Comprehensive Facts on Endometriosis – Causes, Symptoms, Effects, and Treatment


​Endometriosis is a gynecological health condition affecting women between 15 and 49 years. It affects women in their productive age. The approximate number of women with endometriosis is 176 million globally.

Endometriosis can affect you physically and emotionally. It can also alter your lifestyle with constant pain taking a heavy toll on your well being. Knowing everything on endometriosis would be your initial step of getting better.

What is Endometriosis?

Endometriosis is a gynecological condition where the uterus lining abnormally starts to grow outside the uterus. The endometrial cells transfer to other parts of the body through various means such as menstrual retrograding.

The uterus lining called endometrium, can then grow abnormally around the pelvis, fallopian tubes, ovaries, lymph nodes, peritoneum, bladder, or in the bowel.

The endometrium growth causes endometrial implants (tissue implants) to the affected parts, which is called endometriosis.

Can Endometriosis Cause Infertility?

Endometriosis does not cause infertility, but some symptoms can affect your level of fertility, making it challenging to get pregnant. Endometriosis cysts, scarring and adhesions can block the fallopian tubes and ovaries preventing ovulation and fertilization.

However, there are treatments to correct the endometriosis symptoms. Even in extreme endometriosis stages 3 and 4, there are successful surgeries that can fix some adverse symptoms affecting fertility. One of the procedures is laparoscopy, which also diagnoses the extent of endometriosis.

Endometriosis has four stages, and every endometriosis case would fall on any of them. The extent of endometrial implants, size, location, and other factors determine the stage of endometriosis.

Endometriosis Minimal Stage - Stage 1

Stage 1 of endometriosis would reveal small and few endometrial implants. Also, there can be a few lesions on the ovary. The endometrial implants can also cause some discomfort and pain around the pelvic cavity during the menstrual period.

Endometriosis Mild Stage - Stage 2

In stage 2 or the mild stage of endometriosis, your doctor, through examination, can report more and deeper implants. You will continue to experience pain during your menstrual period.

Endometriosis Moderate Stage - Stage 3

In stage 3 of endometriosis, the lesions advance to other body parts. The endometrial implants increase and grow deeper into your ovaries and the pelvic lining. The endometriosis cysts may start forming due to shedding blood of endometrial tissue. The cysts, therefore, appear bloody and hence the name 'chocolate cysts.'

 At the moderate stage of endometriosis, some scar tissues or adhesions form due to endometriosis inflammation. The scar tissue, while trying to heal, can bind organs together, such as binding the ovary to the pelvic wall. The adhesions can cause nausea and severe, sharp-stabbing, pelvic, and menstrual pain.

Endometriosis Severe Stage - Stage 4

In the severe stage of endometriosis, the adhesions get dense and increase all over the pelvic area. The endometrial implants become deep and also increase. The cysts grow large and extend to the ovaries, fallopian tubes, and the bowels.

Endometriosis Facts

Endometriosis can genetically begin as early as the fetus age. At puberty or early reproductive age, estrogen hormones trigger symptoms of endometriosis.

Approximately 10 percent of women in their productive age are affected by endometriosis globally.

 In other cases, endometriosis can linger in the body unnoticed and without revealing any symptoms. Most women can live with endometriosis for more than ten years before diagnosis.

In the uterus, the endometrial lining is involved in menstrual periods. When the lining grows abnormally outside the uterus, it continues thickening, breaking down, and bleeding during menstrual periods but, without an outlet.

With no exit point for the displaced endometrial tissue, the condition worsens when the tissue gets trapped inside the body. Such happenings can cause adverse effects such as endometriosis cysts growth, which are medically known as endometriomas or 'chocolate cysts'.

Endometriosis cyst growth can irritate surrounding tissue, which can then develop into scar tissue and adhesions. In critical cases, the scar tissue can become fibrous, causing some organs around the scar tissue to stick to it.

As endometriosis stages advance, the tissue continues to grow causing more adverse complications. The fallopian tubes can block due to endometriosis cysts. Cysts can cause severe pelvic and menstrual pain during your menstrual period.

Other effects of endometriosis are excessive exhaustion, painful intercourse, and fertility reduction.

Some other health conditions which directly link with endometriosis are:

  • Fibromyalgia
  • Asthma
  • Autoimmunity
  • Allergies
  • Complications of the Bladder and the Intestines
  • Ovarian cancer
  • Chemical sensitivities

 What Causes Endometriosis?

