Endometriosis: Causes, Symptoms, Stages & Treatments

Treatment, causes and stages of endometriosis

Endometriosis is a condition that affects a woman’s reproductive organs. It occurs where the tissue that normally lines the inside of your uterus grows outside of your uterus. Endometriosis is usually found in the lower abdomen, or pelvis, but can appear anywhere in the body. When you have this condition, tissue tends to grow on your ovaries, fallopian tubes, and your abdominal organs.

Women with endometriosis often have lower abdominal pain, period pain, or pain with sexual intercourse. They may also report having a hard time getting pregnant. Besides, some women with endometriosis may not have any symptoms at all. There’s no cure, but treatment can help with the symptoms.


What causes endometriosis?

Although the exact cause of endometriosis is not certain, there are some possible explanations. One theory suggests that during menstruation, some of the tissue backs up through the fallopian tubes into the abdomen, a sort of “reverse menstruation,” where it attaches and grows. Another theory suggests that endometrial tissue may travel and implant via blood or lymphatic channels, similar to the way cancer cells spread. A third theory suggests that cells in any location may transform into endometrial cells. Last but not the least, it can also occur as a result of direct transplantation in the abdominal wall. For example after a cesarean section. Additionally, it appears that certain families may have predisposing genetic factors to the disease.

What are the symptoms?

Pain right before and during your periods is the most common symptom. Cramps aren’t fun for anyone, but with this disease, they can be even more intense. A lot of people also have ongoing lower belly or lower back pain. The pain can range from barely noticeable to preventing you from getting out of bed in the morning. However, some women may have no symptoms at all.

Other symptoms may include:

  • heavy or painful periods
  • bloating
  • pain in the intestines or lower abdomen
  • spotting or bleeding between menstrual periods
  • fatigue
  • diarrhea
  • constipation
  • nausea especially during menstruation
  • painful intercourse
  • infertility
  • pain in other places such as the lower back
  • pain before or with urination

However, it is sometimes mistaken for other conditions that can cause pelvic pain. These includes diseases such as pelvic inflammatory disease (PID), IBS or ovarian cysts. Talk to your doctor if you’re experiencing any of these symptoms.

How does endometriosis affect fertility?

In a normal menstrual cycle, hormones from the ovary make the endometrial tissue grow. After a few weeks, if a woman does not get pregnant, these hormone levels decrease causing the tissue to shed and the woman has a period. This condition which has grown outside the uterus, also responds to the same hormones – the tissue grows and then bleeds. This can be very painful and is why women with endometriosis usually have pain around the same time as their period.

Over time, this can lead to scar tissue that can block your fallopian tubes. This makes it harder for pregnancy to happen causing infertility.


For many women, simply having a diagnosis brings relief. Because it can be very difficult to diagnose. The only sure way to diagnose endometriosis is by a surgical procedure called a laparoscopy. This is an operation, under an anaesthetic, in which a thin telescopic tube with a light (a laparoscope) is inserted into the abdomen through a cut in the belly button. This allows the gynecologist to see if there is any endometrial tissue within the pelvis. Some or all of the visible tissue is removed so it can be examined under a microscope to confirm a diagnosis.

Other examinations include:

  • Ultrasound : A diagnostic imaging technique that uses high-frequency sound waves to create an image of the internal organs.
  • CT scan : A noninvasive diagnostic imaging procedure that uses a combination of X-rays and computer technology to produce horizontal, or axial, images — often called slices — of the body to detect any abnormalities that may not show up on an ordinary X-ray.
  • MRI scan : A noninvasive procedure that produces a two-dimensional view of an internal organ or structure.

Stages or grades of endometriosis

The American Fertility Society has created a grading system for endometriosis. This system allows surgeons to record the location, extent and depth of endometriosis implants, the severity and presence of adhesions, and also ovarian endometriomas seen during surgery. It may be classified as mild or minimal, moderate or severe and can also be listed as a grade or stage I through to IV.

Grade Symptoms


Appears as small patches or surface lesions scattered around the pelvic cavity.


Appears as larger widespread disease starting to infiltrate tissue and often found on the ovaries, uterosacral ligaments and pouch of Douglas.


Affects most of the pelvic organs, often with distortion of the anatomy and adhesions.

Is there any treatment?

There is no cure but it can be treatment can be with medicine or surgery. If your symptoms aren’t too bad, pain relievers may be enough to help. If you don’t want to get pregnant right now, your doctor or nurse can prescribe hormonal birth control like (like the pill or a hormonal IUD) to cut down on pain and bleeding. There are other medications you can take for endometriosis if you’re trying to get pregnant.

Surgery may be an option for you if your symptoms are really bad or if you want to get pregnant but haven’t been able to. A surgeon will remove the growths that are outside of your uterus, cutting down on pain and making it easier for you to get pregnant. But often the growths come back after surgery, so you may need to take medication, too. As a last resort, some people have a hysterectomy — removing the uterus and sometimes the ovaries, though it’s impossible to become pregnant after that.

Healthy eating and keeping active are key ways to manage endometriosis. Some women with endometriosis often have a sensitised bowel and find avoiding certain foods helpful. Others find complementary therapies helpful, especially in managing pain.

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