Table of ContentsView AllTable of ContentsCausesWho Is at Risk?Causes of SymptomsStressLater in LifeYou’re Not to BlameCan It Go Away?ResearchCoping TipsNext in Endometriosis GuideHow to Get an Endometriosis Diagnosis
Table of ContentsView All
View All
Table of Contents
Causes
Who Is at Risk?
Causes of Symptoms
Stress
Later in Life
You’re Not to Blame
Can It Go Away?
Research
Coping Tips
Next in Endometriosis Guide
Endometriosisoccurs when tissue similar to the tissue that lines the uterus is present in an area outside of the uterus, such as on or in organs in the pelvis or abdomen. Experts are not sure what causesendometriosis. Several theories exist, but no one theory provides a complete explanation.
Understanding Endometriosis Causes
The exact cause of endometriosis isn’t known, but several theories have been proposed. Some researchers believe there are multiple causes that interact or overlap to cause endometriosis to develop.
Genetics
While there is no evidence that endometriosis is directly inherited, it tends to run in families, indicating a possiblegenetic link.
Having a close relative (parent, child, or sibling) with endometriosis is a risk factor for developing the condition.
Menstruation
Researchers believe this is a common occurrence in people who menstruate but doesn’t explain why endometrial cells grow outside the uterus in some people but not others. It is likely that other factors play a role along with retrograde menstruation.
Menstruation can also cause a worsening of existingsymptoms of endometriosis. The hormones that trigger endometrial tissues inside the uterus to grow and then shed also affect endometriosis tissues. Because there is nowhere for this tissue to shed, it can build up outside the uterus.
Immune System
Many people with endometriosis appear to have otherimmune system disordersand reduced immunity to other conditions. It hasn’t been established whether this is a factor in the development of endometriosis or whether it results from having endometriosis.
One theory is that problems with the immune system impair its ability to find and destroy endometrial tissue growing in areas it shouldn’t be.
Blood or Lymph System Transport
This theory suggests that endometrial tissue can use the blood or lymphatic systems to travel to other areas of the body. This is a similar mechanism to howcancer cells can spread.
Direct Transplantation
These transplanted endometrial cells may then attach to other areas of the body, like the walls of the abdomen.
Transformation
Through a process calledcellular metaplasia, cells outside the uterus could become cells that are similar to endometrial cells and start growing.
Hormones
The hormone estrogenseems to contribute to the inflammation, tissue growth, and pain associated with endometriosis. The relationship is not yet fully understood as endometriosis can still occur without the influence of estrogen.
Researchers are exploring a possible link between endometriosis and a problem with the hormone system.
Endometriosis can happen to anyone born with a uterus, but somefactors may increase the riskof developing it, including:
Although extremely rare endometriosis can occur in people assigned male at birth.
Why Can There Be a Delay in Diagnosis of Endometriosis?On average, a person experiencing symptoms of endometriosis in the United States will go 10 years before receiving a properdiagnosis of endometriosis.The variability in symptoms, limited awareness about the condition both in and out of themedical profession, and the tendency for symptoms to be attributed to something else (such as menstrual cramps) can contribute to this delay in diagnosis.
Why Can There Be a Delay in Diagnosis of Endometriosis?
On average, a person experiencing symptoms of endometriosis in the United States will go 10 years before receiving a properdiagnosis of endometriosis.The variability in symptoms, limited awareness about the condition both in and out of themedical profession, and the tendency for symptoms to be attributed to something else (such as menstrual cramps) can contribute to this delay in diagnosis.
On average, a person experiencing symptoms of endometriosis in the United States will go 10 years before receiving a properdiagnosis of endometriosis.
The variability in symptoms, limited awareness about the condition both in and out of themedical profession, and the tendency for symptoms to be attributed to something else (such as menstrual cramps) can contribute to this delay in diagnosis.
What Causes Endometriosis Symptoms?
Endometrial tissuetypically growson or around the following:
Less commonly, it can occur on and around the following:
This tissue can grow, swell, andbleedeach month in response to menstrual cycle hormones (just as the uterine lining does). But because it is not easily expelled from the body like menstruation, it can build up, leading to inflammation and other problems.
