Endometriosis is a disorder that affects many women in painful and frustrating ways. It occurs when the tissue that lines the uterus, called the endometrium, grows outside of the uterus. This is often a very painful condition.

The endometrium usually is found growing in the ovaries or fallopian tubes, the ligaments around the uterus, the lining of the pelvic cavity or the area between the uterus and the bladder and the rectum. In rare cases can be found in other areas of the pelvis such as the bladder, vagina, cervix, rectum, or intestines. When this tissue is found outside of the uterus, endometriosis occurs. It can cause heavy bleeding during periods, bleeding between periods, fatigue, pain with urination or bowel movements during your period, as well as diarrhea or constipation during menstruation.

The tissue finds itself outside the uterus in a few different ways. Menstrual blood can sometimes flow back into the fallopian tubes, causing endometrium to be deposited in the fallopian tubes or the ovaries. It can also be caused by hormonal changes in the cells of the reproductive organs outside the uterus. Surgeries such as a hysterectomy or cesarean section can place endometrium outside of the uterus along the incision site. Some immune system disorders can also cause endometriosis.

When the endometrium grows outside the uterus, it goes through the same cycle as the lining of the uterus. It thickens, then breaks away during the menstrual cycle. Because this happens outside the uterus in endometriosis patients, the endometrium has nowhere to go to be expelled from the body. When this happens in the ovaries, cysts can form from the endometrial tissue. The tissue surrounding these cysts becomes irritated and can form scar tissue or even adhesions between the reproductive organs and other surrounding tissue. This causes the pain associated with endometriosis.

Risk factors include early onset of your period. Studies have shown women who start their period at an early age have a higher risk for endometriosis. Conversely, late onset of menopause can also be a risk factor in older women. Other risks include heavy periods, short or unpredictable menstrual cycles, high estrogen levels, other reproductive disorders and a family history of endometriosis. Pregnancy and breastfeeding can lower your risk of endometriosis, as does later onset of your period, usually after the age of 14. Studies indicate that eating a lot of fruit, especially citrus fruit, can lower your risk of endometriosis.

Because of the cysts and scar tissue formed by endometriosis, this condition can cause infertility. It also can cause heavy and painful periods, pain with elimination, and painful sex. If you have these symptoms, do not hesitate to talk to your health care provider about your concerns and the possibility you are suffering from endometriosis.

Endometriosis is a serious and painful condition, but intervention by you and your doctor can help alleviate the pain. Being aware of pain and changes in your body and menstrual cycle can help you and your doctor catch endometriosis early and make treatment more effective. This can save your reproductive and sexual health.

Mayo Clinic

Johns Hopkins

Office on Women's Health