What Every Woman Should Know About Endometriosis

July 16, 2023
Lisa P. Otey, MD

The Endometrium

The inner lining of the uterus consists of a particular type of tissue called endometrium. When the endometrial tissue grows outside the uterus this is called endometriosis.

The inner lining of the uterus reacts to the woman’s menstrual cycle. This cycle is about 28 days. What happens is that the endometrium develops and thickens in preparation for pregnancy. If pregnancy does not happen, the endometrium is discarded off by bleeding. This monthly phenomenon is triggered by the hormones progesterone and estrogen.

The Endometriosis

Endometriosis is when endometrial tissue is found not in the inner part of the uterus but in other parts of the body. Even if it is found outside the uterus, this endometrial tissue acts and looks like a tissue in the inner lining of the uterus. Your Houston Gynecologist can help diagnose and treat this condition as this is one of the more common conditions they see. They mostly appear in these areas:

  • Surface of the uterus
  • Fallopian tubes
  • Ovaries
  • Bladder and ureters
  • Bowel
  • Rectum
  • Cul-de-sac (the area behind the uterus)

This endometrial tissue may develop on the organs in the pelvis or in the peritoneum. It can also develop in the tissue that lines the inside of the abdomen and pelvis. In exceptional cases, the endometrial tissue may be found in other areas of the body. When the endometrial tissue develops in the ovaries it may result in a cyst which is called an endometrioma.

Like the endometrial tissue that grows in the inner lining of the uterus, the endometrial tissue found outside the uterus reacts to the woman’s menstrual cycle. Those found outside are shed off and bleed like those found in the inner lining of the uterus during the woman’s menstrual cycle. The shedding and bleeding of this tissue outside the uterus every month can result to scar tissue, also known as adhesions. These adhesions or scarring can be painful. In some instances, the adhesions bind the organs together. Endometriosis can also be a cause of infertility.

Through time, the symptoms of the endometriosis generally worsen. In most cases, treatment may keep the condition from becoming worse.


No one is really sure about the cause or origin of endometriosis. In most women, during their menstruation, a small amount of blood cells flow through the fallopian tubes and into the abdomen. In women with the condition endometriosis, during their periods, rather than flowing through the fallopian tubes, the cells in the blood attach themselves to other areas and grow there. The endometrial cells may also be transported to other areas of the body via lymph and blood vessels.

Who are at risk?

The condition endometriosis is common in women aged 30-40. However, this condition can happen in women of whatever age who menstruate. Among women who menstruate, this condition usually occurs on women who had never had children. Family background plays an important role in this condition. Women with mother, sister or daughter with endometriosis are more likely to have this condition. In close to three quarters of women with chronic pelvic pain, endometriosis is found.


  • Pelvic Pain
  • Pain may happen during urination, bowel movements, pain with sex or just before or during your menstrual cycle
  • Menstrual bleeding may happen more than once every month
  • Infertility

The above-mentioned symptoms may be indicators of endometriosis. However, they could also be indicators of other health problems. If any of this symptom is manifesting, visit your Houston Gynecologist.

The level of pain is not an indicator of the severity of the condition. In some women, the slight pain may be a severe condition; while in some women, the severe pain may be a mild condition. Other women, meanwhile, do not feel any pain at all or experience none of the symptoms. Some women only found out they have endometriosis if they found out that they cannot have children as endometriosis is prevalent among infertile women. This condition is found in one third of women who are infertile.


If there are indicators that you have endometriosis, your doctor may conduct a physical examination on you, including the pelvic exam. In some instances, your doctor may treat your endometriosis without conducting any further examinations or surgery when other causes of pelvic pain can be ruled out. This condition can be mild, moderate or severe. The magnitude of this condition can be determined by looking straight inside the body through laparoscopy. If during laparoscopy endometrial tissue is found, your doctor may also decide to remove it immediately. This procedure requires a general anesthesia.


The treatment of endometriosis depends on the extent of the condition – on whether the condition is mild, moderate or severe. Treatment also depends on whether you want to have children or not. The treatment can be through medication, surgery or the combination of the two. The two treatments may relieve infertility and pain for a time but symptoms may return after treatments.

Contact us by phone or web to make a same day appointment to discuss your specific needs. We’re always happy to hear from you!