There are no proven endometriosis causes so far. Despite that, some possible reasons could lead to endometriosis.

Abnormal Menstrual Flow

Abnormal menstrual flow or retrograde menstruation is when endometrial cells in the menstrual blood flow back instead of exiting. The menstrual blood enters the fallopian tube and to the pelvic cavity.

The endometrial cells from the retrograde menstruation attach themselves on the pelvic walls and the pelvic organs. Once the cells find the new settlement, they continue thickening and bleeding as usual in every menstrual cycle. The new endometrial cells cause more health complications such as the growth of cysts.

Cells Transformation

Estrogen and other hormones can transform embryonic cells into endometrial implants at puberty age.

Also, peritoneal cells lined on the walls inside the abdomen can transform into endometrial cells. The proposed explanation for such occurrence is the inadequacy of peritoneal defense or abnormal body immunity.

Endometrial Cells Transport

Lymphatic system or blood vessels can transport and plant endometrial cells to other parts of the body.

Implantation in Surgical Scar

Endometrial cells can accidentally get attached to an incision after surgery such as a C-section or hysterectomy.


There is a likelihood that endometriosis can pass to another person genetically. Girls can inherit endometriosis from their mothers. Although genetics is only a potential, it's lifestyle that creates the problem. If you are concerned then you might consider getting DNA testing.

One study researching the link between endometriosis and genetics, reports that there is a high possibility of such a link. The report concludes that various studies frequently demonstrated that the condition could also be inherited.

Immune System

When the immune system is compromised, the system fails to protect the body against harmful attacks. One of those attacks is the endometrial tissue growing abnormally outside the uterus lining.

Endometriosis Risk Factors

Some factors can put you at risk of developing endometriosis:

  • Early menstruation age
  • Endometriosis in the family history
  • Menstrual cycle less than 27 days
  • Menstrual period of more than 7 days
  • Defects of the uterus or fallopian tubes
  • Heavy menstruation

 Symptoms of Endometriosis

Statistics show that 20 to 25 percent of women with endometriosis are asymptomatic (showing no symptoms). One of the most common signs of endometriosis is severe menstrual pain (dysmenorrhea). The endometriosis menstrual pain is worse than the common menstruation cramping. Other symptoms include:

Chronic Pain

You may experience severe and persistent abdominal, pelvic and lower back pain, especially during the entire menstrual period.

Heavy Menstrual Flow

You can have heavy menstrual bleeding that can go beyond seven days.

Spotting Blood

You can experience spot bleeding which is also known as intermenstrual bleeding. It is bleeding in between your menstrual period.

Fertility Reduction
Experiencing challenges to conceive can be a sign of endometriosis. It can be corrected through surgery if the endometriosis cysts have not damaged the ovaries and fallopian tubes. You might also consider having an evaluation and we can then recommend an herbal therapy/treatment.

Painful Urination and Bowel Movements

You may experience constipation, diarrhea, painful urination and bowel movement pain during your menstrual period.

Bloody Urine and Stool

You can notice some bloody stool or bloody urine during your menstrual period.

Nausea and Vomiting

You can feel nauseous and vomiting a few days before your menstrual period and probably through the entire time of your menstrual cycle.

Pressure in the Bladder or Bowels

Some fibrous tissue of endometriosis can cause pressure in the bladder or bowels.

Painful Intercourse

Endometriosis can cause severe virginal pain especially during intercourse.

Endometriosis Fatigue

You can feel excessively tired, which is a symptom of chronic fatigue syndrome (CFS), a condition linked to endometriosis.

The endometriosis symptoms increase as you age. At the age of 40, a few years towards menopause, most of the symptoms are more noticeable. Diagnosis of the condition then becomes easy.

What are the Effects of Endometriosis?

Endometriosis can affect your health and life in various ways. Some of the most common endometriosis effects include:


Some women in the mild stage of endometriosis can conceive and carry a pregnancy to a full-term. However, some may have difficulties in getting pregnant due to some adverse endometriosis symptoms. The symptoms can be formation of cysts which would block the ovaries or fallopian tubes.

If you have endometriosis and you want to have children, don't panic. Visit We recommend seeing your doctor first to discuss your situation and bring your findings to us for alternative solutions.


One study published in 2018 supports some observations that, some clear cell ovarian cancer and endometrioid ovarian cancer can occur to endometriosis patients. However, the risk is minimal.

