What Is Endometriosis And What Are The Causes & Risk Factors?

Endometriosis: What Is It And What Are The Causes? - DoctorOnCall

Endometriosis is a condition often experienced by women regardless of age that occurs due to various factors. Many people may have heard about it but maybe not be too sure about the exact meaning of endometriosis and what endometriosis is. The disease happens when the tissue that is supposed to be inside the uterine wall grows on the outer parts or other organs outside of the uterus. Although this tissue may grow on the outer parts of the uterine, the menstrual process can exist as usual but it can cause severe pain and affect the fertility rate of women and their chances of getting pregnant. If left untreated, the growing tissue has the potential to rupture and eventually cause heavy bleeding and other complications.

What Is Endometriosis?

The term endometriosis can be defined as a condition in which the endometrial lining grows abnormally on the outer part of the uterine wall namely ectopic for example it can grow on the ovaries, fallopian tubes, posterior muscle ligaments, or the pelvic part i.e. joints and intestines and results in severe menstrual pain, abnormal bleeding either too much or too little and often correlated with pain at the lower abdomen or around the pelvic area.

It is estimated that 10 to 15 percent of women suffer from this disease each year. Unfortunately, most of them do not get an early diagnosis related to the disease and often realized it when it is in the chronic stage, hence affecting their quality of life. An endometriosis cyst or ovarian cyst is a condition in which a lump of tissue grows inside of the ovary either one or both parts which are known as endometrioma. This tissue can grow as small as 2 inches which are multiple in size and has the potential to grow larger until 8 inches. Therefore, it is important to seek medical treatment either through medication or surgery to remove the cyst depending on the patient's condition.

In contrast, adenomyosis is a condition in which endometrial tissue grows on the muscles of the uterus. Most women are often unaware they are suffering from adenomyosis because the disease rarely shows the presence of symptoms. It is estimated that about 25-65 percent of women suffer from this disease yearly and the number keeps on increasing.

Causes of Endometriosis

To date, there is no exact answer regarding the factors that cause endometriosis. Yet most of the researchers can only estimate based on theoretical facts. Among the possible occurrence of endometriosis are as follows:


1. Retrograde menstruation

Retrograde menstruation is among the old theories adopted to date and it is said that 90% of these studies are reliable. This condition occurs when the menstrual blood that is supposed to flow out of the uterus through the vaginal instead re-enters the fallopian tube back and then goes into the pelvic space. This condition is normal for most women but frequent backward blood flows leads to the occurrence of endometriosis and can cause other health issues.


2. Immune system disturbance

A weakened immune system often gives rise to other various health problems. A healthy immune system is able to identify if there are any abnormalities that happen in the cell and immediately produce an enzyme to engulf and destroy any pathogens, viruses, or bacteria inside the body but a person with immunocompromised is unable to produce effective enzymes and thus fails to destroy the endometrial tissue that grows outside of the uterus. Therefore, it is important to consume nutritional foods because a balanced diet can enhance the ability of the immune system to fight against diseases.


3. Post-surgery risk factor

Certain women who had undergone surgery have a high risk to develop endometriosis, especially women who had a history of several times surgery through cesarean or hysterectomy. Cesarean section is likely to injure the lining of the endometrium cell and the effect of the wounds causes them to stick to each other and move out of the uterus area.


4. Unstable hormones

The unstable hormone is a potential contributor to endometriosis. The production of estrogen and progesterone hormones must be regulated at balanced levels to ensure the women's reproductive system is able to function properly. If there is an imbalance in these hormones, apart from endometriosis, women's reproductive system may be affected as it may cause abnormal blood flow, PMS, PCOS, fibroids, fatigue, and in turn resulting in mental problems such as anxiety and depression. Estradiol is a type of estrogen hormone that acts to regulate the tissues in the uterus. If someone suffers from endometriosis, an increase in the level of this hormone at a high rate may trigger chronic inflammation and pain. On the contrary, pregnant women with endometriosis find that symptom such as pain is reduced due to increased levels of progesterone hormone which is involved in controlling the reproductive system while pregnant.


5. Genetic factor

A person who has a family history of endometriosis is also more likely to get endometriosis because genetics is one of the biggest factors contributing to many diseases in humans. In addition, women who give birth at a later age also have the potential to develop endometriosis.


Risk Factors for Endometriosis


  1. Women who have never given birth are said to be at risk for endometriosis because the production of hormones during pregnancy and childbirth can protect a person from getting chronic diseases including cancer.

  2. Someone who experiences menstruation at an early age under 12 is at higher risk.

  3. Women who go through menopause at a later age also have the potential to develop endometriosis, which is associated with metaplasia, a situation in which cells change to abnormal shapes in tissues that are commonly found.

  4. Individuals who have a short or too long menstrual cycle for more than 7 days also contribute to endometriosis.

For more information, please contact your doctor or pharmacist.

The information provided is for information purposes only and is not meant to be a substitute for the advice of a registered medical practitioner. This information should not be used for diagnosing health problems or for self-medication. Bayer Co (Malaysia) Sdn Bhd shall not be responsible for any damages or losses arising out of access to or use of information provided.


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Written By Yasmin Yusuf, Bachelor of Science (Hons) Cell and Molecular Biology, University of Putra Malaysia on

Reviewed By DoctorOnCall Panel Doctor