Endometriosis is a chronic condition that affects about 10% of women of reproductive age. It is a condition in which the tissue that usually lines the uterus (womb) grows outside of the uterus, primarily in the pelvic and abdominal cavities. Symptoms may include painful periods, pelvic or abdominal pain, and pain during sex. In more severe cases, infertility may occur. There is no known cure for endometriosis, but treatment may include medications, such as hormone therapy, or surgery.


The most common symptom of endometriosis is pelvic pain, especially during or just before menstrual periods. Additional symptoms can include:

  • painful periods (dysmenorrhea)
  • pain during intercourse
  • excessive bleeding during menses
  • infertility
  • fatigue
  • bloating
  • diarrhea and/or constipation
  • nausea
  • lower back pain


The exact cause of endometriosis is unknown. Possible causes include genetics, immune system dysfunction, environmental factors, and a disruption in the normal process of retrograde menstruation. Retrograde menstruation is when menstrual blood and endometrial tissue flow back into the pelvic cavity and attaches itself to organs and structures in the area instead of being expelled from the body. Additionally, hormonal imbalances such as higher levels of estrogen can contribute to the development of endometriosis. Factors like obesity and certain dietary habits may also trigger the condition.

Risk factors

Endometriosis is a condition where tissue similar to the lining of the uterus is found in other parts of the body. Risk factors for developing endometriosis include:

  1. Age: Women of reproductive age are most likely to be affected, typically in their 30s and 40s.
  2. Family history: Women are more likely to have endometriosis if their mother or sister have it.
  3. Hormonal factors: Elevated levels of certain hormones, such as estrogen, can put a woman at higher risk for endometriosis.
  4. Short menstrual cycles: Women with menstrual cycles that are shorter than 27 days may be more likely to develop endometriosis.
  5. Low body mass index (BMI): Women who are underweight or have a low BMI may also be more likely to develop endometriosis.
  6. Never giving birth: Women who have never given birth may be more likely to develop endometriosis.
  7. High stress levels: Stressful life events or prolonged high levels of stress can increase a woman’s risk of developing endometriosis.
  8. Alcohol consumption: Women who consume alcohol may have higher levels of estrogen, which can increase the risk of endometriosis.
  9. Smoking: Women who smoke may be more likely to develop endometriosis than nonsmokers.


Endometriosis is typically diagnosed through a combination of physical examination, medical imaging tests, and laparoscopic surgery. During a physical examination, your doctor will carefully evaluate any pelvic pain and other possible symptoms you may be experiencing. Medical imaging tests, such as ultrasound and MRI, can be used to detect the presence and location of endometriosis. In most cases, a laparoscopy is used to confirm the diagnosis and can provide the most accurate picture of the extent of the disease. During this procedure, a small camera is inserted into the abdomen to look for endometrial tissue outside of the uterus.


Endometriosis can be classified into four subtypes based on their location and severity. These are superficial endometriosis, ovarian endometriomas, deep infiltrating endometriosis and adenomyosis.

  1. Superficial endometriosis: This occurs when the endometrial cells attach to the surface of the organs, such as the ovaries, fallopian tubes, bladder and rectum. This form of endometriosis is often characterized by discomfort, pain and cramping.
  2. Ovarian Endometriomas: This occurs when endometrial tissue grows within the ovary. This can lead to ovarian cysts, which can cause additional pain and discomfort.
  3. Deep infiltrating endometriosis: This form of endometriosis occurs when the tissue goes beyond the surface of the organs and into deeper tissues. This type is often more difficult to diagnose and can cause more severe symptoms.
  4. Adenomyosis: This occurs when the endometrial tissue invades the muscle wall of the uterus. This can cause abnormal bleeding and severe pain during menstruation.


The main treatments for endometriosis are medications, surgery, and alternative therapies.


Hormonal medications, such as birth control pills, progestins, and gonadotropin-releasing hormone (GnRH) agonists, may be used to reduce symptoms and slow the growth of endometrial tissue.


Depending on the severity, endometriosis can be treated with laparoscopic or open surgery. The surgery is used to remove endometrial tissue, scar tissue, and ovarian cysts.