According to the study, ovarian cancer in women with endometriosis is as low as 0.3 to 0.8 percent.

Relationship and Social Impact

Endometriosis can impact the relationship with your family members or your spouse. You may find it difficult to disclose your situation to your family. Since only a few of your relatives would know the magnitude of your suffering, they may fail to understand you or empathize with you. Your relationship can then suffer from such misunderstandings.

One of the endometriosis symptoms is painful intercourse. The condition can affect a couple's relationship adversely.

During your menstrual period accompanied by severe pain, it can be challenging to socialize. The pain which can last about seven days can profoundly interfere with your social life.


Endometriosis is associated with severe pain and chronic fatigue. The two conditions can affect you emotionally. You can experience depression, anxiety, and sadness, especially when you are facing the situation solely without moral support.

Endometriosis Diagnosis

Before performing any endometriosis test, your doctor may ask you a few questions concerning your symptoms. The doctor may also ask you to describe the pain and its location.

Your doctor may then proceed with other examinations.

Pelvic Physical Examination

Your physician or doctor may lightly press on the position of the uterus and both ovaries. The examination is to check for any abnormalities such as inside swellings that can signify cysts.

When the cysts have not formed, it may be challenging for your doctor to feel anything. Therefore, the physical examination may not be the right way to diagnose endometriosis at this stage.


Your doctor may use an ultrasound scanner that can reveal pictures of endometriosis showing what is happening inside the abdomen by moving the scanner across the stomach. Other times, direct visualization inside the abdomen can be the best choice of examination. Your doctor may use a wand-like scanner to examine you through the vagina.

The examination on top of the abdomen and the one inside it would both produce images of the condition of endometriosis. The inside review would be more precise in viewing the presence and the location of cysts.


Laparoscopy examination is a procedure that involves a surgeon. The surgeon makes a small incision next to the navel to insert the laparoscope. Laparoscopy is a visual inspection to determine the presence of endometrial tissue in other areas other than inside the uterus.

Laparoscopy, which is a 'minimally invasive surgery,' sends images from the camera to the connected monitor. The surgeon can then view the extent of endometrial implants and the location while removing some sample tissues for more tests (biopsy).

MRI scan

Magnetic resonance imaging (MRI) is an examination using a powerful magnetic field and radio waves to generate and relay images of organs and tissues to a computer. The images reveal the precise location and the extent of endometrial tissue and cysts if any.

The MRI examination provides detailed information and pictures of endometriosis to enable your surgeon to make plans for surgery if required.

What is the Treatment for Endometriosis?

Endometriosis treatments primarily would require medication. In critical cases, doctors can prescribe endometriosis surgery. The type of procedure would depend on the results of the endometriosis diagnosis. Your doctor can discuss the treatment with you.

Your doctor may suggest medication treatment and only recommend endometriosis surgery when every other treatment has failed.

 Treating Pain

Your doctor can prescribe some over-the-counter pain medicines. Some of the medications would be NSAIDs (nonsteroidal anti-inflammatory drugs), ibuprofen, or naproxen sodium.

Hormonal Therapy

Unless you are planning to get pregnant, your doctor may prescribe hormonal therapy to strengthen the pain medicines. Combining pain medication with hormone medicines can relieve you from the severe menstrual period pain and chronic pelvic pain.

Hormone therapy is not a permanent procedure but, a relief of endometriosis symptoms. The treatment only lasts as long as you are on hormone therapy. However, hormone therapy can be useful in preventing new endometrial implant growth. 

Some of the hormone therapies include:

1. Hormonal contraceptives

As long as you are using the hormonal contraceptive regimen, you can:

  • Control hormones that contribute to the growth of endometrial tissue
  • Reduce menstrual period pain or get rid of the pain
  • Reduce the duration of the menstrual period
  • Reduce the menstrual flow

Some of the hormonal methods your doctor might propose are birth control pills, vaginal rings, and patches.

2. Gonadotropin-releasing hormone agonist (Gn-RH-a)

For non-response of NSAIDs in treating your menstrual period pain, your doctor might propose the use of gonadotropin-releasing hormone.

Gn-RH-a lowers estrogen hormones and stops menstruation, as long as you are using it. The main aim of using Gn-RH-a is to shrink endometrial tissue.

Gn-RH-a can weaken the bones and accelerate menopause symptoms hence the need to limit its use to less than six months.

