Between two and five percent of all North American women of reproductive age suffer from a painful, potentially debilitating condition called endometriosis, in which cells normally found in the lining of the uterus migrate to other parts of the abdomen while continuing to respond to hormonal signals that trigger menstruation. 

Endometriosis is often extremely painful because tissues that are usually sloughed off through the vagina during menstruation may have no place to exit from the body when they are found outside the uterus. 

Additionally, endometriosis is one of the three leading causes of female infertility: It’s been estimated that between 30 to 40 percent of all endometriosis sufferers are infertile. Infertility may be related to anatomical changes: Endometriosis sufferers typically exhibit fibrous adhesions in their abdomens as well as other anatomic irregularities that make embryonic implantation problematic. In some cases, the endometrial tissues may release chemical factors that harm developing embryos.

Women with endometriosis generally first notice symptoms a few years after they begin menstruating. Endometriosis symptoms disappear temporarily with pregnancy and permanently after menopause.

Endometriosis Causes

The causes of endometriosis have not been clearly confirmed. Hereditary and environmental factors may both play a role: Women whose close female relatives suffer from endometriosis are ten times more likely to be diagnosed with endometriosis themselves. Some medical experts think that endometriosis can be explained by a phenomenon called retrograde menstruation in which menstrual blood flows backwards into the pelvic cavity. The endometrial cells contained in this menstrual flow then implant themselves on the ovaries, fallopian tubes and other anatomical structures.

Endometriosis Prevention

In the absence of a definitive endometriosis etiology, it’s not possible to prevent endometriosis through specific behaviors and techniques. However, there are risk factors associated with endometriosis development and some of these can be addressed.

Childless women are much more likely to exhibit endometriosis symptoms than women with children. However, alleviating endometriosis symptoms is not a good reason to have a child! 

Women with menstrual cycles that are shorter than 27 days and who bleed for more than eight days during a single cycle are at risk for developing endometriosis. Birth control pills containing estrogen and progestin will decrease the amount of menstrual flow in these women and prevent the endometrial cells from thickening and sloughing.

Women with a history of pelvic inflammatory disease (PID) develop endometriosis at a higher rate than women in the population at large. Women with severe PID may require surgery such as a laparoscopy, a laparotomy, or in cases where a woman is sure she does not want to give birth to a child, a hysterectomy. Laparoscopy and laparotomy may also be effective as surgical treatments for infertility.

The thickening of the lining of the uterus during the menstrual cycle is associated with elevated levels of the hormone estrogen. There are ways women can lower their own estrogen levels. These include exercising regularly, maintaining a body weight with a low amount of body fat, and avoiding large amounts of alcohol and caffeine.