What is endometriosis? A Mayo Clinic expert explains

Hi, I'm Dr. Megan Wasson, a minimally invasive gynecologic surgeon at Mayo Clinic. In this video, we will cover the basics of endometriosis, including what is it, who gets it, as well as the symptoms, diagnosis and treatment. Whether you are looking for answers for yourself or someone you love, we are here to give you the best information available. Endometriosis is a condition in which cells similar to the lining of the uterus, or endometrium, grow outside the uterus. Endometriosis often involves the pelvic tissue and can envelop the ovaries and fallopian tubes. It can affect nearby organs, including the bowel and bladder. So during the menstrual cycle, or period, this tissue responds to hormones, and due to its location, frequently results in pain. Endometriosis causes surrounding tissues to become irritated and potentially develop scars and sticky fibers that bind tissues together. In some cases, endometriosis can cause cysts on the ovaries. These are called endometriomas. Fortunately, there are effective treatments to manage and treat endometriosis.

There are some possible explanations of what sparks the endometrial-like tissue to grow out of place. But the exact cause is still uncertain. However, there are some factors that make someone more likely to get endometriosis, such as never giving birth, menstrual cycles occurring more frequently than every 28 days, heavy and prolonged menstrual periods that lasts longer than seven days, having higher levels of estrogen in your body, having a low body mass index, having a structural issue with the vagina, cervix, or uterus that prevents the passage of menstrual blood from the body, a family history of endometriosis, starting your period at an early age, or starting menopause at an older age.

The most common symptom of endometriosis is pelvic pain, either during or outside of the normal menstrual period that is beyond normal cramping, Normal menstrual cramping should be tolerable and should not require someone to miss time from school, work or normal activities. Other symptoms include cramps that begin before and extend after a menstrual period, lower back or abdominal pain, pain with intercourse, pain with bowel movements or urination, and infertility. Individuals with endometriosis may experience fatigue, constipation, bloating, or nausea, especially during periods. If you are feeling these symptoms, it's a good idea to talk to your health care provider.

First, your provider will ask you to describe your symptoms, including the location of the pelvic pain. Next, they may do a pelvic exam, an ultrasound, or an MRI to get a clearer view of the reproductive organs, including the uterus, ovaries, and fallopian tubes. To definitively diagnose endometriosis, surgery is required. This is most commonly performed by laparoscopy. The patient is under general anesthesia while the surgeon inserts a camera into the abdomen through a small incision to evaluate for endometrial-like tissue. Any tissue that looks like endometriosis is removed and examined under the microscope to confirm the presence or absence of endometriosis.

When it comes to treating endometriosis, first steps involve trying to manage symptoms through pain medications or hormone therapy. Hormones, such as birth control pills, control the rise and fall of estrogen and progesterone in the menstrual cycle. If those initial treatments fail and symptoms are impacting a person's quality of life, surgery to remove endometriosis tissue may be considered.

Dealing with endometriosis, its pain, complications and fertility problems can be hard to cope with and be stressful. Consider joining a support group of people who can relate to what you are going through. If you'd like to learn even more about endometriosis, watch our other related videos or visit mayoclinic.org. We wish you well.