Endometriosis: What You Need to Know

Endometriosis is a gynecologic disorder that affects people with a uterus and ovaries. The condition occurs when tissue that normally lines the uterus (endometrium) grows outside of the uterus and can impact surrounding organs, such as ovaries, bowel, bladder, and fallopian tubes.

Approximately 1 in 10 people with a uterus are diagnosed with endometriosis yearly, and nearly half of those experience infertility. In addition, endometriosis is considered the primary cause of chronic pelvic pain in people who menstruate and are of childbearing age.

This article will provide important statistics and facts you should know about endometriosis.

Endometriosis Overview

The endometrium plays a vital role in the menstrual cycle and pregnancy. It thickens in preparation for the implantation of a fertilized egg and is shed during menstruation if conception does not occur.

When endometrial tissue escapes the uterus, it can invade other organs like the fallopian tubes, ovaries, intestines, and bladder. As a result, the tissue can become inflamed and bleed every month as it did in the uterus.

Endometriosis can cause chronic pelvic pain, heavy menstrual cycles, painful periods, and infertility leading to depression.

How Common Is Endometriosis?

The prevalence of endometriosis is difficult to determine because many people don't have symptoms or their symptoms go unreported. Between 1% and 7% of people with endometriosis are asymptomatic, while up to 70% of people have chronic pelvic pain.

It is estimated that more than 10 million people in the United States have endometriosis.

Endometriosis by Ethnicity

A 2019 review that compiled facts from many other studies reported the following statistics regarding race and ethnicity in people with endometriosis:

• Asian people were 50% more likely to be diagnosed with endometriosis than White people.
• Black and Hispanic people were half as likely to be diagnosed with endometriosis as White people.

Several factors could have influenced these results. For example, health disparities such as lack of health insurance, language barriers, cultural practices, underreported symptoms, and biased beliefs about pain and gender may have affected the data collected. More research is needed to explore this topic further.

Endometriosis by Age and Gender

Endometriosis is most common in people between the ages of 30 and 40; however, people as young as 15 have been diagnosed with the condition. Those born without a uterus are not at risk of having endometriosis.

Causes and Risk Factors of Endometriosis

Although the exact cause of endometriosis is unknown, researchers believe several body dysfunctions may contribute to its development. Unfortunately, there is currently no way to prevent endometriosis; however, risk factors associated with the disorder can help identify the condition sooner.

Causes

In addition to high estrogen levels, the following are suspected reasons for endometriosis:

• Retrograde menstruation: Menstrual blood can flow in the wrong direction through the fallopian tubes into the pelvic cavity. This can lead to the transfer of endometrial cells from the uterus to other organs.
• Metaplasia: Some cells can transform from one type of tissue to another. For example, endometrial tissue can replace tissue outside of the uterus.
• Genetics: Some people may have a genetic predisposition to developing the disease.
• Endometrial displacement: Endometrial fragments may be able to travel to other organs and tissues through the lymphatic or blood vessel system.
• Immune system dysfunction: Some people with endometriosis also have defects in their immune system. More research is needed on this subject.

Risk Factors

Here are some risk factors for developing endometriosis:

• You have a family history of endometriosis, especially your mother, sister, or daughter.
• You started your period before the age of 11.
• You have short monthly cycles (less than 27 days).
• You have heavy menstrual cycles that last more than seven days.

You should report any symptoms of endometriosis to your healthcare provider, especially if you have risk factors.

Mortality Rates for Endometriosis

Although endometriosis doesn't directly cause death, if left untreated, it can lead to the following life-threatening medical conditions:

• Ectopic pregnancy: Ectopic pregnancy is a gynecologic emergency that can result in bleeding into the abdominal cavity, leading to death. Endometriosis has been associated with a higher than average rate of ectopic pregnancy.
• Bowel obstruction: A bowel obstruction or perforation (opening) can occur if endometrial tissue invades the intestines. Bowel endometriosis has been observed in up to one-third of menstruating people, putting them at a higher risk for one of these gastrointestinal emergencies, leading to infection and possible death.
• Cancer: One study found that endometriosis was associated with certain cancers like ovarian cancer.

Screening and Early Detection

There are currently no screening or early-detection tests for endometriosis. In addition, diagnosis can take up to 10 years due to people not reporting symptoms, people normalizing their symptoms, a lack of healthcare provider knowledge, and misdiagnosis. Therefore, it's essential to know the signs of endometriosis and have regular gynecologic health exams to establish a baseline assessment.

If your healthcare provider suspects you have endometriosis, imaging tests, medication, and surgery can be used to diagnose the condition.

Summary

Endometriosis is a gynecologic condition that affects 10% of people with a uterus in the United States. When endometrial tissue travels and grows outside the uterus, it can cause chronic pain, heavy menstrual cycles, and infertility. It's important to know the signs of endometriosis and have regular gynecologic exams to help identify warning signs if they appear.

Although endometriosis doesn't cause death directly, it can lead to life-threatening conditions. If you are experiencing symptoms, schedule an appointment with your healthcare provider.