Endometriosis: Causes, Symptoms, and Treatment
Medically reviewed by Sumiran Racherla, MD, Internal Medicine. Last reviewed: October 23, 2026.
What kind of doctor treats Endometriosis?
A gynecologist, a doctor for the female reproductive system, usually diagnoses and treats endometriosis. Care can include medicine and sometimes surgery. A direct primary care or concierge doctor can be a first stop for an evaluation and can refer you to a specialist when needed.
What is endometriosis?
Endometriosis is a disease in which tissue like the lining of the uterus grows in other places in your body. The uterus, or womb, is the place where a baby grows during pregnancy.
These patches of tissue are called implants, nodules, or lesions. They are most often found on or under the ovaries and on the fallopian tubes, which carry eggs to the uterus. They are also found behind the uterus and on the bowels or bladder.
The growths are not cancer. But they can still cause problems. They may swell and bleed like the uterus lining does during a period. It is a common health problem in women.
Symptoms
The main symptoms of endometriosis are pelvic pain, which often happens during your period, and infertility, which means trouble getting pregnant.
- Painful menstrual cramps that may get worse over time
- Pain during or after sex
- Low back pain
- Pain with bowel movements (pooping) or urination (peeing), usually during your period
- Heavy periods, or spotting or bleeding between periods
- Feeling very tired
In rare cases, you may also find blood in your stool or urine.
Causes and who gets it
No one knows for sure what causes it. The most likely cause is called retrograde menstrual flow. In this, some tissue shed during a period flows through a fallopian tube into the pelvis.
It runs in families, so genes may play a part. A faulty immune system may fail to find and destroy the tissue growing outside the uterus. The hormone estrogen appears to promote it.
Anyone who has periods can get it. It is more common in women in their 30s and 40s.
You are at higher risk if:
- A mother, sister, or daughter has it
- Your period started before age 11
- Your monthly cycles are short, less than 27 days
- Your periods are heavy and last more than 7 days
How doctors diagnose it
Doctors often diagnose endometriosis from your symptoms, a pelvic exam, and imaging tests. Imaging can be an ultrasound or an MRI. Your provider will first ask about your symptoms and medical history.
Imaging can miss endometriosis. A normal result does not rule it out.
Doctors can start treatment for your symptoms without surgery. A surgery called laparoscopy is used in some cases to confirm endometriosis or to treat it. Your doctor may suggest it if imaging is normal or if treatment does not help.
In a laparoscopy, the surgeon uses a laparoscope, a thin tube with a camera and light. It goes in through a small cut near your belly button. Sometimes a small tissue sample, called a biopsy, is taken.
Treatment
There is no cure for endometriosis, but there are treatments for the symptoms.
For mild symptoms, over-the-counter pain medicines such as ibuprofen or naproxen may help.
Hormone therapy stops the ovaries from making hormones. This may slow the tissue and stop new patches from growing. Types include birth control pills, progestin therapy, and GnRH medicines. GnRH medicines cause a temporary menopause. Hormone treatment works only while you take it. Pain may come back when you stop.
Surgery is usually chosen for severe symptoms. It is also used when hormones do not help or when you have fertility problems. The surgeon may remove the patches or cut some nerves in the pelvis.
For infertility caused by endometriosis, treatments include laparoscopy to remove the patches and IVF, a fertility treatment.
When to see a doctor
Talk with your doctor if you have symptoms of endometriosis. Examples are pelvic pain, very painful periods, or trouble getting pregnant. Bleeding between periods can have other causes. But if it happens often, see your doctor. If you see blood in your stool or urine, tell your doctor.
Call 911 or go to the emergency room if you have severe belly pain or pressure, bleeding that will not stop, fainting, or trouble breathing.
How a direct primary care or concierge doctor fits in
A direct primary care doctor charges a flat monthly fee instead of billing insurance, while a concierge doctor usually charges more and often works alongside insurance. A direct primary care or concierge doctor can hear your symptoms and do a first exam. They can arrange tests such as an ultrasound. They can refer you to a gynecologist and help track your care over time.
Common questions
Can endometriosis be cured?
No, there is no cure for endometriosis. Treatments can help with the symptoms.
Do I need surgery to be diagnosed with endometriosis?
No, not always. Doctors often diagnose it from symptoms, a pelvic exam, and imaging. Surgery is used in some cases to confirm it or to treat it.
Can I get pregnant if I have endometriosis?
Yes, many women with endometriosis get pregnant. But it may be harder to get pregnant. If you have trouble, talk to your doctor about treatments.
Does endometriosis go away after menopause?
Not always, but for some women the painful symptoms get better after menopause. The body stops making estrogen, and the growths slowly shrink. Some women who take hormone therapy for menopause may still have symptoms.
Can endometriosis be prevented?
No, you can't prevent it. If you notice symptoms, talk with your doctor early.
Sources
- MedlinePlus - Endometriosis
- European Society of Human Reproduction and Embryology - ESHRE guideline: endometriosis (2022)
- Office on Women's Health - Endometriosis
Medical Disclaimer
This content is for general educational and informational purposes only and is not medical advice. It is not a substitute for professional medical advice, diagnosis, or treatment, and reading it does not create a doctor-patient relationship. Always seek the advice of your physician or another qualified health provider with any questions about a medical condition, and never disregard or delay seeking professional advice because of something you read here. If you think you may have a medical emergency, call 911 (or your local emergency number) immediately.
