In this installment of our Medical Myths series, we examine some common misconceptions surrounding endometriosis. These include myths about causes and treatment options, as well as other aspects of the condition.
In our Medical Myths series, we approach medical misinformation head on. Using expert insight and peer reviewed research to wrestle fact from fiction, MNT brings clarity to the myth riddled world of health journalism.
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Endometriosis is a chronic condition in which tissue similar to that usually lining the inside of the uterus grows outside the womb. This condition can cause pain during periods, sexual intercourse, and urination or bowel movements. It can also be responsible for other symptoms, including nausea, fatigue, and mental health concerns.
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Sometimes, depending on the tissue’s location, it can cause problems with fertility. Moreover, endometriosis can occur in or around other organs, including the lungs.
Worldwide, approximately 10% of females of reproductive age have endometriosis. Although extremely rare, endometriosis in males can occur. Furthermore, because endometriosis symptoms are so varied, people with the condition often experience a delay in diagnosis.
Risk factors for endometriosis include having a mother, sibling, or daughter with the condition, having periods that began before age 11, or having periods that are heavy or last longer than 7 days. Having a history of short monthly cycles of fewer than 27 days can also increase the risk of endometriosis in some individuals.
Confirming an endometriosis diagnosis often involves laparoscopic surgery, a common surgical procedure done under anesthesia. Once a doctor confirms a diagnosis, treatments include managing the symptoms with hormone therapy or pain relief medication. If the pain associated with endometriosis is severe or if fertility has become affected, surgery is an option. However, there is currently no known cure for the condition.
Despite these known facts, many myths surround endometriosis, leaving many people confused about what to believe.
To help separate fact from fiction, we talked with Dr. Barbara Stegmann, clinical lead, Woman’s Health at Organon and OB-GYN, and Carly King, N.D., licensed naturopathic doctor at Entrepreneur and The Health Centre Integrative Therapies.
We also looked at recent peer-reviewed research to reveal the science-backed truths about endometriosis.
1. Periods are normally very heavy, very painful, or both
Although estimates suggest that more than half of all menstruating females experience some pain during periods, severe pain can sometimes indicate the presence of endometriosis.
Dr. King told Medical News Today:
“Periods can be heavy and painful with endometriosis, but it’s not always the case. Pain can show up in other areas, such as with bowel pain, urinary pain, ovulation pain, as well as pain in other areas of the body. Period bleeds can vary in volume — cycle lengths can also vary, with midcycle bleeding a potential symptom as well.”
Dr. Stegmann added:
“Periods are normally very heavy/very painful — this is only a partial myth. Some people do have very heavy, very painful periods, but that is only one end of the spectrum. Some have mild cramps and light periods, and some have pain between periods. So, it is best to speak to [a healthcare professional] if you have concerns.”
2. Pregnancy can cure endometriosis
“Pregnancy does not cure endometriosis,” Dr. King told MNT. “Some women see improvements in symptoms during pregnancy, although others do not, and still others may see a worsening of symptoms,” she added.
Dr. Stegmann also emphasized that “[t]here are no cures for endometriosis.” Still, she explained that pregnancy does cause hormone levels to change. This variation in hormones may result in people experiencing different pain levels after having a baby.
Research also suggests that pregnancy does not seem to offer benefits for women with endometriosis. In addition, scientists note that although some endometriosis lesions show regression, others remain stable or increase.
3. A hysterectomy can cure endometriosis
According to one study involving 137 female participants with endometriosis who underwent a hysterectomy, 84% of the participants were satisfied with the results after surgery.
However, while “[a] hysterectomy can relieve symptoms of endometriosis for many people, […] the condition can recur after the surgery,” Dr. King noted.
“Symptoms can also continue if there are endometrial lesions still present outside of the uterus,” she added.
“Endometriosis responds to estrogen, which is made by the ovaries. A hysterectomy typically removes the uterus versus the ovaries and therefore wouldn’t cure endometriosis,” Dr. Stegmann further explained.
“There are different types of endometriosis, from lesions that are just on the surface to those that invade into the bowel and other organs. That type is called deep infiltrating endometriosis, or DIE. Those lesions will likely not improve even if you have your ovaries removed or your hormones suppressed,” she continued.
