Common Causes, Symptoms & Treatments for Endometriosis: A Complete Women’s Health Guide

can endometriosis be cured?

Endometriosis is a silent yet disruptive condition that affects millions of women globally. It’s a chronic, often painful disorder in which tissue similar to the lining of the uterus grows outside the uterus, leading to inflammation, scar tissue formation, and a host of troubling symptoms. For many women, it causes not just physical discomfort but emotional and reproductive challenges as well.

Despite being so common, endometriosis is frequently misunderstood or misdiagnosed. Many women endure years of unexplained pain before getting the answers they need. Understanding the causes, symptoms, and treatment options is the first step toward effective management—and a better quality of life.

What Is Endometriosis

Endometriosis occurs when endometrial-like tissue (normally found lining the inside of the uterus) implants and grows outside the uterine cavity. This tissue responds to the menstrual cycle just like the uterine lining—thickening, breaking down, and bleeding—but it has nowhere to exit the body. As a result, it causes:

  • Chronic inflammation
  • Internal bleeding
  • Scar tissue formation (adhesions)
  • Pain and dysfunction in pelvic organs

Endometriosis is most often found on the ovaries, fallopian tubes, pelvic lining, and the outer surface of the uterus. In more advanced cases, it may spread to the bladder, intestines, and other organs.

Causes & Risk Factors

The exact cause of endometriosis remains unknown, but several theories and risk factors have been proposed:

Leading Theories Include:

  • Retrograde Menstruation: Menstrual blood flows backward into the pelvic cavity instead of exiting the body.
  • Coelomic Metaplasia: Peritoneal cells transform into endometrial-like cells.
  • Immune System Dysfunction: The immune system fails to recognize and destroy endometrial-like tissue growing outside the uterus.
  • Genetic Predisposition: Family history increases the likelihood of developing the condition.

Risk Factors:

  • Early menstruation (before age 11)
  • Short menstrual cycles (<27 days)
  • Heavy menstrual periods
  • Delayed pregnancy or never giving birth
  • A close relative with endometriosis
  • Low body mass index (BMI)

Symptoms of Endometriosis

Symptoms can vary widely—from mild to debilitating—and some women may be asymptomatic.

Common Symptoms Include:

  • Severe menstrual cramps (dysmenorrhea)
  • Chronic pelvic pain
  • Pain during or after sex (dyspareunia)
  • Painful urination or bowel movements, especially during menstruation
  • Heavy or irregular periods
  • Bloating, nausea, or fatigue
  • Infertility

It’s important to note that the severity of symptoms does not always correlate with the extent of the disease. Some women with mild endometriosis experience severe pain, while others with advanced disease may have few or no symptoms.

How Endometriosis Is Diagnosed

Because symptoms mimic those of other conditions, diagnosis can be delayed by years. Here’s how healthcare professionals typically diagnose endometriosis:

1. Medical History & Symptom Review

A detailed review of menstrual history, pain symptoms, and family background.

2. Pelvic Examination

To detect abnormalities like cysts or scarring, though this may not be conclusive.

3. Imaging Tests

  • Ultrasound (especially transvaginal)
  • MRI for deeper lesions
    These can suggest but not confirm endometriosis.

4. Laparoscopy (Gold Standard)

A minimally invasive surgical procedure that allows direct visualization and biopsy of endometrial implants. It also allows treatment during the same procedure.

5. Staging the Disease

Endometriosis is staged from I (minimal) to IV (severe), based on the location, extent, and depth of the implants and presence of scar tissue.

Medical Treatments

Medical therapy aims to relieve symptoms and reduce recurrence. It doesn’t cure the condition, but it can significantly improve quality of life.