For an extended use of Gn-RH-a to more than six months, your doctor may combine it with add-back therapy to add small amounts of progesterone hormones.

3. Progestin Therapy

Progestin therapy is effective in shrinking endometrial implants. It also reduces chronic pelvic pain, and other symptoms in most women with endometriosis.

Taking progestin can stop menstruation by reducing estrogen. The treatment can stop new endometrial implants growth outside the uterus.

Some of the progestin therapies your doctor might propose using include:

  • A contraceptive implant such as Nexplanon
  • Intrauterine device (IUD) with progestin such as Mirena or Skyla
  • Contraceptive injection such Depo-Provera
  • Progestin pill such as Camila

Your doctor can suggest progestin therapy if birth control pills or Gn-RH-a are not effective in relieving endometriosis symptoms.

Danazol Oral

Danazol is a medication your doctor may prescribe for use in relieving pelvic pain due to endometriosis. The medication stops menstruation and hence, the growth or thickening of endometrial tissue.

However, Danazol has some side effects such as producing acne and abnormal hair growth on your face and other parts of the body.

Conservative Surgery

The removal of endometriosis implants through conservative surgery is another endometriosis treatment. The surgery can also help to relieve severe menstrual pain. Conservative surgery can correct endometriosis infertility.

The surgery's main aim is to remove endometrial implants without injuring any of the reproductive organs.

One of the procedures for conservative surgery is a laparoscopy. It is a minimally invasive surgery that analyzes the extent of endometriosis, diagnosing the condition, and removing endometrial tissue.

Your surgeon would use one incision for the three procedures. The surgeon makes tiny abdominal incisions to diagnose endometriosis. After diagnosis, the surgeon can choose the best way to treat endometriosis. It can either be in removing or vaporize the growth, or even burn the implants.

Laser technology is the most effective way of destroying endometrial tissue.

Hysterectomy and Oophorectomy (Ovariectomy)

After every other treatment has failed to correct the symptoms, a hysterectomy would be your last resort.

Uterus and cervix removal (hysterectomy) and the removal of one or both ovaries (oophorectomy or ovariectomy) are crucial surgeries. You may require consulting widely since the operation is an irreversible procedure if you later wish to get pregnant. Both surgeries were once popular in endometriosis treatment which is now changing.

Hysterectomy and oophorectomy surgeries have after-effect risks such as causing early menopause symptoms (no matter the age). Gynecologists and other health experts are deviating from the operation to focus on removing endometrial tissue using other methods.

The side effects of hysterectomy such as menopause can lead to other health conditions, including metabolic conditions and cardiovascular (heart and blood vessel) disease.

Complementary and Alternative Medicines (CAM)

CAM therapy is effective in managing pain, especially severe menstrual pain and chronic pelvic pain. Some of CAM therapies for endometriosis mainly include herbs and spices, acutherapy, detoxification, aromatherapy massage, and others.

Herbs and Spices

Herbs and spices are natural medicines which have been used for ages in many generations. Some of these medicines are effective in relieving menstrual pain and other endometriosis symptoms.

Some clinical researches have proved that herbal remedies can help treat endometriosis symptoms. Some of these herbs include:

1. Passion Flowers and Chamomile

Passion flowers and chamomile contain a natural compound known as chrysin. Chrysin has essential roles in dealing with endometriosis. One study of 2018 confirmed that chrysin is an anti-inflammatory therapy best to use in endometriosis patients. Chrysin also prevents the continual formation of endometrial tissue by suppressing the rapid increase of endometriosis cells. Chrysin can induce cell death by changing the proportion of the cell cycle.

2. Ginger

Ginger is effective in reducing endometriosis-related menstrual pain by providing an anti-inflammatory effect.

3. Turmeric

Curcumin found in turmeric is anti-inflammatory and antioxidant, which can reduce symptoms of endometriosis. Also, curcumin can suppress endometrial tissue growth by lowering the estrogen level in the body.

4. Peppermint

Peppermint contains anti-inflammatory and antioxidant properties that can help reduce endometriosis chronic pelvic pain and menstrual pain.

Aromatherapy Massage

Some essential oils can be useful in reducing endometriosis menstrual pain. Aromatherapy effective massage mixture comprises of essential oils such as lavender, cinnamon, rose, and clove in an almond-oil base.


Acupuncture therapy is effective in treating chronic pelvic pain and menstrual pain in endometriosis. The treatment mediates the central nervous system to release some necessary neurotransmitters to ease the pain. 


