Endometriosis Awareness: What It Is, What Causes It and Its Impact

Endometriosis is a chronic medical condition that affects millions of people, most often women of reproductive age. Despite its prevalence, it remains underdiagnosed and misunderstood, which is why raising awareness is so vital. This blog explores potential causes, how endometriosis can impact daily life and the treatment options available to provide relief. We speak to Mitchell West, M.D., an obstetrician/gynecologist (OBGYN) at INTEGRIS Health Medical Group Women’s Baptist, to learn more. 

“When I meet patients with endometriosis, I try to ensure that they understand their diagnosis—it is important to me that they know we are trying to address their concerns,” West says. “While we cannot truly ‘cure’ endometriosis, my goal is to work with my patients to develop a treatment plan to help manage their pain and associated symptoms so that they can live their life as unburdened as possible by this disease.” 

What is endometriosis?

At a glance: Endometriosis is a condition where tissue similar to the lining of the uterus (endometrium) grows outside the uterus, often causing pain, inflammation and fertility challenges. Endometriosis impacts about 10 percent of women of reproductive age.

The endometrium is the inner lining of the uterus. 

• During each menstrual cycle, this tissue thickens to prepare for potential pregnancy.
• If no pregnancy occurs, the endometrium breaks down and is shed during menstruation. 

For people with endometriosis, endometrial-like tissue outside the uterus also responds to hormonal changes and behaves similarly to the uterine lining during the menstrual cycle. 

• This means it thickens, breaks down and bleeds.
• However, unlike the uterine lining, this tissue has no way to exit the body.
• Endometriosis often develops in the ovaries, fallopian tubes, outer surface of the uterus, pelvic lining and the ligaments supporting the uterus (uterosacral ligaments).

Symptoms from the tissue buildup vary in each person but can become problematic when left untreated.

• Chronic pelvic pain, especially during menstruation
• Painful bowel movements or urination
• Heavy or irregular periods
• Fatigue and bloating
• Pain during intercourse
• Scar tissue formation
• Development of cysts

Younger women (ages 25 to 35) are most commonly affected by endometriosis, but symptoms can start as early as teenage years.

• On average, it can take seven to 10 years for people to receive an accurate diagnosis, largely due to symptom overlap with other conditions and normalization of menstrual pain.

What causes endometriosis?

The exact cause of endometriosis is still not fully understood, which classifies it as idiopathic (arising spontaneously or from an obscure or unknown origin), but there are several possibilities researchers are exploring.

• Retrograde menstruation occurs when menstrual blood travels backward through the fallopian tubes and into the pelvic cavity – instead of flowing out – leading to endometrial-like cells attaching to surfaces outside the uterus.
• A family history of endometriosis can increase the likelihood of developing the condition.
• People with endometriosis may have a less effective immune system, which fails to recognize and destroy endometrial-like tissue outside the uterus.
• Estrogen, a hormone that regulates the menstrual cycle, may promote the growth of endometrial-like tissue.
• After surgeries like a C-section, endometrial cells may become implanted in the incision site and lead to abnormal tissue growth.

What happens when you have endometriosis?

Why it matters: Living with endometriosis can be challenging, as the condition can significantly affect daily life.

Chronic pelvic pain is one of the most common and debilitating symptoms of endometriosis. 

• This pain can occur consistently or episodically, often worsening during menstrual cycles.
• It disrupts daily life by making routine activities such as working, exercising or even relaxing at home difficult.
• This persistent discomfort can lead to exhaustion, affect sleep quality and zap energy levels.

Severe menstrual pain often occurs, far beyond “normal” menstrual cramping. 

• This pain can be sharp, throbbing or radiating, which makes it hard to focus on work, school or personal responsibilities.
• Days can be lost to managing this discomfort, resulting in missed opportunities and reduced productivity.

Painful intercourse, a symptom known as dyspareunia, is a common and distressing issue.

• This can negatively affect romantic relationships, leading to feelings of frustration, guilt or insecurity for both partners.

Fertility problems can occur due to the presence of scar tissue, adhesions or endometriomas.

• This can be a deeply emotional experience, especially for women who have always dreamed of starting or growing a family.
• Although fertility treatments can provide hope, they often come with financial burdens and emotional stress.

Living with chronic pain and uncertainty can take a toll on mental health. 

• Many women with endometriosis experience anxiety, depression or feelings of helplessness.
• The unpredictability of flare-ups creates constant worry, while struggling to manage the condition can lead to low self-esteem.

Social isolation may occur due to the pain and fatigue associated with endometriosis.

• Cancelled plans and missed gatherings may leave you feeling isolated or excluded.
• Over time, this can erode friendships or strain family relationships, making feelings of loneliness even worse.

Can endometriosis cause cancer?

What to know: Endometriosis itself does not directly cause cancer. However, having endometriosis may increase the likelihood of certain cancers, such as ovarian cancer, particularly if the condition is unmanaged for many years. 

Having endometriosis won’t directly lead to cancer, but it can increase the risk of developing it in the future.

• New research in 2024 showed people with endometriosis are four times more likely to develop ovarian cancer.
• Women with ovarian endometriomas or deep infiltrating endometriosis are 10 times more likely to develop ovarian cancer.

The association between endometriosis and ovarian cancer is particularly strong for type I ovarian cancers, which include endometrioid, clear cell, mucinous and low-grade serous cancers.

• The risk is less pronounced for type II ovarian cancers, such as high-grade serous cancers.

Despite the similar name, endometriosis does not increase the risk of endometrial cancer, which affects the lining of the uterus.

How to treat endometriosis

Why it matters: Endometriosis is a chronic condition that can be managed with medications, dietary changes and, in severe cases, surgery. These treatment options help manage pain, slow disease progression and improve quality of life.

Medications help treat pain associated with endometriosis and also can impact hormones that can influence endometriosis growth.

• Over-the-counter (OTC) pain relievers, such as ibuprofen and naproxen, are often the first line of treatment to manage mild to moderate pain.
• Hormonal treatments, such as birth control pills, GnRH agonists and progestin therapy, focus on controlling the hormonal cycles that influence endometriosis growth and symptoms.
• Aromatase inhibitors block estrogen production in tissues and are sometimes used in combination with hormonal therapies for more severe cases.

Surgery is typically reserved for cases of severe pain that can’t be managed by medications or when women experience infertility, bowel or bladder problems or have large endometriomas.

• Laparoscopic surgery is the most common surgical procedure for endometriosis, where a surgeon removes or destroys endometriosis lesions, adhesions and scar tissue.
• Hysterectomy involves the removal of the uterus and, in some cases, the ovaries and fallopian tubes – it’s considered a last resort because it permanently ends menstruation and fertility.

Dietary modifications can play a supportive role in managing symptoms of endometriosis by reducing inflammation.

• The anti-inflammatory diet focuses on fruits, vegetables, whole grains and healthy fats that have antioxidant properties.
• Many people find that reducing their intake of red meat, gluten, dairy and processed sugar can help minimize symptoms.
• Boosting nutrient intake with fiber-rich foods (greens, whole grains and legumes), iron-rich foods (greens, lentils and fortified cereals) and magnesium-rich foods (bananas, almonds and dark chocolate) help with gut health, anemia caused by heavy bleeding and soothing cramps.

Next steps: Living with endometriosis can be challenging, but you don’t have to face it alone. At INTEGRIS Health, our OBGYN specialists provide expert care, compassionate support and personalized solutions to help you manage your symptoms and improve your quality of life. 

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