A special type of tissue called the endometrium lines your womb (an organ called the uterus). Endometriosis occurs when these endometrial cells start growing in other places in the body such as the ovaries, fallopian tubes, and nearby structures. Very rarely, it can occur in more distant parts of the body, like the lungs, brain, and skin.

The tissue still acts like it's in the womb, growing and shedding along with your monthly cycle. These growths may bleed during your period, but the blood has nowhere to go. This causes swelling and scar tissue, which can lead to pelvic pain, infertility, and other problems.

Symptoms of endometriosis include:

• Chronic pelvic pain
• Infertility
• Bleeding between periods
• Lack of energy

The symptoms mimic many other problems, so endometriosis can be difficult to diagnose. But it's relatively common—about 11% of people who menstruate may have it. It's most common during your 30s and 40s. 

Risk factors for endometriosis include:

• Having a close female relative (mother, sister, daughter) with endometriosis
• Starting your period early (before age 11)
• Having short monthly cycles (less than 27 days)
• Having heavy periods that last longer than 7 days
• Never having children
• Having a health problem that blocks the normal flow of your period

Doctors don't know what causes endometriosis, so there's no known way to prevent it.

There are several different types of endometriosis. Doctors break them down based on where the endometrial cells are growing.

Types of endometriosis include:

• Superficial peritoneal endometriosis: The most common and least severe type of endometriosis. It occurs in the pelvic peritoneum, the mucous membrane that lines the inside of your abdomen and pelvis.
• Endometriomas: Also called cystic ovarian endometriosis. This is when cysts of endometrial tissue and blood form in the ovaries. You may hear these called "chocolate cysts" because they're filled with dark brown fluid.
• Deeply infiltrating endometriosis: When the endometrial tissue grows deeply into other organs. They can be inside or outside the pelvic cavity, including the bladder and bowel. If there's enough scar tissue, it can even bind organs together. It's less common.
• Abdominal wall endometriosis: It's rare, but endometrial tissue can spread into the abdominal wall. The abdominal wall is the layer of muscles, fat, and connective tissue that contains the stomach and intestines. This type of endometriosis may occur after abdominal surgery, as the endometrial cells bond to an incision.

The women's health experts at Carilion will listen to you about your symptoms. Endometriosis has no cure, but we offer many treatments to ease its symptoms.

Your treatment will depend on the type and severity of your endometriosis and whether you’re trying to get pregnant. Your doctor will review your options with you and help choose the best treatment for your needs.

Hormone therapy

If you're not trying to get pregnant, your doctor may suggest hormonal birth control as the first step in treating endometriosis. Hormonal birth control can help stop bleeding and reduce pain. 

With extended-cycle birth control, you only have a few periods a year. With continuous cycle birth control, you have no periods. These methods of hormonal birth control are available in a pill, shot, implant, or intrauterine device. 

If you're trying to get pregnant, drugs called gonadotropin-releasing hormone (GnRH) agonists may help. GnRH stops the hormones that control ovulation, the menstrual cycle and the growth of endometriosis tissue. When you stop taking it, your cycle returns, and you have a better chance of getting pregnant.

Pain medicine

In addition to suppressing your period to control pain, your doctor may suggest other medications for pain relief, such as ibuprofen (Motrin, Advil), naproxen (Aleve), or mefenamic acid. There are other secondary pain medications if more pain control is needed.

Surgery

If hormone treatments and pain medicine don't provide relief, you may need surgery. Surgical procedures remove the patches of endometriosis tissue. 

Endometriosis surgery is minimally invasive. Most people go home the same day. Minimally invasive surgery means smaller incisions and quicker recovery time. We get you back to living your life to the fullest.

If your endometriosis is severe, you may consider a hysterectomy to remove your uterus.