
Endometriosis Uncovered: Exploring Causes, Symptoms, and Treatment Options
Endometriosis is a chronic medical condition in which tissue similar to the lining of the uterus (endometrium) grows outside the uterus, leading to a variety of symptoms and complications.
It is a debilitating condition that affects millions of women worldwide, including a significant number in Australia. The condition can cause severe pain, particularly during menstruation, and may lead to fertility issues.
What is Endometriosis?
Endometriosis occurs when tissue that normally lines the inside of the uterus (the endometrium) is found in other areas of the body, such as the ovaries, fallopian tubes, or the tissue lining the pelvis. In rare cases, this tissue can spread beyond the pelvic organs.
Similar to normal endometrial tissue, this displaced tissue thickens, breaks down, and bleeds with each menstrual cycle. However, because it has no way to exit the body, it becomes trapped, causing inflammation, pain, and the formation of scar tissue.
3 things you might not know about Endometriosis
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It Can Affect Multiple Organs: While endometriosis is commonly found in the pelvic region, it can also occur in other parts of the body, including the lungs, diaphragm, and even the brain. These rare cases of extra pelvic endometriosis can lead to unique symptoms such as chest pain or difficulty breathing, depending on the location of the endometrial tissue.
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Endometriosis is Linked to Autoimmune Disorders: There is evidence suggesting a link between endometriosis and autoimmune diseases such as lupus, rheumatoid arthritis, and thyroid disorders. This connection is thought to be related to underlying immune system dysfunction in women with endometriosis​.
- Endometriosis is Not Just a Reproductive Condition: While endometriosis is primarily associated with reproductive organs, it can cause a wide range of systemic symptoms. These include chronic fatigue, digestive problems (such as irritable bowel syndrome), and even mental health conditions like anxiety and depression. The chronic pain and hormonal imbalances caused by endometriosis can significantly affect a woman’s overall well-being.
The 5 Causes of Endometriosis

The exact cause of endometriosis remains unknown, but several factors are believed to contribute to its development:
1. Retrograde Menstruation
The most widely accepted theory suggests that menstrual blood flows backward through the fallopian tubes and into the pelvic cavity instead of leaving the body. This backward flow allows endometrial-like cells to implant on pelvic organs.
2. Genetic Predisposition
Endometriosis tends to run in families, and women with close relatives (mother, sister, aunt) who have the condition are more likely to develop it themselves
3. Immune System Disorders
Some research suggests that immune system dysfunction may prevent the body from recognising and destroying endometrial-like tissue growing outside the uterus.
4. Environmental Factors
Exposure to toxins in the environment, such as dioxins, may increase the risk of developing endometriosis by disrupting hormonal balance.
5. Hormonal Imbalances
Estrogen plays a key role in the development of endometriosis. High levels of estrogen can promote the growth of endometrial tissue outside the uterus.
Data on Endometriosis in Australia

Endometriosis is a significant public health issue in Australia, affecting around 1 in 9 women by the age of 44, according to the Australian Institute of Health and Welfare (AIHW).
It is estimated that approximately 830,000 Australian women live with endometriosis.
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Age of Onset: Endometriosis often begins in adolescence, with symptoms usually presenting between the ages of 15 and 49. Many women experience delayed diagnosis, with the average time to diagnosis being around 7 to 12 years after the onset of symptoms​.
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Economic Impact: Endometriosis has a significant economic burden on both individuals and the healthcare system. A 2019 report by Ernst & Young estimated that endometriosis costs the Australian economy approximately $7.7 billion annually, primarily due to productivity losses and healthcare costs.
- Fertility Issues: Around 30-50% of women with endometriosis experience fertility issues. The condition can cause inflammation, scarring, and blockages in the reproductive organs, making it difficult for an egg to implant in the uterus
Expert Opinions
Leading Australian experts on endometriosis have highlighted the need for greater awareness and research into the condition.
Professor Jason Abbott, a gynaecologist and expert in endometriosis at the University of New South Wales, notes:
"Endometriosis is a chronic condition that affects women in many aspects of their lives. Early diagnosis is key to managing symptoms, and unfortunately, many women experience delayed diagnosis, leading to unnecessary pain and suffering."
Similarly, Professor Grant Montgomery, a researcher at the University of Queensland, has studied the genetic links to endometriosis. He explains:
"While we have identified some genetic markers associated with endometriosis, there is still much to learn about the interplay between genetics, environment, and hormonal factors in the development of the disease."