4. Endometriosis only affects the female reproductive organs
“Endometriosis lesions are most commonly found in the pelvis and lower abdomen,” Dr. King told MNT. “However, they can develop anywhere in the body,” she noted.
Dr. Stegmann explained further:
“Actually, most endometriosis does not affect the reproductive organs but implants on the inside of your abdomen on a surface called the peritoneum. That is what causes pain. But endometriosis can be found just about anywhere and has been seen in the lining of the lung and even in the brain, where it causes seizures when the woman has a period.”
“Fortunately, this does not occur very often, and your [healthcare professional] should be able to help watch for signs or symptoms of implants [located in] other places,” she continued.
Still, a 2017 study in mice that investigated the potential for endometrial-derived cells to migrate to other organs of the body suggests that endometriosis in locations distant from the pelvis may be more common than previously recognized.
5. Endometriosis always causes pain
Study data suggest that more than 60% of females with an endometriosis diagnosis report chronic pelvic pain. Moreover, people with endometriosis are 13 times more likely to have abdominal pain than those without the condition.
Still, Dr. King notes that despite pain being a common symptom, it is possible to receive a diagnosis of endometriosis even if a person is not experiencing any pain.
Dr. Stegmann added: “Some people with mild forms of endometriosis have excruciating pain, and some people with DIE have little or no pain at all. We think this may be related to whether the implant releases certain pain-causing chemicals, as well as where the implant occurs. In fact, some people never know they have really advanced endometriosis until they have […] abdominal surgery.”
6. Menopause stops endometriosis
Although research is limited, scientists estimate that 2–5% of females have postmenopausal endometriosis.
Dr. King told MNT:
“Endometriosis doesn’t necessarily end when you’re in menopause. In fact, the condition can develop years after your periods stop.”
Dr. Stegmann explained, “For the same reason that a hysterectomy doesn’t always cure endometriosis, menopause may not cure it either.”
She suggested that if endometriosis-related pain does not stop after menopause, it is best to consult a healthcare professional about pain management options.
7. Endometriosis equals infertility
Studies suggest that 30–50% of females with endometriosis also experience difficulty becoming pregnant. Still, Dr. King noted that despite statistics linking the condition to fertility challenges, “endometriosis does not automatically mean a diagnosis of infertility.”
Dr. Stegmann agreed:
“I have had patients with [severe] endometriosis that become pregnant and those with mild endometriosis that do have issues. The only way to know if you will have problems with getting pregnant is to try. Just make sure you work with your [healthcare professional], since many of the medications used to treat endometriosis prevent pregnancy and will need to be stopped for you to be successful.”
8. Abortion causes endometriosis
The myth that abortion causes endometriosis may have surfaced due to abortion-related political debate. However, this is not a fact-based claim.
Dr. King told MNT: “While the exact cause of endometriosis is still unknown, there does appear to be a genetic link. There is no evidence that abortion causes endometriosis.”
When asked whether having an abortion could cause endometriosis, Dr. Stegmann was clear:
“Absolutely not. There is no association between abortion and endometriosis.”
9. Birth control pills can cure endometriosis
Although Dr. King noted that birth control pills do not cure endometriosis, “they may help reduce symptoms due to suppression of ovulation and menses,” she explained.
“Nothing cures endometriosis,” Dr. Stegmann reiterated. “But birth control pills do treat endometriosis by leveling out your hormones and preventing you from bleeding. So, they are a good treatment, but not a cure,” she explained.
Other medications used to treat endometriosis include pain relievers, such as nonsteroidal anti-inflammatory drugs.
Additionally, in 2018, the Food and Drug Administration (FDA) approved a gonadotropin-releasing hormone antagonist, a medication to help treat the pain associated with endometriosis.
10. High estrogen levels cause endometriosis
Debunking this myth, Dr. King said: “High estrogen levels have not been shown to cause endometriosis. However, estrogen-blocking medications can help relieve symptoms.”
Additionally, research suggests that although high estrogen levels may not cause endometriosis, estrogen and its receptors may play a role in the processes that scientists associate with the condition.
Still, a 2022 study notes that preventing or treating endometriosis may also involve therapies that target immune system activity.
The scientists who conducted the study found evidence suggesting that the activation of specific white blood cells may result in chronic inflammation and may contribute to the development of the condition.
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