What is endometriosis?

This article was medically reviewed by Andrew Horne, Professor of Gynaecology and Reproductive Sciences at Edinburgh University's MRC Centre for Reproductive Health.

Endometriosis is a chronic condition that is characterized by tissue similar to that found in the uterus, growing in other parts of the body. This tissue is found in organs and on other structures, most commonly on the lining of the pelvis or in the ovaries, but it has also been found elsewhere in the body, including the lungs and diaphragm.  

Each month, it is thought that the tissue builds up and breaks down as bleeding, exactly as it does within the uterus during the menstrual cycle, but unlike in the uterus where it can exit the body, it has nowhere to escape. This leads to inflammation, chronic pain and scar tissue.    

Endometriosis can affect women and those assigned female at birth (AFAB) of any age, including teenagers, and is a long-term condition. 

Pain is the main signifier of endometriosis. It is usually experienced in the lower tummy or back, as period pain, pain outside of periods, pain during or after sex, or pain when peeing or pooing. 

Other commonly experienced symptoms include:

• Tiredness
• Nausea
• Blood in urine or poo
• Heavy menstrual bleeding
• Constipation
• Diarrhoea

Sufferers also report numerous other symptoms, and more research is needed to establish clear links and understand why these occur. Endometriosis can cause fertility problems but not all of those living with endometriosis will have issues getting pregnant.  

Endometriosis can have a massive impact on the lives of sufferers, not just because the symptoms they experience can be so debilitating, but because it can also impact attendance at work or school and impede a person’s ability to enjoy a normal social life. The physiological symptoms can also result in mental health impacts, including depression and anxiety. The impacts are well documented and researched and it is why both sufferers and experts are crying out for better funding and research to improve diagnostics and treatment options. 

The condition can be difficult to diagnose and will often require a referral to a specialist. There is currently no cure for endometriosis, but there are a range of treatments and procedures doctors can explore to help alleviate it. These include painkillers, hormones, and surgery to remove the tissue.  

More funding and research are needed to really understand what causes endometriosis. The main theories discussed when it comes to the cause of endometriosis are: 

• Genetic predisposition: some studies suggest the condition tends to run in families and therefore some people are more predisposed to it than others. 
• Retrograde menstruation: sometimes menstrual blood containing endometrial cells flows backwards up the fallopian tubes into the pelvis instead of out of the vagina during menstruation. Research states that this happens to everyone who has periods; most of the time, the body can clear the excess blood and tissue. For those who can’t clear it, it is thought the tissue implants itself and grows. 
• Immune system: an issue with the immune system that may mean the body can’t identify and destroy endometrial-like tissue that’s growing outside the uterus. 
• Cell transformation: hormones or immune factors may promote the cells that line your abdomen to transform into ‘endometrium-like’ cells. 

If you think you have any of the symptoms of endometriosis, or your periods are having an impact on your daily life you should book an appointment with your GP. See our handy guide for how to prepare for the appointment. If you want to track or have been asked to track your symptoms, sign up here to find out more about when our app will be available.  

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