What is Endometriosis

Endometriosis is a chronic, often painful condition in which tissue similar to the lining of the uterus grows outside it. Our Los Angeles specialists diagnose and treat it at every stage, including deep disease outside the pelvis.

While it most often affects the ovaries, fallopian tubes, and pelvic lining, endometriosis can also involve the bladder, intestines, diaphragm, and in rare cases, even the lungs.

— Our Process

Understanding What Causes Endometriosis

Despite how common it is, the cause of endometriosis is still not fully understood. There are several leading theories, and it’s likely that multiple factors contribute:

01 Retrograde menstruation

where menstrual blood flows backward into the pelvic cavity instead of out of the body.

02 Coelomic metaplasia

in which cells in the pelvic lining transform into endometrial-like tissue.

03 Stem cell or immune system involvement

where tissue may spread through blood or lymphatic systems, or the immune system fails to clear stray endometrial cells.

04 Genetic factors

as endometriosis tends to run in families.

05 Environmental triggers

such as hormone-disrupting chemicals, which may influence disease development.

Endometriosis isn’t caused by anything a person did, and it can affect anyone with a uterus, regardless of lifestyle or health history.

—Silent Struggle —

Who It Affects and Why It’s Often Missed

Endometriosis affects an estimated 1 in 10 women and people assigned female at birth during their reproductive years—roughly 176 million people globally. Symptoms can begin with the first period and continue until menopause.

Despite being so common, many individuals face long delays in diagnosis—sometimes 7 to 12 years. This is partly because symptoms can mimic other conditions, and because society often minimizes or normalizes menstrual pain.

A lack of awareness among both patients and healthcare providers contributes to this delay. There’s also no single blood test or imaging scan that can definitively diagnose endometriosis, which means many go undiagnosed or misdiagnosed for years.

Recognizing the Symptoms

Endometriosis can look different from person to person. Some experience debilitating symptoms, while others may have no symptoms at all. Common signs include:

Severe pelvic pain, especially before and during menstruation
Pain during sex, particularly with deep penetration
Painful bowel movements or urination, often cyclical
Chronic fatigue and low-grade inflammation
Bloating, constipation, or diarrhea
Painful ovulation
Infertility or difficulty conceiving
Shoulder or chest pain, if the diaphragm or lungs are involved

Over time, these symptoms can go from cyclical to constant. For many people, it’s not just “bad periods”—it’s a daily battle with pain, fatigue, and uncertainty.

How It Impacts Daily Life

Endometriosis can be physically and emotionally draining. It affects far more than just reproductive health:

It can interfere with work or school due to frequent pain flares or medical appointments.
Intimacy may be painful or impossible, straining relationships and self-confidence.
Digestive symptoms may mimic conditions like IBS but don’t improve with diet or typical GI treatments.
Fatigue, hormonal side effects, and isolation can contribute to anxiety and depression.

In more advanced cases, endometriosis may involve the bowel, bladder, or other organs, leading to structural damage, adhesions, or even emergency complications.

How It’s Diagnosed

Diagnosis is challenging. While ultrasounds and MRIs can sometimes detect ovarian cysts (endometriomas) or deep lesions, they often miss mild to moderate disease. A definitive diagnosis typically requires laparoscopy, a minimally invasive surgery that allows direct visualization and biopsy of lesions.

Staging (I–IV) is used to describe how widespread the disease is, but does not always reflect the level of pain or symptoms. For example, someone with Stage I endo might have severe pain, while someone with Stage IV may have little discomfort.

— Therapy Choices —

Treatment Options

There’s no cure for endometriosis, but there are effective ways to manage the symptoms. Treatment depends on the severity of symptoms, desire for future fertility, and how the disease affects other organs.

Medical Management

First-line treatments often include:

These treatments may reduce symptoms temporarily, but they do not eliminate lesions or stop the disease from progressing in many cases.

Surgical Management

Surgery is often recommended when:

The most effective approach is laparoscopic excision surgery, where endometriosis is cut out rather than burned off. This allows for complete removal of the disease with a lower risk of recurrence.

At the Comprehensive Endometriosis Institute, our team performs advanced laparoscopic and robotic excision surgeries, including for complex cases involving:

In some cases, a multidisciplinary approach is needed, involving colorectal surgeons, urologists, or thoracic surgeons to safely remove disease from multiple organ systems.

— Surgical Intervention

Living With Endometriosis: When Surgery Is Needed

For some, endometriosis is manageable with medical therapies and lifestyle changes. But for others, it reaches a point where surgery is the only option that can provide lasting relief.

You may be a candidate for surgery if:

Pain interferes with your ability to work, study, or function daily
Sex is consistently painful
You’ve tried multiple medications with no improvement
You're experiencing bowel or bladder complications
You’ve been diagnosed with endometriomas or deeply infiltrating disease
You’re struggling with infertility

Endometriosis that disrupts your life deserves to be taken seriously. You shouldn’t have to settle for a life of pain, failed treatments, or being told “it’s just part of being a woman.”

At the Comprehensive Endometriosis Institute, we see you, we believe you—and we specialize in the kind of surgical care that can change your life.

Final Thoughts

Endometriosis is a whole-body disease that affects far more than the uterus. It’s complex, misunderstood, and too often dismissed. But it’s also manageable—with the right team, the right diagnosis, and the right treatment plan.

Whether you’re just beginning to explore what’s causing your symptoms, or you’re looking for answers after years of pain, you’re not alone. We’re here to help you take the next step toward understanding, relief, and long-term healing.

If you’re living with severe endometriosis and ready to explore your surgical options, we’re here to support you every step of the way.