The Endometriosis Center

Frequently Asked Questions

What is endometriosis?

Endometriosis occurs when cells similar to the lining of the uterus, known as the endometrium, spread into the pelvis or other areas of the body.

This abnormal tissue irritates the surrounding tissue in different organs, causing inflammation, pain, bleeding, scar tissue (adhesions), infertility and other issues that can severely impact your quality of life.


Endometriosis most frequently affects the:

  • reproductive system (uterus, fallopian tubes, ovaries, vagina, for example)
  • bladder and ureter
  • rectum and bowels
  • pelvic wall and nerves

It can also affect:

  • the diaphragm
  • the abdominal wall
  • the liver
  • the major blood vessels
  • other vital structures and organs (such as lungs, brain, eyes) to a lesser extent

While there is no cure for endometriosis, timely diagnosis and expert treatment from endometriosis specialists can:

  • alleviate symptoms
  • preserve fertility
  • relieve pain
  • stop the disease from progressing

The cause of endometriosis is not yet known. Our researchers continue to provide new insights into the factors that contribute to endometriosis, advancing the understanding and treatment of this painful, chronic condition.

Any woman (or person identified as female at birth) old enough to have menstrual periods can get endometriosis. It’s especially common among women ages 25–40, affecting millions of American women.

Women with a family history of endometriosis (such as a mother, aunt or sister) are at greater risk. Other risk factors include:

  • A history of pelvic infection
  • Any medical condition that prevents the normal passage of menstrual flow
  • Having never given birth
  • Long periods or short, frequent menstrual cycles
  • Painful periods
  • Starting menstruation at an early age

In rare cases, endometriosis can also be found in those without a uterus or ovaries or even during menopause.

Severe, debilitating pain is the most common symptom of endometriosis. The recurrence of symptoms with the menstrual cycle in the early stages of the disease is common, but any severe pelvic pain should be investigated. Other signs and symptoms include:

  • Change in urinary frequency or urgency
  • Bleeding between periods
  • Excessive bleeding
  • Fertility issues
  • Gastrointestinal issues including nausea, bloating, constipation or diarrhea
  • Pain during or after sexual intercourse
  • Pain during urination or bowel movements
  • Painful periods during and outside of the menstrual cycle, including severe cramps, lower back pain and abdominal pain
  • Severe fatigue

Symptoms and their frequency vary for each patient. There is no clear correlation between the stage of the disease and the severity of pain or infertility.

Many women with endometriosis have no symptoms. The condition may go undiagnosed until a woman has difficulty getting pregnant. Endometriosis is a common cause of previously unexplained infertility.

Women with endometriosis suffer for 10 years, on average, before receiving an accurate diagnosis and treatment.

To avoid diagnostic delays, seeking help from an endometriosis specialist experienced in the evaluation, diagnosis and treatment of this complex condition is crucial. Our endometriosis experts provide timely, accurate diagnoses that can help:

  • Prevent years of unnecessary pain and suffering
  • Stop the progression of your disease
  • Preserve fertility when needed and possible

Diagnostic tools include:

  • A detailed medical history and thorough discussion of your symptoms
  • A physical exam, including a pelvic exam
  • Pelvic ultrasound and special MRI imaging — an “endometriosis MRI” — to view the reproductive organs and rule out other causes

Currently, the only way to definitively confirm endometriosis is through robotic/laparoscopic surgery and a biopsy.

  • Robotic surgery/laparoscopy is a minimally invasive procedure in which a thin tube with a camera on the end (laparoscope) is inserted through a small incision in the abdomen or the vagina to look for signs of endometriosis.
  • A biopsy is a small tissue sample removed during laparoscopy and examined under a microscope by a pathologist to confirm the presence of endometriosis.

Our minimally invasive gynecologic surgeons have the refined skills and the experience required to expertly perform these types of procedures. Treatment can be performed simultaneously, when needed.

Currently, no cure for endometriosis exists. However, many available treatment options are available to alleviate your pain, improve fertility and restore quality of life. Treatment is tailored around your specific symptoms, severity of disease and personal preferences.

To provide the best possible relief of your symptoms, our treatment strategies include medical management, surgery and a multidisciplinary approach that addresses all aspects of your health impacted by endometriosis.

Medical management

  • Pain medications include over-the-counter nonsteroidal anti-inflammatory drugs and prescription painkillers.
  • Hormone therapies relieve pain, shrink or slow the growth of endometrial tissue, and prevent new growth by controlling or preventing the menstrual cycle. Suppression medications may be used before and after surgery, as needed.


Surgery may be performed using a minimally invasive robotic or laparoscopic approach or through traditional abdominal surgery, when necessary.

  • Excision surgery involves cutting out endometrial tissue while preserving the affected organs and surrounding structures. Robotic or laparoscopic excision surgery is considered the gold standard in endometriosis treatment. Our board-certified, fellowship-trained minimally invasive gynecologic surgeons are known for their expertise in performing these meticulous procedures.
  • Hysterectomy with or without removal of the ovaries may be considered in cases of severe pain with adenomyosis that isn’t responding to other treatments. This is a last resort treatment for women in their reproductive years. A hormonal therapy might be needed after surgery in case of bilateral removal of the ovaries.

To make an appointment with The Endometriosis Center at Texas Children’s Pavilion for Women, call 832-826-7500.