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Endometriosis is a common chronic disorder in women in which tissue similar to the lining of your uterus (the endometrium) spreads outside the uterine cavity.

The endometrial-like tissue thickens, breaks down, and bleeds with every menstrual cycle, and over time, the broken-down tissue has nowhere to go and becomes trapped in the pelvic area. When endometriosis involves the ovaries, cysts called endometriomas may form, surrounding tissue can become irritated, and eventually, scarring can develop, causing pelvic tissues and organs to stick together.

Endometriosis can affect women of any age, including teenagers, and an estimated 10% of women of childbearing age suffer from the condition. While endometriosis most commonly involves the ovaries, fallopian tubes, and the tissue lining the pelvis, in rare cases, endometrial-like tissue may appear outside pelvic organs.

The condition can cause pain — sometimes severe — especially during menstrual periods, in addition to fertility problems. Fortunately, effective treatments are available.


Risk Factors

Endometriosis usually develops several years after the onset of menstruation. Several factors place you at greater risk of developing endometriosis, such as:

  • Having never given birth
  • Periods starting early in life
  • Experiencing menopause later in life
  • Short menstrual cycles
  • Heavy menstrual cycles that last longer than seven days
  • Having higher levels of estrogen in your body or greater lifetime exposure to the estrogen your body produces
  • Family history of endometriosis
  • An illness that prevents the body from releasing blood during menstruation
  • Causes

    While there is no known definitive cause for endometriosis, there are several likely contributing factors:


    Research shows that women with endometriosis have higher estrogen levels, which can affect the endometrial tissue outside the uterus and lead to inflammation and pain.

    Retrograde menstruation

    The flow of blood containing endometrial cells into the pelvic cavity rather than escaping through the fallopian tubes. These endometrial cells stick to the pelvic walls and surfaces of pelvic organs, where they grow and bleed over the course of each menstrual cycle.

    Endometrial cell transport

    Endometrial cells transported by blood vessels or tissue fluid (lymphatic system).

    Surgical scar implantation

    After surgery, such as a hysterectomy or C-section, endometrial cells may adhere to a surgical incision.

    Immune system disorder

    An immune system condition may prevent the body from recognizing and destroying endometrial-like tissue outside the uterus.

    Endometriosis Treatment


    There are many symptoms associated with endometriosis, but the most common is pain, whether intense or mild. However, it is important to note that pain may not be an accurate indicator of your condition’s severity. For example, you could have mild endometriosis with severe pain, or advanced endometriosis with little or no pain. It is not uncommon for endometriosis to go undetected until a subsequent infertility procedure or investigation reveals it. Endometriosis-related pain is typically felt in the abdomen, pelvic region, and lower back.
    Common signs and symptoms of endometriosis include:

  • Menstrual cramps and pelvic pain beginning before and extending several days into your period. Pain in the lower back and abdomen may also occur
  • Occasional heavy periods or bleeding between periods (intermenstrual bleeding)
  • Pain during or after sexual activity
  • Pain with bowel movements or urination (most likely to occur during menstruation)
  • Fatigue
  • Diarrhea
  • Constipation
  • Nausea
  • Endometriosis symptoms may temporarily improve with pregnancy and disappear entirely with menopause unless taking estrogen.


    Endometriosis has no cure, but its symptoms can be managed. Medical and surgical options are available to help reduce your symptoms and address any potential complications. Treatment options include:

  • pain medication
  • hormone therapy
  • surgery
  • Endometriosis Treatment at Sheba

    Sheba’s Endometriosis Treatment Center, the first of its kind in Israel, brings together gynecologists, laparoscopic surgeons, fertility specialists, endocrinologists, pain experts, and medical researchers to form a multidisciplinary treatment team.

    The center focuses on early detection and treatment of the disease at any stage, research of the disorder and its side effects, support for endometriosis patients, and the development of public awareness of the illness.

    Dedicated to providing our patients with the best possible care, the center continuously develops new endometriosis treatments through independent research as well as collaboration with other leading clinics.

    Among other advanced services, the world-class clinical team at Sheba’s Endometriosis Treatment Center provides diagnostic and surgical laparoscopy, hysterectomy, advanced medication, and hormone therapy.

    As early detection of endometriosis is essential to prevent potentially irreversible damage and infertility, we recommend those affected or suspecting they suffer from the condition to seek clinical care as soon as possible.

    Request a consultation

    Sheba Medical Center provides innovative, personalized medical care to patients from around the world. We are the largest, most comprehensive hospital in the Middle East and dedicated to providing advanced and compassionate medicine for everyone.

    We welcome all cases, including the rarest and the most challenging. Our medical teams collaborate to provide the best possible health outcomes. From your initial inquiry through the long-term follow-up care, we are here for you.

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