Endometriosis 101 – A Comprehensive Guide

3 Mins read

During the National Endometriosis Awareness Month (this March 2020), let’s take up this challenge to spread an awakening and awareness about this painful condition called “Endometriosis” which affects 6-10% women globally.

Endometriosis is a condition that can affect anyone that has a period. It can often be very painful and should not be ignored.

Firstly, what is the endometrium?

The endometrium is one of the stars of the female reproductive system, playing key roles during the menstrual cycle as well as during pregnancy. The Endometrium is the innermost layer in the uterus where implantation takes place. It prevents adhesions between the opposed walls of the myometrium, thereby maintaining the potency of the uterine cavity serving as the “wallpaper” of the uterus that houses a developing baby. It is amazing to know that it is one of the few organs in the human body that changes in size every month throughout a woman’s fertile years.

What is endometriosis?

Now that we know about the endometrium, let’s look at what endometriosis is. Endometriosis is a condition where cells similar to the endometrium, grow outside the uterus; on the pelvic organs, ovaries, or fallopian tubes. Endometriosis can also impact the length of someone’s menstrual cycles, as well as how long their bleeding lasts. Since their body has more tissue to shed, their periods may last longer. Their cycles may become shorter, with menstruation beginning sooner than every 28 days. They may also experience bleeding and pain during ovulation.

The cause is unknown. But researchers suspect genetic, immunologic, and hormonal factors. In most cases, it has taken an average of 10 years and 8 doctors to be diagnosed with endometriosis. It’s often misdiagnosed as appendicitis, colon and ovarian cancer, fibroids, irritable bowel syndrome (IBS), or sexually transmitted diseases. That’s why it’s critical for women to know, understand, and be vocal about their symptoms. Education and awareness can lead to early detection.

Endometriosis can happen to any female who has her menstrual periods, but it is more likely to happen to women in their 30’s and 40’s.

Stages of endometriosis

  • Endometriosis is often classified as mild, moderate, or severe or as stage I-IV.
  • Mild or stage I – small patches, surface lesions, or inflammation on or around organs in the pelvic cavity.
  • Moderate or stage II / III – sometimes more widespread and starting to infiltrate pelvic organs, peritoneum (pelvic side walls), or other structures. Sometimes there is also scarring and adhesions.
  • Severe or stage IV – infiltrative and affecting many pelvic organs and ovaries, often with distortion of the anatomy and adhesions.

These stages provide a useful guideline, however, they also have limitations. For instance, the amount of endometriosis does not always correspond to the amount of pain and discomfort. A small amount of endometriosis can be more painful than severe one. It depends, largely, on where it is actually growing inside the body.


Symptoms vary from person to person and doctors do not always list the following as medically recognised symptoms. However, many women have reported experiencing:

  • Painful periods (cramping, pelvic and leg pain, lower-back and abdominal pain)
  • Irregular periods
  • Painful bowel movements
  • Digestive problems including IBS
  • Reduced fertility
  • Heavy periods and bleeding between periods
  • Nausea and vomiting
  • Chronic pain and fatigue

Some women have no symptoms at all.

All of the symptoms above may have other causes. It is important to seek medical advice to clarify the cause of any symptoms you may experience. If your symptoms change after diagnosis, it is important to discuss these changes with a medical practitioner.

It is easy to attribute all your problems to endometriosis, but it may not always be the cause of your symptoms. The symptoms of endometriosis can also indicate many other conditions and because endometriosis manifests itself in a variety of ways, diagnosis can be difficult.

Diagnosing endometriosis

Endometriosis can’t be confirmed through symptoms or tests and is easy to miss with ultra-sounds, CT and even MRI. The most effective way to diagnose the condition is through a laparoscopy (a surgery where a doctor looks in the abdomen with a camera usually through the belly button) and taking a sample of a suspected abnormality. Endometriosis is rarely found in girls before they start their period, but it is found in up to half of young girls and teens with pelvic pain and painful periods.


Endometriosis is still relatively misunderstood and very under-researched in the medical world. Thus, unfortunately, there is no known current cure – the most common treatment is surgery and hormonal medication.

If the endometriosis is found during a laparoscopy, surgeons remove the area with tools that apply a laser, an electric current, helium gas, or heat. Hormone treatment includes using birth control pills to stop menstruation. By doing this, it slows down the growth of endometriosis. Other treatments include NSAIDS (Non-steroidal anti-inflammatory drugs, pain killers, and anti-inflammatories such as paracetamol, naproxen, ibuprofen, and codeine.

Unfortunately, endometriosis is a long-term chronic condition that can significantly impact a woman’s physical health, emotional well-being, and daily routine. For some women, symptoms get so bad that it stops them from doing their routine activities and may lead to feelings of depression and anxiety.

However, you may find some comfort in knowing you’re not alone. 1 in 10 women has endometriosis. And, that is a pretty powerful statistic.

Share your EndoStory to reach out to the others having the same condition. Endometriosis is hard work, but you can claw back some quality of life with the right support!


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