Endometriosis FAQ: Answers to Women’s Most Common Questions About Endometriosis by Dr. Alan Lindemann

Think you may have endometriosis? Endometriosis is an often painful disease that is estimated to affect more than 6.5 million women in the United States. It causes tissue similar to that which normally lines the uterus to grow outside of the uterus, with symptoms that may include excessive menstrual cramps, abnormal or heavy menstrual flow and painful intercourse.

It is estimated that at least 11 percent of women in the U.S. between the ages of 15 and 44 have endometriosis. Especially common among women in their 30s and 40s, it can make getting pregnant difficult, potentially causing infertility. Here, I'll demystify the disease, answering women’s most common questions.

Q: How does endometriosis get triggered in the body?

A: Over the years there have been various explanations. The generally accepted answer is that endometriosis is spread by retrograde menstrual flow. This means that at least some of the menstrual flow goes backward, up the fallopian tubes and out into the tissue surrounding the ovaries, instead of down and out the uterus. Why this would happen is unknown, however, it is widely believed that a predisposition for endometriosis is hereditary. So if your mother or your grandmother had it, you may get it, too.

Q: What happens if endometriosis is left untreated?

A: Endometriosis acts like glue, causing pelvic structures to adhere to each other. There are different courses endometriosis could take if left untreated. Infertility and pain are among the first symptoms. The disease can eventually cause ureters (the tubes bringing urine from the kidneys to the bladder) to close, possibly ending in kidney failure. This is why it’s important to diagnose and treat endometriosis as soon as you can.

Q: What are the early symptoms of endometriosis?

A: Pain would most often be an early symptom, but there is not always a correlation between abdominal pain and the degree of endometriosis. Some women with the most severe endometriosis have no symptoms, while others with minimal endometriosis have debilitating pain. Other symptoms include painful intercourse, heavy menstrual bleeding, bleeding between periods, fatigue, gastrointestinal issues and lower back pain.

Q: Can you have a healthy pregnancy and birth with this condition?

A: Pregnancy can occur with endometriosis. Sometimes surgery and anti-hormone medications such as Lupron can help with pregnancy. The issue of whether endometriosis interferes with pregnancy hasn't been resolved. Some say up to 80 percent of pregnancies in people with endometriosis result in miscarriages (loss of pregnancy before 20 weeks). Other studies indicate miscarriage is more frequent with early endometriosis. Still others have concluded there isn’t an increased rate at all. The definitive study has yet to be done.

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