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In endometriosis, endometrial-like tissue (tissue that prepares your body for a fertilized egg) is found outside the uterus. It may be found on organs in the abdomen or pelvis. As it responds to hormones, the tissue swells, breaks down and bleeds, but it's unable to leave the body when you menstruate. This results in inflammation of the surrounding tissue, which can cause scarring.

Endometriosis Causes

Possible causes include:

  • Menstrual tissue backs up through the fallopian tubes and spills into the abdomen
  • Immune system allows the tissue to implant on other organ surfaces and develop into endometriosis
  • Lymph system carries endometrial cells from the uterus
  • Certain cells left on abdominal organs during embryonic development turn into endometrial tissue

Hormones and growth factors cause the disease to progress.

Endometriosis Risk Factors

endometriosis lesions outside the uterus

Factors that may increase your risk of endometriosis include:

  • Family history — a mother or sister with endometriosis
  • Early onset of menstruation
  • Not being pregnant — pregnancy slows or stops the disease from progressing. The condition usually resolves at menopause. The symptoms may return with hormone replacement therapy.
  • Prolonged menstrual bleeding — more than 7-8 days
  • Abnormal development of the uterus, with a blocked segment

Endometriosis Symptoms

Symptoms range from mild to severe. You may have many large growths with little pain or small areas with intense pain.

Symptoms include:

  • Cramping and pelvic pain, especially just before and during menstrual bleeding
  • Pain during sex
  • Heavy periods
  • Low back pain
  • Pain during bowel movements or urination
  • Infertility
  • Miscarriage

Diagnosing & Treating Endometriosis

Your doctor performs a pelvic exam. Diagnosis is usually confirmed with a laparoscopy. This test allows your doctor to see if there are patches of endometrial tissue and scar tissue.

Treatment aims to:

  • Control pain
  • Slow endometrial growth
  • Restore or preserve fertility

Treatment options depend on:

  • Severity of symptoms
  • Size, number and location of growths
  • Degree of scarring
  • Extent of the disease
  • Age and whether you want to have a baby

Pain Medication

Your doctor may recommend:

  • Over-the-counter pain relievers to ease mild symptoms
  • Nonsteroidal anti-inflammatory drugs to reduce inflammation and help with cramping
  • Prescription pain relievers

Hormonal Therapy

Hormones are an option for women who are not trying to become pregnant. Birth control pills and other injectable drugs interfere with estrogen production. These medications may decrease pain and shrink the size and number of endometrial growths.

Symptoms and endometrial growths tend to come back when you stop taking the hormones. If your doctor prescribes birth control to manage endometriosis, he or she may recommend you use them continuously, so that you do not menstruate. After surgery, birth control pills may reduce the chance of these growths returning.


Your doctor may try to remove endometrial growths if you have severe symptoms or you want to get pregnant. This is often done with laparoscopic surgery. In severe, unmanageable cases, your doctor may remove your uterus and ovaries. 


Content was created using EBSCO’s Health Library. Edits to original content made by Rector and Visitors of the University of Virginia. This information is not a substitute for professional medical advice.