Acutherapy differs from Acupuncture. It simultaneously produces mechanical, thermal and electrical stimuli which work together to create a chain of electro-chemical reactions. This sets off a chain of electro-chemical reactions that stimulates the production of neuro-transmitters. Then, messages are sent to the brain to organize the proper peptides to restore the body to its homeostatic (physical and chemical) state.

One 2014 study confirms that clinical acupuncture therapy is effective in treating endometriosis symptoms with minimal side effects.


Electro-acupuncture therapy is an extension of acupuncture therapy. Electro-acupuncture provides bioelectrical trace current in the acupoints after needling. The advantage of electro-acupuncture therapy is that it has positive long-term effects. It is effective in relieving endometriosis menstrual pain.


Chiropractic is a therapy that aims in correcting body alignment problems whil e supporting body-self natural healing.

Chiropractic care can eliminate endometriosis-related symptoms such as lower back pain, pelvic pain, and menstrual pain. Further, chiropractic can boost the autonomic nervous system function. The nervous system controls the subconscious bodily functions such as the heartbeat, metabolisms, and others to improve the body health.

Chiropractic care can regulate the menstrual cycle and ovulation and hence boosting fertility.


Endometriosis links to some compounds in chemicals that disrupt hormone response. Some sources of such chemicals are grooming products and cosmetics.

Detoxification can remove hormone-disrupting chemicals from your body.


You cannot prevent endometriosis, but you can reduce the possibility of its development. One of the ways of lowering endometriosis development is by controlling estrogen levels. Low estrogen results in thinning endometrial tissue.

The effective way of lowering estrogen level is by:

Birth Control Hormone

The surest way of lowering the level of your estrogen is using hormonal therapy.

Regular Exercise

As you reduce your fat, you will be dropping your estrogen level as well.

Baby Breastfeeding

Breastfeeding your baby links to hormonal changes such as lowering estrogen levels. It plays a significant role in reducing the development of endometriosis. As long as you are breastfeeding your baby, you will be less likely to develop endometriosis symptoms.

Frequently Asked Questions (FAQs) on Endometriosis
Q: What are the signs of endometriosis?

A: The first signs of endometriosis you might notice are:

  • Heavy menstruation flow that extends beyond seven days
  • Extreme menstrual pain worse than the usual cramps
  • Nausea and vomiting
  • Intermittent bleeding between your menstrual cycle
  • Shorter menstrual cycle less than 27 days

Q: How do you get endometriosis?

A: One of the leading causes of endometriosis is menstrual flow retrograding back into your body instead of flowing out. The endometrial tissue then finds its way to other parts of the body outside the uterus such as the fallopian tubes, ovaries, or on other parts of the pelvis.

Another main factor is inheriting the endometriosis genes from a relative. The endometriosis begins to show symptoms at the productive age of a woman.

Q: Can you have a baby if you have endometriosis?

A: Endometriosis links to infertility. However, there is still a chance of getting pregnant, especially when you are in endometriosis stage one or stage two.

Therefore, your answer is yes. You can still get your baby even with endometriosis. Arrange to visit your doctor for examination and to discuss how you can go about it.

You can also opt for natural treatment if you are experiencing temporal infertility. Get in touch or visit us at Island Healthworks for further advice and natural treatment.


Endometriosis is a health condition that affects most women in productive age physically, emotionally, and upsetting their lifestyles. However, you should not allow endometriosis to degrade the quality of your life.

While science experts have not come up with a cure for endometriosis, there are successful methods, both conventional and natural, which can manage your condition. Treat your endometriosis case uniquely and approach the relevant institutions for advice.

At Island Healthworks, we believe in the use of herbal products, minerals, and vitamins through a nutritional approach to support body systems and self-healing. We know that most foods in the market today are modified and hence contain harmful chemicals, the source of many health issues.

Island Healthworks recommend eating organic foods and using Quality Controlled Herbs and Supplements. Call to make an appointment and discuss some alternative options.

You are the custodian of your health and hence your health is your responsibility. Eat and live well for excellent health. 

Yvonne Dollard Perc: Owner of Island Healthworks, Natural Health Practitioner, Teacher, Writer and Editor.
Elizabeth Njuguna: Researcher, Freelance Writer, with a Focus on Natural Health.
Sherry Robb: Print, Web and Social Media Designer Specializing in the Natural Health and Fitness Industries.
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Saturday, 08 May 2021