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March is Endometriosis Awareness Month

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March is recognized as Endometriosis Awareness Month. Endometriosis affects more than 11% of women between the ages of 15-44 in the United States. It is defined as a disorder in which tissue similar to the tissue that forms the lining of your uterus, the endometrium, grows outside of your uterine cavity. Endometriosis most commonly involves your ovaries, fallopian tubes and the tissue lining your pelvis. It can oftentimes go undiagnosed for years and might go unnoticed until a woman starts trying to conceive. 


Endometriosis can cause pain in the pelvic region, often during menstruation. Many women experience cramping and uncomfortable bloating during their periods, but women with endometriosis can experience far worse period pain. It’s possible that it can worsen with time as well.

According to the Mayo Clinic, common symptoms and signs of endometriosis can include:  

  • Painful periods (dysmenorrhea). Pelvic pain and cramping may begin before and extend several days into a menstrual period. You may also have lower back and abdominal pain.
  • Pain with intercourse. Pain during or after sex is common with endometriosis.
  • Pain with bowel movements or urination. You’re most likely to experience these symptoms during a menstrual period.
  • Excessive bleeding. You may experience occasional heavy menstrual periods or bleeding between periods (intermenstrual bleeding).
  • Infertility. Sometimes, endometriosis is first diagnosed in those seeking treatment for infertility.
  • Other signs and symptoms. You may experience fatigue, diarrhea, constipation, bloating or nausea, especially during menstrual periods.

The Mayo Clinic also notes that, “the severity of your pain isn’t necessarily a reliable indicator of the extent of the condition. You could have mild endometriosis with severe pain, or you could have advanced endometriosis with little or no pain.”


Although the exact cause of endometriosis is not certain, the Mayo Clinic lists possible explanations:

  • Retrograde menstruation. Retrograde menstruation causes menstrual blood containing endometrial cells to flow back through the fallopian tubes and into the pelvic cavity instead of out of the body. The endometrial cells stick to the pelvic walls and surfaces of pelvic organs, where they grow and continue to thicken and bleed over the course of each cycle.
  • Transformation of peritoneal cells. This means that hormones or immune factors promote the transformation of peritoneal cells, cells that line the inner side of your abdomen, into endometrial-like cells.
  • Embryonic cell transformation. Hormones such as estrogen may transform embryonic cells, cells in the earliest stages of development, into endometrial-like cell implants during puberty.
  • Surgical scar implantation. After a surgery, such as a hysterectomy or C-section, endometrial cells may attach to a surgical incision.
  • Endometrial cell transport. The blood vessels or tissue fluid (lymphatic) system may transport endometrial cells to other parts of the body.
  • Immune system disorder. A problem with the immune system may make the body unable to recognize and destroy endometrial-like tissue that’s growing outside the uterus.


Endometriosis symptoms can cause disruptions in day-to-day life if left unaddressed. While endometriosis has no cure, its symptoms can be managed and can help reduce complications. 

  • Pain Medication
  • Hormonal Contraceptives
  • Hormone Therapy
  • Surgery

Talk to A Midwife

At City of Oaks Midwifery, our certified nurse-midwives (CNMs) offer full-scope midwifery services to women across their lifespan from adolescence through menopause, with a special emphasis on pregnancy, childbirth, and gynecologic and reproductive health. Endometriosis can affect a woman’s reproductive health and can impact daily life. Treatments can help manage pain and fertility issues. 

We are here to support you and answer your questions every step of the way. If you have any questions about endometriosis or fertility health, we are here to help. Call (919) 351-8253 to make an appointment at our Raleigh, NC midwifery practice.


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