Pain Management

  • NSAIDs (ibuprofen, naproxen) to reduce inflammation and menstrual pain

Hormonal Therapy

Used to suppress menstruation and limit the growth of endometrial-like tissue:

  • Oral contraceptives (combined estrogen and progestin)
  • Progestins (pills, injections, or IUDs like Mirena)
  • Gonadotropin-releasing hormone (GnRH) agonists/antagonists to lower estrogen levels
  • Aromatase inhibitors (used off-label)

Hormonal therapy may cause side effects such as hot flashes, mood changes, and bone loss (with long-term GnRH use). “Add-back” therapy (low-dose estrogen/progestin) is sometimes used to reduce side effects.

Surgical Treatment Options

Surgery is often considered for women who:

  • Have not responded to medical therapy
  • Have severe symptoms
  • Have fertility concerns
  • Have cysts or structural complications

Types of Surgery

  • Laparoscopic excision (removal of implants)
  • Cystectomy (removal of ovarian cysts called endometriomas)
  • Adhesiolysis (removal of scar tissue)
  • Hysterectomy (removal of uterus; with or without ovaries) in severe, unresponsive cases

Surgery improves pain and may enhance fertility but recurrence is possible. It is best performed by an experienced gynecologic surgeon.

Fertility and Endometriosis

Endometriosis can lead to infertility by:

  • Distorting pelvic anatomy
  • Causing inflammation
  • Damaging eggs or blocking fallopian tubes

Fertility Treatment Options:

  • Fertility-sparing surgery to remove implants
  • Ovulation induction and timed intercourse
  • Intrauterine insemination (IUI)
  • In vitro fertilization (IVF) in moderate to severe cases

Long-Term Management & Recurrence

Even after successful treatment, endometriosis can return. Ongoing management includes:

  • Hormonal suppression post-surgery
  • Pain tracking and symptom journals
  • Regular medical follow-ups
  • Avoiding estrogen triggers (in some cases)

Menopause may naturally reduce symptoms due to hormonal decline.

Lifestyle, Support & Mental Health

Endometriosis doesn’t just affect the body—it impacts mental and emotional well-being. Many women report:

  • Fatigue
  • Anxiety and depression
  • Relationship stress

Self-Care & Support Strategies:

  • Gentle exercise (yoga, stretching)
  • Anti-inflammatory diet
  • Pelvic physiotherapy
  • Mental health counseling
  • Support groups or online communities

When to See a Specialist

Consult a gynaecologist or women’s health specialist if you experience:

  • Severe pelvic pain or heavy bleeding
  • Pain during sex
  • Difficulty conceiving
  • Ineffective pain relief with basic treatment

FAQs: Endometriosis

Can endometriosis be cured?

There is no known cure, but symptoms can be effectively managed with medical or surgical treatment.

Can you get pregnant with endometriosis?

Yes, many women conceive naturally or with the help of fertility treatments.

What is the best treatment for endometriosis?

It depends on your symptoms, age, fertility goals, and disease severity. Treatment is often individualised.

Is endometriosis life-threatening?

No, but it can severely affect quality of life if untreated.

Does menopause end endometriosis symptoms?

Often, yes. Menopause usually causes symptoms to decline due to a drop in estrogen levels.

Conclusion

Endometriosis is a complex, often misunderstood condition—but it’s not a life sentence. With timely diagnosis and personalized treatment, women can manage symptoms, protect their fertility, and live a full, empowered life. If you or someone you know is struggling with unexplained pelvic pain or reproductive issues, seek expert help. Relief, answers, and support are available.

Tags

Share

    Other posts

    Providing compassionate obstetric and gynaecological care for women in Port Elizabeth. Led by Dr. Tembisa Tini, with a focus on expert, family-centred healthcare.

    Contact

    • billing@drtini.co.za
    • practice@drtini.co.za
    • accounts@drtini.co.za
    • reception@drtini.co.za
    • 0414510369
    • Room 201, Life Mercantile Hospital, Cnr Durban and Kempston Roads, Korsten, Port Elizabeth, 6014
    © 2025 Dr Tembisa Tini Inc. All Rights Reserved.