Endometriosis: Everything You Need to Know

Neeru Singh, MD
March 8, 2021
6 min

According to the Office of Women's Health, endometriosis affects 11% of women between 15 and 44 or roughly 6.5 million women in the United States. However, research suggests the number of those affected may be even higher than that since endometriosis is often misdiagnosed or underdiagnosed.

What Is Endometriosis?

Endometriosis is a disease in which tissue similar to the tissue that lines the inside of your uterus, called the endometrium, grows outside of the uterus. It usually affects your pelvic regions, which include your ovaries, fallopian tubes, and uterus. 


This tissue behaves outside your uterus the same way it would when it's lining your uterus—by growing and swelling and shedding with your menstrual cycle. However, since this lining can't leave your body through your vaginal canal like your menstrual cycle does, it builds up inside your body. Endometriosis growth can cause inflammation, scarring, cysts, and adhesions.

Symptoms of Endometriosis

The most common symptom of endometriosis is pelvic pain. Some women experience severe menstrual cramps while others experience pain during sexual intercourse, while going to the bathroom, or when they are ovulating. 

Other symptoms include:

  • Heavy periods
  • Bleeding in between periods
  • Infertility
  • Fatigue
  • Gastrointestinal issues such as constipation, diarrhea, and nausea, usually with your period


Symptoms can be persistent or cyclical, coming with your menstrual cycle and dissipating after it. In some cases, symptoms get worse over time.

Why Diagnosis Can Be Difficult 

One study found it can take up to seven years from when a woman first experiences symptoms to the time she gets diagnosed with endometriosis. The Endometriosis Foundation of America reports indigenous people of color have an even more challenging experience receiving an endometriosis diagnosis.


There are a few theories as to why some women endure years of pain and discomfort before receiving an accurate diagnosis. For one, many of the symptoms of endometriosis are similar to other conditions such as pelvic inflammatory disease and irritable bowel syndrome, leading to a delayed accurate diagnosis.


Then there's the tendency to write off menstrual pain and problems as part of the normal menstrual cycle. Severe pain is NEVER normal.


An experienced physician may be able to diagnose endometriosis based on a pelvic exam and a detailed description and history of symptoms, but the only reliable way to diagnose endometriosis is by laparoscopy, which is an invasive and expensive procedure.


During a laparoscopy, a physician makes a small incision near your abdomen and inserts a small camera so they can see your pelvic region and look for signs of endometriosis. Your physician may also take a biopsy (scraped cells) for further testing.

Endometriosis and Infertility

Some women don't find out they have endometriosis until they have a problem conceiving a child. Endometriosis is one of the most common causes of female infertility. From 30% to 50% of women with endometriosis experience fertility problems, and, conversely, 30% to 50% of women who experience infertility have endometriosis.


Endometriosis can impact fertility in a few ways, including interfering with the proper function of the fallopian tubes, releasing the egg, and joining the egg and sperm. Fortunately, there are many treatment options to help women with endometriosis go on to have a healthy pregnancy, delivery, and baby.

How Endometriosis Is Treated

Treatment options will depend on symptoms and whether or not you're trying to get pregnant. Pain medication and anti-inflammatories are often the first lines of treatment. If you're not trying to get pregnant, your doctor may recommend hormonal birth control to help reduce the pain and bleeding and reduce the number of periods you get yearly.


Surgery to remove the adhesions and lesions is also an option for people in severe pain and those who want to get pregnant. Other treatment options that may help include healthy lifestyle modifications, stress management, and acupuncture. 


Another option for those with endometriosis who want to get pregnant is a gonadotropin-releasing hormone (GnRH) agonist. This helps reduce the growth of endometriosis while taking it so that you can increase your chances of getting pregnant when you stop taking the medication. You may have to try a combination of treatments to find what's most effective for your lifestyle, family plans, and symptoms.

Women’s Health and Wellness at Carbon Health

No matter where you are on your life journey, Carbon Health’s healthcare providers are here to help support you through all your women’s healthcare needs. Book an appointment today to talk to a provider about what you’re going through and they will be there to help, support, and guide you through your health journey.

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Carbon Health’s medical content is reviewed and approved by healthcare professionals before it is published, but it is not intended to be a substitute for professional medical advice, diagnosis, or treatment. Talk to your healthcare provider about questions you may have regarding your health or a medical condition, and before making changes to your healthcare routine.

Neeru Singh, MD

Neeru Singh, MD, is a Medical Director at Carbon Health. As a primary care physician, she enjoys educating and guiding patients on important health decisions.


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