Help for Endometriosis

Endometriosis is a complex and often confounding condition that can be difficult to diagnose. Symptoms of endometriosis often mimic other disorders, including pelvic inflammatory disease or irritable bowel syndrome.

Women with endometriosis are more likely than other women to have some of these conditions as well. While the most common symptom of endometriosis is pain—most often during menstruation—it can also cause abnormal bleeding, painful sex, and bowel and urinary problems.

Endometriosis is sometimes a silent condition. Some women don’t have pain or other symptoms, so they don’t find out they have the condition until they experience difficulty getting pregnant. Endometriosis is the leading cause of infertility in the United States and also increases the risk of miscarriage and other problems in pregnancy. However, the vast majority of women with endometriosis are ultimately able to have a child.

Endometriosis is estimated to affect about one in 10 U.S. women of reproductive age. This number could be much higher, however, because experts believe the condition is underdiagnosed. Symptoms sometimes begin shortly after puberty, when teens experience pain during menstruation. They may continue until well after menopause.

Endometriosis can greatly affect a woman’s quality of life and productivity. It’s estimated to cost $87 billion each year in both health care and workrelated costs, according to the Endometriosis Foundation of America. A 2011 study in Fertility and Sterility found that symptoms cause women with endometriosis to have about 38% lower productivity at work than women without this condition. The women who participated in the study also reported reductions in their quality of life and said the condition hindered their ability to do tasks and daily activities at home.

Many women suffer longer than necessary because of delays in diagnosis. A 2011 study by the World Endometriosis Research Foundation found that among women ages 18 to 45, there was an average delay of seven years between the first symptoms and the time of diagnosis. Most cases are diagnosed when women are in their 30s or 40s.

In some cases, diagnosis is delayed because teenagers and adult women assume that their symptoms are a normal part of menstruation. Those who do seek help are sometimes dismissed as overreacting to normal menstrual symptoms.

While there is no known cure for endometriosis, medications, surgery, and lifestyle changes can help you find relief and manage the condition.

In this report, we will examine what’s known about endometriosis, the symptoms, and some of the potential causes. We’ll also discuss other health conditions that commonly affect women with endometriosis. Finally, we’ll explain treatment options and outline steps that doctors can take to help preserve your fertility.

Prepared by the editors of Harvard Health Publishing in consultation with Marc R. Laufer, MD, Professor of Obstetrics, Gynecology & Reproductive Biology, Harvard Medical School Chief of Gynecology and Director, Boston Center for Endometriosis, Boston Children’s Hospital. (2019)

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