WHO IS AFFECTED?
Endometriosis, endo for short, is a chronic condition primarily linked to a woman’s menstrual cycle, albeit men are reported to be affected as well. 
Any woman can be affected, although it is commonly found in women in their mid-20s to 40s. You are more likely to have endometriosis if:
- you have relatives with endometriosis;
- you have never given birth; and/or
- you have issues with your menstrual cycle (short cycle, periods lasting more than 7 days, or you have a condition that prevents the normal flow of menstrual blood during your period). 
WHAT ARE THE SYMPTOMS?
Women with endo may share some or all of the following symptoms:
- painful menstrual cramps, chronic pain in the lower back and pelvis, pain during or after sex, intestinal pain, and painful bowel movements;
- bleeding or spotting in between periods;
- infertility: having difficulty becoming pregnant; and/or
- stomach (digestive) problems. 
HOW DOES IT WORK?
Unfortunately, doctors do not have an answer to what causes endometriosis or even how it is treated.
We do know endometriosis occurs when tissues similar to the lining of the uterus, called endometrium, grow outside the womb and are primarily found on the ovaries, bowel and pelvic area.  Doctors believe the endometrium travel outside the womb through a process called retrograde menstruation, when the menstrual blood flows back through the fallopian tubes into the pelvic cavity instead of out of the body.  It is also theorised that the hormone oestrogen promotes endometriosis. 
When the endometrium transports to other areas of the body, this is known as an endometrial implant.  In rare occasions, endometrium can appear in the skin, lungs and brain.  When the tissues grow on the ovaries, it is called an endometrioma, also known as a chocolate cyst.  The nickname comes from the colour and consistency of the trapped blood that fills the cyst, which resembles chocolate.
WHAT ARE THE EFFECTS?
Endometrial cysts (tumors/growths) are benign, meaning non-cancerous, but they can become problematic for some women. The endometrium continues to thicken, break down and bleed as it normally would during the menstrual cycle.  However, the tissues become trapped, as there is no escape.  This may cause pain and swelling, as well as pain from adhesions (internal scar tissue) which can bind internal organs.  The growths may also expand, blocking the fallopian tubes, cover or grow in the ovaries, or cause problems in the intestine or bladder. 
ARE THERE ANY COMPLICATIONS?
In addition to pain, endometriosis can lead to health complications, such as infertility. Half of women who are infertile are affected by endometriosis.  Moreover, according to the Mayo Clinic, ovarian cancer occurs at a higher rate in women with endometriosis, however, the overall lifetime risk of ovarian cancer is low to begin with.  Another rare type of cancer, adenocarcinoma, can also develop in women with endometriosis. 
HOW IS IT DIAGNOSED?
Doctors can diagnose endometriosis through the following ways:
- a pelvic exam;
- capturing images of the reproductive organs using ultrasound or MRI; and/or
- laparoscopy: insertion of a camera through the belly button to look inside the pelvic area. 
Unfortunately, the results from a pelvic exam and imaging tests are not that reliable, sometimes leaving many women undiagnosed or misdiagnosed. The gold standard for diagnosis is via laparoscopy.
IS THERE ANY RELIEF?
If your doctor confirms endometriosis, they may prescribe hormonal oral contraception to reduce the pain during menstruation, or a gonadotropin releasing hormone (GnRH) agonist to block the menstrual cycle and lower the amount of oestrogen in the body, which may help relieve pelvic pain.  Depending on the severity of pain, your doctor may also advise to remove any cyst(s) through laparoscopic surgery, or even undergo a hysterectomy, although a hysterectomy alone may not result in relief as the endo may have travelled elsewhere. There are even holistic treatments available, such as acupuncture, which resolves pain by promoting the uterine blood to flow freely.
Many women who are able to become pregnant report relief from endo pains after delivery due to the release of oestogen. In addition, most menopausal women experience reduced pains, as the body stops making oestrogen at this stage. 
On that note, if you are afraid of surgery, are staying clear of medication, or weary of holistic treatments; either hope for menopause to come sooner rather than later, or get to making babies, ladies! (Just kidding…)
If you read this post and believe you may have endo, or are looking for alternative treatments for your endo, I highly recommend for you to contact your family doctor.
You may also wish to read the following resources, which I cited throughout this post for further information, or as a guide to help plan how to discuss endo with your physician:
The information published in this post was intended for informational and educational purposes only. Nothing in the content should be considered, or used as a substitute for medical advice, diagnosis, or treatment. Consult your physician regarding the applicability of any opinions or recommendations with respect to your symptoms or medical condition.