Managing Endometriosis
Currently, there is no cure for endometriosis, but there are several treatment options available to manage symptoms:
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Pain Relief: Non-steroidal anti-inflammatory drugs (NSAIDs), such as ibuprofen, are commonly used to relieve pain.
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Hormonal Therapies: Hormonal treatments such as oral contraceptives, progestins, or gonadotropin-releasing hormone (GnRH) agonists are often used to reduce the production of estrogen and control the growth of endometrial tissue.
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Surgery: In more severe cases, laparoscopic surgery can be used to remove or destroy endometrial-like tissue outside the uterus.
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Fertility Treatment: For women experiencing fertility issues, in vitro fertilisation (IVF) may be an option if other treatments are not effective.
- Lifestyle Changes: Some women find relief through lifestyle changes such as dietary modifications, regular exercise, and stress reduction techniques like yoga or meditation.
Endometriosis Treatments
There are several treatment options available to manage symptoms and improve quality of life. The best treatment plan depends on the severity of symptoms, the desire for fertility, and the individual's response to different therapies.
1. Pain Relief
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Non-Steroidal Anti-Inflammatory Drugs (NSAIDs): Medications like ibuprofen or naproxen are commonly used to reduce pain and inflammation associated with endometriosis. These are often the first line of treatment for women with mild to moderate pain​.
- Alternative Medicine:Â Alternative medicine offers several promising options beyond conventional treatments. These therapies aim to manage symptoms like chronic pain, inflammation, and hormonal imbalances.
2. Hormonal Therapy
Hormonal treatments are designed to reduce or stop the production of estrogen, a hormone that fuels the growth of endometrial-like tissue. These therapies are not a cure but help to manage symptoms by preventing further tissue growth.
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Oral Contraceptives: Birth control pills containing both estrogen and progesterone can help regulate hormones and reduce or eliminate menstruation, which in turn reduces the symptoms of endometriosis.
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Progestin Therapy: Progestin-only medications, such as the contraceptive injection Depo-Provera or hormonal intrauterine devices (IUDs) like Mirena, can also suppress the growth of endometrial tissue​.
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GnRH (Gonadotropin-Releasing Hormone) Agonists: These medications (e.g., leuprolide) induce a temporary menopause-like state by significantly lowering estrogen levels, helping to shrink endometrial tissue and relieve pain. However, these can have side effects similar to menopause, such as hot flashes and bone loss​.
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Danazol: This medication suppresses the growth of endometrial-like tissue by lowering estrogen levels and increasing male hormones (androgens). It is effective but can cause undesirable side effects such as weight gain, acne, and voice changes​.Â
3. Fertility Treatments
Endometriosis is a leading cause of infertility, but various fertility treatments can help women conceive.
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Laparoscopic Surgery: As mentioned, surgery to remove endometrial tissue can improve fertility by clearing blockages in the reproductive organs.
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In Vitro Fertilisation (IVF): For women who continue to struggle with infertility, IVF may be recommended. This treatment bypasses many of the issues caused by endometriosis by fertilising the egg outside the body and then implanting it into the uterus​.
4. Lifestyle and Alternative Therapies
Many women with endometriosis find that lifestyle changes and complementary therapies can help manage symptoms in addition to medical treatments.
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Dietary Adjustments: Some evidence suggests that a diet high in omega-3 fatty acids, fruits, and vegetables, while reducing intake of red meat and trans fats, may help manage inflammation and pain.
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Exercise: Regular physical activity can reduce estrogen levels and improve overall well-being, making it a helpful complementary treatment for managing endometriosis symptoms​.
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Acupuncture: Some women find relief from pain through acupuncture, which can help stimulate the body’s natural pain-relief mechanisms.
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Mind-Body Therapies: Techniques such as yoga, meditation, and mindfulness can help reduce the stress and anxiety that often accompany chronic pain conditions like endometriosis​.
Summary
Endometriosis is a complex and often misunderstood condition that affects the lives of millions of women worldwide, including a significant portion of the Australian population. While the causes remain uncertain, ongoing research into genetic, hormonal, and environmental factors continues to shed light on the disease. Early diagnosis and tailored treatment options are critical to improving the quality of life for women with endometriosis.
If you or someone you know is experiencing symptoms of endometriosis, it's important to seek medical advice from a healthcare professional who can provide appropriate diagnostic and treatment options.
References:
- Australian Institute of Health and Welfare (AIHW), Endometriosis Report, 2021
- Ernst & Young, The Economic Impact of Endometriosis in Australia, 2019
- Australian Government, National Action Plan for Endometriosis, 2018