Endometriosis: Symptoms and Causes

Endometriosis is a disease in which the endometrium — the tissue that makes up the lining of the uterus — grows outside of the uterus itself. It affects 1 in 10 women in the United states, but many don’t understand the symptoms, making it difficult to diagnose. So, how does endometriosis begin, and what signs should your watch out for?

Early Warnings

The main symptom of endometriosis is pelvic pain, typically during menstruation. Unfortunately, girls are taught that such pain is normal, so many women write off their initial symptoms. If the pain continues or occurs at other times, such as during intercourse, they may grow more concerned and seek help from a doctor. Other symptoms include heavy bleeding during or between periods, as well as fatigue, diarrhea, or nausea, especially during menstruation.


Endometriosis, Long Term Effects

Left untreated, endometriosis can cause infertility by disrupting the structure of the reproductive system, literally pushing it out of shape and affecting both ovulation and a woman’s ability to conceive. Many women find out they have endometriosis while being treated for infertility. In fact, women with infertility are 6 to 8 times more likely to have endometriosis than women with normal fertility.


Endometriosis, Diagnosis

Endometriosis can be diagnosed through a manual pelvic exam or by an abdominal or transvaginal ultrasound. These tests may not definitively point to endometriosis, however, especially if growths are small. Other medical treatments may be tried, but if symptoms persist, a doctor may recommend minimally invasive laparoscopic surgery. This procedure uses a tiny camera to look for endometrial growths and may involve taking a small tissue sample for biopsy.

Potential Causes for Endometriosis

The exact cause of endometriosis or whether there even is a single root is unknown, but there are many theories as to possible causes:


  • Your immune system normally clears away endometrial cells outside of the uterus. Immune system disorders may disrupt how your body detects these cells and let them multiply.
  • It is possible for menstrual discharge to flow up the fallopian tubes and into the pelvic cavity in a process called retrograde menstruation. The endometrial cells in the discharge could then multiply.
  • Endometrial cells could adhere to an incision scar after abdominal surgery.
  • Hormonal or immune system disorders could actually change other cells outside the uterus into endometrial cells.


There is also strong evidence that endometriosis has a hereditary component. A woman is five times more likely to develop the condition if a sister also has it, and 50% more likely if even a cousin has it. Genetic testing may be able to diagnose endometriosis much earlier than the standard tests used today.


In our next installment, we’ll look at the stages of endometriosis, treatment options, and the potential impact on natural fertility. If you want more tips for conceiving or information about improving fertility, follow us on Facebook and Twitter, or sign up for our newsletter below.