What causes endometriosis?

The causes of endometriosis are not known. Contributing factors can include:

• Instead of menstrual (period) blood flowing out of the body as usual, some travels backwards along the fallopian tubes and into the pelvis. This blood can contain cells from the endometrium. In some women, these endometrial cells stick onto the surfaces of pelvic organs and start growing. Normal pelvic tissue can turn into endometriosis
• Women who have a close relative with endometriosis are up to 10 times more likely to develop the condition.

Other possible contributing factors for endometriosis include:

• long and heavy periods
• frequent periods or short cycles
• starting your period before 11
• having your first pregnancy when you're older
• problems with the immune system
• low body weight
• alcohol use

Endometriosis symptoms

Common symptoms include:

• heavy periods or irregular bleeding
• abdominal (tummy) or pelvic pain before and during a period, when having sex or going to the toilet
• bleeding between periods
• bleeding from the bladder or bowel, or changes in urination or bowel movements
• feeling bloated
• being tired and moody, especially around the time of your period
• not being able to get pregnant (infertility)

However, not everyone with endometriosis will experience symptoms.

Endometriosis diagnosis

To diagnose endometriosis, your doctor will probably ask about your symptoms and periods. You may need to have a laparoscopy, which is a type of surgery that allows doctors to look for endometriosis tissue in your abdomen. If your doctor believes you have endometriosis, they can refer you to a gynaecologist.

Endometriosis treatments

Endometriosis can usually be treated with medicines or surgery. It will depend on:

• your symptoms
• the severity of your endometriosis
• whether you want to become pregnant

Medicines for endometriosis include hormone-based treatments like the pill or an implant or IUD and pain relief medicine. Hormone treatments can reduce pain and reduce the growth of endometrial cells. However, they work only as long as you take them, so the endometriosis may come back.

Surgical treatment aims to remove as much of the endometriosis as possible. There are several options, including laparoscopic surgery where a small cut is made in your abdomen to allow examination and removal of the endometrial tissue. Surgery may also be combined with medicines. In very severe cases, a hysterectomy to remove the whole womb might be suggested.

Make sure you get plenty of sleep, exercise regularly and reduce stress as much as possible.

Visit the Jean Hailes for Women's Health website for more information about endometriosis.