief. A diagnosis of endometriosis can only be certain, though, when the doctor performs a laparoscopy, biopsies any suspicious tissue and the diagnosis is confirmed by examining the tissue beneath a microscope. Laparoscopy is a minor surgical procedure in which a laparoscope, a thin tube with a camera at the end, is inserted into the abdomen through a small incision.

Laparoscopy is also used to determine the location, extent and size of the endometrial growths. Ultrasound : A diagnostic imaging technique that uses high-frequency sound waves to create an image of the internal organs. CT scan : A noninvasive diagnostic imaging procedure that uses a combination of X-rays and computer technology to produce horizontal, or axial, images — often called slices — of the body to detect any abnormalities that may not show up on an ordinary X-ray.

MRI scan : A noninvasive procedure that produces a two-dimensional view of an internal organ or structure. A staging, or classification, system for endometriosis has been developed by the American Society of Reproductive Medicine. The stages are classified as follows:. The stage of endometriosis is based on the location, amount, depth and size of the endometrial tissue.

Specific criteria include:. The stage of the endometriosis does not necessarily reflect the level of pain experienced, risk of infertility or symptoms present. For example, it is possible for a woman in stage 1 to be in tremendous pain, while a woman in stage 4 may be asymptomatic.

If symptoms are mild, health care providers generally agree that no further treatment, other than pain medication, is necessary. Pain medication: nonsteroidal anti-inflammatory drugs, such as ibuprofen or other over-the-counter analgesics. Oral contraceptives, with combined estrogen and progestin a synthetic form of progesterone hormones, to prevent ovulation and reduce menstrual flow.

Laparoscopy also used to help diagnose endometriosis : A minor surgical procedure in which a laparoscope, a thin tube with a lens and a light, is inserted into an incision in the abdominal wall; using the laparoscope to see into the pelvic area, the doctor can often remove the endometrial growths.

Laparotomy : A more extensive surgery to remove as much of the displaced endometrium as possible without damaging healthy tissue. Hysterectomy : Surgery to remove the uterus and possibly the ovaries. If you are trying to get pregnant, your doctor may prescribe a gonadotropin-releasing hormone GnRH agonist. This medicine stops the body from making the hormones responsible for ovulation, the menstrual cycle, and the growth of endometriosis.

This treatment causes a temporary menopause, but it also helps control the growth of endometriosis. Once you stop taking the medicine, your menstrual cycle returns, but you may have a better chance of getting pregnant.

Surgery is usually chosen for severe symptoms, when hormones are not providing relief or if you are having fertility problems. During the operation, the surgeon can locate any areas of endometriosis and may remove the endometriosis patches.

After surgery, hormone treatment is often restarted unless you are trying to get pregnant. Other treatments you can try, alone or with any of the treatments listed above, include:.

Learn more about endometriosis treatments. For some women, the painful symptoms of endometriosis improve after menopause. As the body stops making the hormone estrogen, the growths shrink slowly. However, some women who take menopausal hormone therapy may still have symptoms of endometriosis. If you are having symptoms of endometriosis after menopause, talk to your doctor about treatment options. Many women with endometriosis get pregnant. But, you may find it harder to get pregnant. Researchers think endometriosis may affect as many as one in every two women with infertility.

No one knows exactly how endometriosis might cause infertility. Some possible reasons include: 7. If you have endometriosis and are having trouble getting pregnant, talk to your doctor. He or she can recommend treatments, such as surgery to remove the endometrial growths.

Research shows a link between endometriosis and other health problems in women and their families. Some of these include:. For more information about endometriosis, call the OWH Helpline at or contact the following organizations:.

Department of Health and Human Services. ET closed on federal holidays. Breadcrumb Home A-Z health topics Endometriosis. Endometriosis Endometriosis happens when tissue similar to the lining of the uterus womb grows outside of the uterus. What is endometriosis? Most often, endometriosis is found on the: Ovaries Fallopian tubes Tissues that hold the uterus in place Outer surface of the uterus Other sites for growths can include the vagina, cervix, vulva, bowel, bladder, or rectum.

What are the symptoms of endometriosis? Symptoms of endometriosis can include: Pain. This is the most common symptom. Women with endometriosis may have many different kinds of pain. These include: Very painful menstrual cramps. The pain may get worse over time. Chronic long-term pain in the lower back and pelvis Pain during or after sex. This is usually described as a "deep" pain and is different from pain felt at the entrance to the vagina when penetration begins.

Intestinal pain Painful bowel movements or pain when urinating during menstrual periods. In rare cases, you may also find blood in your stool or urine. Bleeding or spotting between menstrual periods. This can be caused by something other than endometriosis. If it happens often, you should see your doctor. Infertility , or not being able to get pregnant.