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March is Endometriosis Awareness Month

Too many health conditions can fly under the radar. We’ve all been there – an unexplained pain or sudden cough doesn’t feel like a big enough deal for a copay. If you menstruate, you may have an irregular cycle or skip periods from time to time without a follow-up at the gynecologist. Reproductive conditions like endometriosis may not show outward symptoms, but the ones you do experience could be indicative of a larger untreated problem. Learn more about the warning signs of this potential health complication to know what to look for and ask your doctor about during your next visit.

What is Endometriosis?

Endometriosis is a reproductive disease named for the tissue that lines the uterus, or your endometrium. Patients with endometriosis develop tissue that behaves just as the tissue inside the uterus does but lies outside it – essentially, you have menstrual periods both inside and outside the usual place.

If you have endometriosis, the blood that your endometrial tissue sheds during your period touches other organs inside your abdomen and causes pain and inflammation. You can find this rogue tissue on other reproductive organs or in the abdominal region, bowel, bladder or rectum. In rare cases, endometriosis can appear in other parts of the body like your lungs, brain and skin.

Researchers at the US Office on Women’s Health speculate that endometriosis affects an estimated 11 percent of American women, and is most common in patients in their 30s and 40s.


The most common symptom of endometriosis is pain, especially excessive period cramps that you may feel in your abdomen or lower back. If you have endometriosis, you may experience pain during intercourse or painful urination and bowel movements during periods as well. The amount of pain you feel doesn’t always correlate to the severity of your disease, though, so if you experience any of these symptoms, raise them with your doctor.

Other symptoms of endometriosis include:

  • Abnormal or heavy period flow
  • Spotting during periods
  • Infertility
  • Gastrointestinal problems, such as diarrhea, constipation, bloating or nausea, especially during your period

These symptoms vary – they can be cyclical, meaning they worsen and then ease over the course of your period, or remain consistent over time.

What’s My Risk?

Unfortunately, there’s no clear cause of endometriosis, but a few factors in your medical history may put you at a greater risk for developing the disease. Patients with immune system disorders are likely to have endometriosis because their bodies can’t locate and destroy endometrial tissue growing outside the uterus. Genetics plays a part, as those with mothers, sisters, daughters, or aunts with endometriosis are more likely to have the disease as well. Other key risk factors include:

  • Problems with period flow, such as retrograde menstrual flow. With this condition, your endometrial tissue inside your uterus flows backwards into other areas of the body, like the pelvis.
  • A history of surgery, especially a C-section or other reproductive surgeries. Endometrial tissue has been found on abdominal scars.
  • Family history with ovarian and breast cancers, allergies, asthma, chemical sensitivity, chronic fatigue syndrome and fibromyalgia
  • No history of pregnancy, or a first-time pregnancy after the age of 30
  • Short menstrual cycles of 27 days or fewer or periods that last more than 7 days

In most endometriosis patients, symptoms tend to lessen or vanish entirely after menopause. As the ovaries stop making estrogen, endometrial tissue growths shrink.


Endometriosis may be difficult to prevent, but keeping estrogen levels low through lifestyle changes and medication can help.

  • If you take hormonal birth control with lower doses of estrogen, you may already be lowering your risk of endometriosis.
  • Because fat cells produce estrogen, doctors recommend a regular exercise routine – more than 4 hours a week – alongside a diet rich in fruits and vegetables to maintain a healthy weight in the appropriate range for you.
  • Alcohol raises estrogen levels, as do caffeinated beverages like sodas and green tea. Stick to one a day for each of these categories.


Endometriosis can be difficult to detect. Your doctor may conduct a pelvic exam to feel for cysts and scars behind the uterus, or they may call for imaging tests like an MRI, ultrasound or CT scan. The only definitive diagnostic tool is laparoscopy, a minimally invasive surgical procedure with a camera.

Riverside Medical Clinic offers obstetrics and gynecology services at five of our locations, but if you suspect you may have endometriosis, any of our physicians can help you find the right specialist. Learn more about services offered or schedule an appointment on our site, or about other common reproductive health conditions at www.womenshealth.gov.