Alternative Therapies

There are a variety of alternative therapies that can be used to treat endometriosis. These include acupuncture, herbal remedies, dietary changes, stress reduction techniques such as yoga and meditation, and different types of physical therapy.


Endometriosis is a complex condition with no known cause, so reducing risk is difficult. However, there are some steps that can be taken to reduce the risk of developing endometriosis or to manage its symptoms.

  1. Exercise regularly: Studies have shown that regular aerobic exercise helps reduce the levels of pain and discomfort associated with endometriosis.
  2. Follow a healthy diet: Eating a nutritious diet may also help reduce endometriosis symptoms. It is important to focus on reducing inflammation causing foods such as processed and sugary foods, and replacing them with more nutritious options such as fresh vegetables, fruits, and whole grains.
  3. Avoid exposure to environmental toxins: Exposure to environmental toxins and pollutants have been linked to an increased risk of endometriosis. Try to minimize contact with these toxins, including smoke, pesticides, and car exhaust.
  4. Avoid heavy alcohol and caffeine consumption: Heavy caffeine and alcohol consumption may worsen symptoms associated with endometriosis.
  5. Limit exposure to certain additives: Studies show that certain food additives such as artificial colors and flavors may also increase the risk of endometriosis.
  6. Seek medical attention: Talk to your doctor if you are experiencing any of the symptoms associated with endometriosis, as early treatment can help reduce the risk of developing more serious health complications.

Gender differences?

Yes, there are gender-specific differences in the presentation and management of Endometriosis. Endometriosis is much more common in women than in men, and the primary symptom is pelvic pain. Women may also experience abdominal discomfort, heavy menstrual flow, and infertility. Men, on the other hand, may present with pain in the testicles and a feeling of fullness in the lower abdomen.

In terms of management, the majority of Endometriosis treatments are catered to women, as the majority of cases are seen in women. Hormonal medications, such as birth control pills, are commonly prescribed to reduce Endometriosis symptoms. Surgery is also an option to remove the Endometriosis tissue. For men, however, treatment may focus on reducing pain and relieving symptoms with medication, such as anti-inflammatories and opioids. In some cases, surgery may be necessary to remove the Endometriosis tissue.


Nutrition plays a vital role in the management of endometriosis. According to doctors, eating a healthy and balanced diet rich in antioxidant-rich, anti-inflammatory and hormone-balancing foods can help to reduce the symptoms of endometriosis. Eating a balanced diet with plenty of fruits, vegetables, whole grains and healthy proteins can help to reduce inflammation which can in turn reduce pain and discomfort associated with endometriosis. Omega-3 fatty acids have also been linked to helping reduce pain and inflammation, so adding foods such as salmon, tuna and flaxseed to the diet can be beneficial. Limiting sugar and refined carbohydrates can also help in reducing inflammation and pain associated with endometriosis. A diet with plenty of vitamins, minerals and antioxidants can also help improve liver function, which is important in the breakdown of estrogen and other hormones, so that they can be flushed out of the body. In addition, avoiding processed foods and alcohol can also help to manage and reduce the symptoms of endometriosis.

Physical Activity

Physical activity can be beneficial for people with endometriosis as it can help to reduce the amount of abdominal pain, cramping, and fatigue, while improving overall quality of life. Regular physical activity can help to improve cardiovascular health, reduce excess body weight, and regulate hormones. Exercise can also help to reduce stress and anxiety, which are often associated with endometriosis. Additionally, physical activity can help to increase circulation, which can help to reduce inflammation, a common symptom of endometriosis. However, it is important to understand the limitations people with endometriosis may have due to their condition, and to practice moderation when engaging in physical activity. Light, gentle exercises, such as walking or swimming, can help people to stay active and increase their strength and endurance in a safe way.

Further Reading

  1. https://www.ncbi.nlm.nih.gov/books/NBK536040/
  2. https://www.ncbi.nlm.nih.gov/books/NBK567777/
  3. https://www.who.int/news-room/fact-sheets/detail/endometriosis
  4. https://www.hopkinsmedicine.org/health/conditions-and-diseases/endometriosis
  5. https://www.womenshealth.gov/a-z-topics/endometriosis

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