Endometriosis: Causes, Symptoms, Diagnosis & Treatment Guide

Endometriosis in Women: Causes, Symptoms & Treatments

Endometriosis often sounds scarier than it really is. Many think of severe pain, infertility, or surgery, and while those are possible, the condition is treatable. Life with endometriosis doesn’t always mean constant suffering.

At its core, endometriosis happens when uterine-like tissue grows outside the uterus. Understanding how it works is the first step to managing it.

What is endometriosis?

Endometriosis occurs when tissue similar to the womb lining (endometrium) grows outside the uterus, often on the ovaries, fallopian tubes, bowel, or bladder.

Just like inside the uterus, this tissue thickens, breaks down, and bleeds during each menstrual cycle. However, since the blood has no way to leave the body, it can cause inflammation, intense pain, and sometimes lead to cysts or scar tissue.

Who can get endometriosis?

Endometriosis mainly affects women of reproductive age, typically between their 20s and 40s, though it can also occur in teens and women nearing menopause.

• •Have a close family member (mother, sister, or daughter) with endometriosis
• •Begin menstruating very early (before age 11)
• •Experience short menstrual cycles (fewer than 27 days)
• •Go through heavy or prolonged periods that last more than a week
• •Struggle with infertility

Endometriosis in India is often underdiagnosed. Social stigma, low awareness, and delayed healthcare access leave many women living with pain for years before getting answers. Early detection and treatment, however, can help prevent complications such as infertility or chronic pelvic pain.

Endometriosis symptoms

Endometriosis signs often resemble period or digestive issues, which is why many women go years without endometriosis diagnosis. Spotting them early can help you seek care sooner.

Signs and symptoms of endometriosis

Some symptoms affect daily life beyond periods and can hint at underlying endometriosis causes:

• •Severe menstrual cramps
• •Heavy or prolonged bleeding
• •Digestive issues (bloating, diarrhoea, or constipation)
• •Pain during or after sexual intercourse
• •Ongoing pelvic or lower back pain
• •Spotting between periods
• •Difficulty conceiving
• •Pain while passing urine or during bowel movements
• •Fatigue or low energy

Endometriosis pain and side effects

Endometriosis side effects and pain spread across different areas of the body, making day-to-day life more difficult.

Some of the most common spots where pain shows up include:

• •Pelvic region
  The most frequent site of pain, often severe cramping.
• •Lower back
  Discomfort or pain that comes along with pelvic pain.
• •Abdomen
  Pain in the lower belly.
• •During intercourse (Dyspareunia)
  Pain during or after sex is a common experience.
• •With bowel movements or urination
  Pain can intensify during periods when passing stool or urine.

Over time, repeated inflammation due to endometriosis can cause scar tissue, which may lead to scar endometriosis. It is a rare condition which is also likely to happen to women with a surgical history.

Recognising these signs early and speaking with a doctor is a wise choice.

Causes and risk factors

When it comes to endometriosis causes, doctors don’t have one single explanation. Different theories try to explain why this condition develops. Understanding the possible causes and risks can help you make sense of what’s happening in your body.

What causes endometriosis?

The exact reason is unclear, but researchers believe several factors may play a role.

• •Menstrual flow issues
  Sometimes, period blood flows backwards into the pelvis (retrograde flow), carrying tissue with it.
• •Family history
  Endometriosis can run in family genes.
• •Immune system issues
  Weak immunity allows tissue growth outside the uterus.
• •Hormones
  Estrogen fuels endometrial tissue growth.
• •Past surgeries
  C-sections or hysterectomies may spread tissue in other areas.

Is endometriosis genetic?

Endometriosis complications

• •Infertility or difficulty conceiving
  It can interfere with ovulation, damage ovaries or fallopian tubes, and make fertilisation harder.
• •Scar tissue and adhesions
  Endometrial tissue can cause organs to stick together, leading to bowel or bladder blockages.
• •Fatigue and emotional impact
  Pain and hormonal changes drain energy, contribute to anxiety, depression, and reduce quality of life.
• •Chronic pain and inflammation
  Pelvic, lower back, or abdominal pain that worsens during periods or intercourse.
• •Heavy or irregular bleeding
  Longer, heavier periods or spotting between cycles.
• •Endometriosis cysts (Endometrioma)
  Fluid-filled sacs on the ovaries causing pain, swelling, or fertility issues.

Is endometriosis cancer-prone?

Diagnosis and tests

Identifying endometriosis symptoms is tricky since they overlap with other conditions. Many women wait years before getting a proper endometriosis test. The good news is, doctors now have several ways to detect it.

How to detect endometriosis

Doctors use a mix of tests to get a clearer picture. While none can confirm endometriosis alone, together they help guide the diagnosis.

• •Laparoscopy
  A small camera is inserted into the abdomen to view and sometimes remove endometrial tissue.
• •Pelvic exam
  Checks for cysts, nodules, or abnormal growths.
• •Ultrasound
  Ultrasound can detect cancer and cysts, though small lesions may be missed.
• •MRI
  Doctors use MRI for cancer[a] and endometriosis, as it provides detailed images to assess the spread.
• •Biopsy test (for cancer)
  Tissue samples are taken during surgery to confirm endometriosis or rule out cancer.

How to cure endometriosis?

The cure for endometriosis isn’t one-size-fits-all. Its approach depends on how severe the symptoms are, your age, and whether you’re planning to have children.

5 endometriosis treatment options

Treatment can range from lifestyle adjustments to advanced medical procedures. Here’s a list:

1. 1. Hormone therapyHormonal treatments regulate menstrual hormones to slow endometriosis tissue growth and reduce pain. Options include birth control pills, progestin therapy, GnRH agonists, and aromatase inhibitors.
2. 2. Pain medicines for endometriosisOver-the-counter pain relievers ease menstrual cramps. Doctors may combine these with hormone therapy for better pain control if pregnancy isn’t planned.
3. 3. Conservative surgeryLaparoscopic surgery removes endometriosis tissue while preserving fertility and easing pain. Severe cases may need larger incisions, with hormones after surgery to reduce recurrence.
4. 4. Fertility treatmentFor women struggling to conceive, fertility specialists may recommend ovulation-stimulating medications or in vitro fertilisation (IVF), depending on severity and individual reproductive goals.
5. 5. HysterectomyHysterectomy, sometimes with ovary removal, is a last resort for severe pain or bleeding, but may trigger early menopause and long-term effects.

How to prevent endometriosis?

There’s no guaranteed way to prevent the condition, but you can reduce risks and manage symptoms early.

• •Regular check-ups aid early diagnosis.
• •Hormonal treatments may slow lesion growth.
• •A healthy lifestyle, stress control, and period tracking help with early detection.

Managing endometriosis over time

Living with endometriosis feels like a long road, but it’s not without hope. With the right care, support, and endometriosis management, many women continue to lead healthy, fulfilling lives.

While there’s no permanent endometriosis cure yet, treatments help reduce symptoms and protect fertility.

Long-term management

Managing endometriosis is about consistency and support:

• •Regular gynaecologist visits help keep symptoms in check.
• •Medication and lifestyle changes can manage pain flare-ups.
• •Fertility issues may be addressed with assisted reproductive technologies.
• •Emotional well-being matters: counselling, support groups, and open talks support mental health.

Don’t ignore the signs, seek care early

Endometriosis can impact daily life, fertility, and overall well-being, but understanding its symptoms and treatment options helps you stay in control.