Endometriosis

Many people experience heavy periods or cramps occasionally, but for those with endometriosis, this pain can be constant and severe. This condition can affect daily life, fertility and emotional well-being - but effective treatments are available. The gynecology team at Banner Health specializes in diagnosing and treating endometriosis to help you manage symptoms and improve your quality of life. 

What is endometriosis? 

Endometriosis affects about 1 in 10 women of reproductive age. It occurs when tissue similar to the uterine lining grows outside the uterus - often on the ovaries, fallopian tubes, bladder or bowel. This tissue reacts to hormones during your menstrual cycle, causing inflammation, scarring and pain. 

There’s no known cure, but early diagnosis and specialized care can help control symptoms. 

Types of endometriosis: 

• Peritoneal (superficial): Small lesions on the pelvic surface 
• Ovarian (endometriomas): Cysts on one or both ovaries 
• Deep or infiltrating: Growths that extend into nearby organs such as the bowel or bladder 

What causes endometriosis? 

The exact cause isn’t known, but several theories and risk factors exist. 

Possible causes of endometriosis: 

• Retrograde menstruation: Menstrual blood flows backward into the pelvis instead of out of the body 
• Induction theory: Hormones or immune factors cause cells in the abdomen to act like endometrial cells 
• Embryonic cell transformation: Early cells respond to estrogen and turn into endometrial-like tissue 
• Peritoneal metaplasia: Normal abdominal cells change and behave like endometrial tissue 
• Cell transport: Endometrial cells may spread through blood or lymphatic vessels 

Risk factors for endometriosis: 

• Family history of endometriosis 
• Immune system disorders 
• Past pelvic surgeries such as a C-section or hysterectomy 

Endometriosis likely develops from a combination of genetic, hormonal and immune system factors. 

What are the symptoms of endometriosis? 

Symptoms vary from person to person. The most common sign is pelvic pain, especially during menstruation, but the pain can occur at other times too. 

Other symptoms of endometriosis include: 

• Heavy or long periods 
• Bleeding between periods 
• Pain during sex, urination, or bowel movements 
• Fatigue 
• Digestive issues like nausea, diarrhea, or constipation 
• Difficulty getting pregnant 

Chronic pain may also lead to depression or anxiety and can interfere with daily activities. 

How is endometriosis diagnosed? 

Diagnosis can take time - on average up to 10 years - because symptoms often resemble other conditions such as uterine fibroids, irritable bowel syndrome (IBS) or pelvic inflammatory disease (PID). 

Your provider may: 

1. Ask about your symptoms, pain patterns and family history 
2. Perform a pelvic exam to check for abnormalities 
3. Order imaging tests such as a transvaginal ultrasound or MRI to identify ovarian cysts or deep endometriosis 

While surgery used to be required for diagnosis, new guidelines recommend imaging first. If surgery is needed, laparoscopic surgery can confirm the diagnosis, remove tissue or collect a biopsy for testing. 

How is endometriosis treated? 

Endometriosis is a chronic condition, but treatment can reduce symptoms and improve fertility. 

Common treatment options for endometriosis: 

• Medication: Pain relievers, hormone therapy or birth control to manage symptoms and slow tissue growth 
• Surgery: Laparoscopic or robotic-assisted procedures to remove or destroy endometrial tissue.  
• Lifestyle management: Diet changes, physical therapy or stress-reduction techniques 
• Fertility treatment: For those struggling to conceive 

In severe cases where other treatments haven’t helped, your provider may recommend a hysterectomy, a surgery to remove the uterus, cervix, fallopian tubes and sometimes the ovaries. This option is typically considered only if you no longer plan to become pregnant. 

Your provider will tailor a plan based on your age, symptoms and reproductive goals. 

Fertility and endometriosis 

Endometriosis can make it harder to get pregnant, but many people with the condition go on to have successful pregnancies, depending on the severity and location of endometrial growths. 

If you’re trying to conceive, talk with your provider or a reproductive endocrinologist. Assisted reproductive techniques such as in vitro fertilization (IVF) or intrauterine insemination (IUI) may improve your chances of pregnancy. 

When to see a doctor for endometriosis 

You should talk with your provider if you: 

• Have severe or worsening pelvic pain 
• Experience pain with urination, bowel movements or sex 
• Have difficulty getting pregnant 
• Notice bleeding between periods or unusually heavy cycles 

Early evaluation can help you find relief and protect your fertility. 

Long-term outlook 

Without treatment, endometriosis can worsen over time, leading to increased pain, fertility issues, or complications like ovarian cysts, scar tissue, adhesions or bowel and bladder problems. 

With proper care and symptom management, most people find meaningful relief and maintain a good quality of life. Ongoing follow-up with your provider helps monitor symptoms and prevent complications. 

Why choose Banner Health for endometriosis care 

At Banner Health, our gynecology specialists use advanced imaging, minimally invasive procedures and compassionate care to diagnose and manage endometriosis. We’ll help you understand your options, manage pain and create a plan that fits your life. 

Find a Banner Health specialist near you.