Endometriosis

Endometriosis is a chronic condition in which tissue similar to the lining of the uterus (the endometrium) grows outside the uterus, most commonly on the ovaries, fallopian tubes, the outer surface of the uterus, and the tissue lining the pelvis. Less commonly, endometrial-like tissue can be found on the bowel, bladder, and in rare cases, distant sites like the lungs.

This misplaced tissue responds to hormonal changes just like the endometrium inside the uterus — it thickens, breaks down, and bleeds with each menstrual cycle. But unlike the uterine lining, which exits the body during menstruation, this displaced tissue has no way to leave. The result is inflammation, scarring (adhesions), and the formation of cysts (endometriomas) that can cause severe pain, particularly during menstruation, and may impair fertility.

Endometriosis affects an estimated 1 in 10 women of reproductive age — approximately 190 million women worldwide. Despite its prevalence, it is notoriously difficult to diagnose, with an average diagnostic delay of 7-10 years from symptom onset. This delay occurs because symptoms overlap with other conditions, many healthcare providers lack awareness of the condition, and definitive diagnosis historically required laparoscopic surgery.

If you experience severe menstrual cramps, chronic pelvic pain, pain during intercourse, painful bowel movements during your period, or difficulty conceiving, endometriosis should be considered as a possible cause. Advocating for yourself with healthcare providers is unfortunately often necessary, as the condition is frequently dismissed or misdiagnosed.

Seeking care from a gynecologist experienced in endometriosis — ideally an excision specialist — can significantly improve both diagnosis and treatment outcomes. Support organizations like the Endometriosis Foundation of America provide valuable resources and community for those navigating the condition.