Endometriosis—Understanding Signs, Symptoms and Treatment Options

Posted by Medical Board on January 18, 2017 in Hormones Women
Endometriosis—Understanding Signs, Symptoms and Treatment Options

Endometriosis affects 5 million women in the United States alone, or (2-10% of women, childbearing age).[3][6] Many of these women, in their 30’s and 40’s[8]suffer debilitating pain and discomfort as a result. Some will have difficulty becoming pregnant. Imagine living with a reoccurring medical condition that negatively impacts your quality of life every month? Fortunately, there is hope.

What is Endometriosis?

Endometriosis occurs when tissue, created to line the uterine wall each month grows beyond the uterus. This tissue can be found on ovaries, fallopian tubes, the outer uterus and surrounding tissue, and in the vagina, cervix, vulva, bladder, rectum or bowel area as well.

How do I know if I have endometriosis?

There are many symptoms that could indicate endometriosis including:

  • Painful menstrual cramping
  • Lower back pain
  • Deep pain during or after sexual intercourse
  • Painful urination or bowel movements
  • Spotting between periods
  • Intestinal pain
  • Infertility
  • Digestive problems including diarrhea, nausea, bloating, constipation

Why does endometriosis cause pain?

Tissue growth associated with menstruation swells and bleeds in areas where it cannot be easily expelled from the body.

This can lead to a myriad of medical problems including:

  • Blocked fallopian tubes
  • Ovarian cysts
  • Inflammation and swelling of tissue
  • Adhesions and scar tissue that binds organs
  • Intestinal and bladder problems

Endometriosis can cause adhesions and scar tissue to develop that can distort internal organs and fuse anatomy together. This is known as “frozen pelvis” and can be very serious.[6]

Infertility may also be a result of endometriosis. Fallopian tubes can become blocked or damaged through scarring, and ovaries can develop cysts and adhere to the uterine wall. It is estimated that 50% of infertile women suffer from endometriosis.[2]

Endometriosis Implants

Endometriosis begins with tiny, pimple-like “implants” that vary in shape, size, and color. These may continue to grow, or can disappear all on their own. Once implants continue to progress, they may appear as lesions, nodules or cysts, referred to as “endometriomas”. These range from small pea size cysts to the size of grapefruits. They also vary in color from clear, to red, or dark brown, filled with old blood.[1]

What causes endometriosis?

It is not clear what specifically causes endometriosis, however there are theories suggesting that endometrial tissue backs up through fallopian tubes into the abdomen and cannot be expelled. The uterine walls are covered with mucous membranes that thicken during the menstrual cycle to nourish and support a fertilized egg. If fertilization does not take place, the uterine lining is normally shed through the vagina. The female hormones, estrogen and progesterone control this cycle of build up and shedding of tissue. These may contribute to the condition.

*There is currently no known cure for endometriosis and symptoms may take years to surface, or never surface at all. Some women cope with minor manifestations very well, while others live with debilitating pain and infertility.[4]

Current studies suggest that certain risk factors make some women more vulnerable to endometriosis. These include:

  • Having a mother, sister, or daughter afflicted with the disease
  • First time childbirth after age 30
  • Caucasian women
  • Women who have an abnormal uterus

How is endometriosis diagnosed?

While a pelvic examination is conducted, as well as a thorough background history, a laparoscopy is done to completely diagnose endometriosis. Other tests may include a biopsy, ultrasound, CT scan, or MRI. Treatment will depend on an individual’s age, general health, symptoms, and future plans for pregnancy.[5]

Treatment Options for Endometriosis

Many treatment options for endometriosis exist including:

  • NSAIDS, (nonsteroidal anti-inflammatory drugs)
  • Opioids could also shed light on how endometriosis causes pain.
  • Hormone Treatments
  • Oral contraceptives
  • Surgical Treatments including,
  • Laparoscopic surgery and laser treatment/incising
  • Laparotomy
  • Hysterectomy
  • Surgery severing pelvic nerves
  • Laparoscopic Uterine Nerve Ablation
  • Presacral neurectomy[7]

Natural Support for Endometriosis

Nutritional deficits that contribute to, or complicate endometriosis can be addressed through dietary supplements such as:

Omega-3 fatty acids, fish oil—Reduces inflammation and improves immune system

Vitamin C— Provides antioxidant protection and immune support

Alpha-lipoic acid—Antioxidant support

L-carnitine—Supports pregnancy by promoting embryo health

Calcium d-glucarate—Helps rid the body of toxins

Diindolylmethane (DIM)— Helps metabolize estrogen

Coenzyme Q10 (CoQ10)—Provides antioxidant/immune support[1]

Endometriosis, while common, can rob a woman of a healthy, pain-free life, and may even affect the ability to become pregnant. While there is no cure for this condition, treatment is available to slow endometrial growth, to manage pain, and to facilitate fertility. Early detection and complete excision may also help arrest further endometrial progression.


1A, 2013 (1997) Endometriosis. Available at: http://umm.edu/health/medical/altmed/condition/endometriosis (Accessed: 13 January 2017).

2Coleman, L. and Overton, C. (2015) ‘GPs have key role in early diagnosis of endometriosis’, The Practitioner., 259(1780), pp. 13–7.

3Diego, U.S., the, R. of, California and reserved, A. rights (no date) Endometriosis treatment. Available at: https://health.ucsd.edu/specialties/obgyn/endometriosis/Pages/default.aspx (Accessed: 13 January 2017).

4pmhdev (no date) ‘Endometriosis – national library of medicine – PubMed health’, .

5University of Utah health care (no date) Available at: http://healthcare.utah.edu/womenshealth/utah-center-for-reproductive-medicine/endometriosis.php (Accessed: 13 January 2017).

6Washington (2017) Fertility & reproductive medicine center. Available at: https://fertility.wustl.edu/getting-started-infertility/infertility-factors/endometriosis/ (Accessed: 13 January 2017).

7What are the treatments for endometriosis? (2013) Available at: https://www.nichd.nih.gov/health/topics/endometri/conditioninfo/Pages/treatment.aspx (Accessed: 13 January 2017).

8What is endometriosis? (2017) Available at: https://www.womenshealth.gov/a-z-topics/endometriosis (Accessed: 13 January 2017).

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