Constipation
When endometrial tissue grows on or near thebowels, it can cause inflammation (swelling), contributing toproblems such as:
Infertility
Endometriosis can affect fertility. This doesn’t mean someone with endometriosis will be unable to get pregnant, but it may causedifficulties conceiving.
Exactly how endometriosis causes problems withfertilityisn’t known, but some possible reasons include:
Endometriomas
Endometriomasare menstrual blood–filled cysts that grow inside the ovary when blood becomes trapped from endometriosis growth. They are sometimes called chocolate cysts because of their dark brown color.
Adhesions
A “sticky” type of fibrous endometrial tissue can form, causing organs to join or bind together. This is called an adhesion, and it can causepelvic pain.
Secondary Endometriosis ConditionsEndometriosis can overlap with other chronic pain syndromes, causing additional pain symptoms. These can include:Irritable bowel syndrome: A group of symptoms, such as cramping, bloating, and diarrhea, that affect the digestive systemInterstitial cystitis (painful bladder syndrome): Chronic pressure, pain, or discomfort in the bladder areaVulvodynia: Chronic, unexplained pain in the vulva
Secondary Endometriosis Conditions
Endometriosis can overlap with other chronic pain syndromes, causing additional pain symptoms. These can include:Irritable bowel syndrome: A group of symptoms, such as cramping, bloating, and diarrhea, that affect the digestive systemInterstitial cystitis (painful bladder syndrome): Chronic pressure, pain, or discomfort in the bladder areaVulvodynia: Chronic, unexplained pain in the vulva
Endometriosis can overlap with other chronic pain syndromes, causing additional pain symptoms. These can include:
Does Stress Cause Endometriosis?
Cause of Endometriosis Later in Life
Symptoms of endometriosis often subside after menopause, but it is estimated that the incidence of postmenopausal endometriosis is about2% to 5%.
Most people with endometriosis after menopause had the condition when they were still menstruating, but rarely it arises in someone with no history of endometriosis before menopause.
This usually is associated with taking menopausal hormone therapy (MHT). It rarely occurs in people who have never taken MHT or the medicationtamoxifen.
You Did Not Cause Your Endometriosis
People with endometriosis often feel like they are responsible for their symptoms because of something they did or did not do.
For example, a 2022 analysis of four focus group discussions found that the participants with endometriosis had been given contradictory information about following an unrealisticallystrict dietfor managing endometriosis.When the diet became impossible to follow, many participants blamed themselves. Eventually, they found listening to their bodies and creating their own personal food practices was more manageable.
There is no known way to prevent endometriosis from developing. It does not develop from making “poor” decisions and did not result from anything you did or did not do.
Can Endometriosis Go Away?
There’s no cure for endometriosis, but treatments can help relieve symptoms such as pain and can improve fertility.
Symptoms often go away after menopause because endometriosis growths can shrink with lowered estrogen levels.
If left untreated, endometriosis might improve on its own, but it can alsoget worse. If symptoms are tolerable, watching symptoms for changes before beginningtreatmentis an option.
What Is the Latest Research on Endometriosis?
To date, there is still no fully supported or understood theory for what causes endometriosis.
Tips to Cope With Endometriosis
Symptoms may alsobe easedwithat-home remediessuch as:
Support from partners, friends, family, community, and online groups can also be very helpful for people with endometriosis.
If you have been diagnosed with endometriosis and want to identify what may trigger anendo flare, keep a journal of possible triggers such as your menstrual cycle, stress, sleep quality, constipation, exercise, intake of alcohol and caffeine, and diet.
Summary
The cause of endometriosis isn’t known, but some theories include genetics, retrograde menstruation, immune system involvement, blood and lymph system transportation, direct transplantation, transformation, and hormones. Multiple factors at one time may be involved.
Endometriosis can cause inflammation leading to problems with surrounding organs, such as constipation. Endometriosis can lead to blood-filled ovarian cysts, scar tissue, and adhesions.Problems with fertilitycan also occur with endometriosis.
Endometriosis is currently being researched as a possible autoimmune disease.
18 Sources
Verywell Health uses only high-quality sources, including peer-reviewed studies, to support the facts within our articles. Read oureditorial processto learn more about how we fact-check and keep our content accurate, reliable, and trustworthy.
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