What is endometriosis?
Endometriosis occurs when tissue similar to the lining of the uterus grows on the ovaries, pelvic lining, bowel or elsewhere. These implants respond to monthly hormones, bleeding and inflaming nearby tissue. Retrograde menstruation is a leading theory, alongside immune and genetic factors (Zondervan et al., 2020). Cysts on the ovary are called endometriomas or "chocolate cysts."
What are the symptoms?
Hallmarks include period pain that over-the-counter meds don't touch, chronic pelvic pain, pain during sex, painful bowel movements or urination, and infertility. Because severe cramps are often dismissed as normal, many people wait 7–10 years for a diagnosis. Ultrasound or MRI can suggest it; laparoscopy confirms it, but current guidelines say treatment can start based on symptoms and imaging (Becker et al., 2022).
How is it treated?
NSAIDs and hormonal therapy—birth control pills, progestins, or GnRH antagonists like elagolix or relugolix combination therapy—are first-line for pain. Laparoscopic surgery removes lesions when medication fails or cysts are large. Ovarian surgery can lower egg reserve, so discuss fertility plans first. Irregular periods may point to PCOS instead.
This article is general health information and is not a substitute for diagnosis or treatment. If symptoms persist, see a doctor.
FAQ
- Can I get pregnant with endometriosis?
- Yes—many people conceive naturally or with IVF, though infertility risk is higher.
- Does a hysterectomy cure endometriosis?
- Not always. Lesions outside the uterus can persist, so it isn't a guaranteed cure.
Sources reviewed: 2026-10-25
References
- Zondervan, K. T., Becker, C. M., & Missmer, S. A. (2020). Endometriosis. New England Journal of Medicine, 382(13), 1244–1256.
- Becker, C. M., Bokor, A., Heikinheimo, O., et al. (2022). ESHRE guideline: Endometriosis. Human Reproduction Open, 2022(2), hoac009.