Endometriosis is a condition where tissue similar to the lining of the uterus grows outside the uterus. This tissue, called endometrium, can spread throughout the pelvic region. It can attach to the outer surfaces of the uterus, bowels, bladder, and ovaries.

Similar to uterine lining, this tissue responds to changes in hormone levels. Even though it can’t shed the way uterine lining does during your period, it impacts your period in other ways.

Here are the answers to some common questions about endometriosis and periods.

During a typical monthly menstrual cycle, the uterine lining grows and expands. It then breaks down and is shed and removed from your body when you get your period. This cycle repeats month after month.

With endometriosis, this tissue grows outside the uterus. Similar to uterine lining, the endometrial-like tissue expands and bleeds in response to hormone changes that occur during the menstrual cycle. The difference is that this tissue isn’t shed and removed from the body. It has nowhere to go.

Endometriosis creates inflammation in the body, resulting in abnormal signaling and disruptive hormones. This can contribute to the development of scar tissue and adhesions. Adhesions occur when thick bands of scar tissue build up and bind other tissues and organs together.

As a result, endometriosis can lead to various types of pain:

  • pelvic pain
  • lower back pain
  • pain with sex
  • cramping
  • painful urination or bowel movements

This pain can occur at any time of the month, but often gets worse during menstruation.

Many people living with endometriosis experience long, heavy periods. Spotting or bleeding between periods is also common.

Endometriosis can cause digestive issues, like diarrhea, constipation, bloating, and nausea. These symptoms also tend to get worse during menstruation.

People who have endometriosis often have longer periods compared with people who don’t live with the condition. A usual period length is around 5 to 7 days. With endometriosis, a period can last more than 7 days.

People living with endometriosis also tend to experience heavier periods compared with those who don’t have the condition. Signs of heavy bleeding include needing to change your pad or tampon after less than 2 hours and passing clots the size of a quarter or larger.

Endometriosis can also cause lighter spotting or heavier bleeding in between periods.

Hormonal contraception can be used to stabilize hormone levels and make periods more manageable. These medications can shorten period length or allow you to skip periods altogether.

This helps prevent some buildup and breakdown of the endometrium. This ongoing cycle is what leads to symptoms of endometriosis.

Endometriosis pain often starts before your period and persists well after. You may feel ongoing pain, whether you have your period or not.

With endometriosis, pain is typically felt throughout the pelvic area and in the lower back. If endometrial-like tissue grows on the bladder, that can make urination painful. If the bowels are affected, you may experience pain or changes in your bowel movements. Sometimes, these symptoms are mistaken for irritable bowel syndrome (IBS).

Different strategies can be used for pain management:

  • Pain medications. Medications to reduce pain and inflammation may be used. Though, they’re often not enough to fully alleviate endometriosis pain, and they don’t address the underlying cause of the pain.
  • Hormonal contraception. Contraception, like the pill, injection, or intrauterine device (IUD), can help regulate hormones and reduce period frequency. Having fewer periods helps slow down the growth of endometrial-like tissue. This helps with the management of endometriosis symptoms.
  • GnRH antagonists. This is a type of medication that lowers the amount of estrogen in the body. This helps reduce the spread of endometriosis, which in turn helps improve its symptoms. These medications can only be used in the short term.
  • Surgery. When endometrium builds up outside the uterus, it can lead to scar tissue and adhesions. Procedures to cut or burn away this excess endometrium can help reduce endometriosis pain.

You may still experience some symptoms between periods or if you don’t get your period. But symptoms of endometriosis typically worsen with your period. So reducing the number of periods you get or skipping them altogether can help improve symptoms.

Using hormonal contraception, such as the pill, shot, or an IUD, can help manage hormone levels. The reduction in estrogen levels can help prevent new lesions from forming. Many of these contraceptive options also make periods lighter and less frequent.

The endometriosis doesn’t go away with the use of hormonal contraception. But it becomes easier to manage.

Endometriosis symptoms may also lessen with menopause, when your body starts to produce less estrogen and you no longer get a period.

Menopause usually happens naturally between the ages of 45 and 55. Menopause can also be induced with medication or surgery. In some cases, these types of approaches and procedures are used to treat endometriosis and improve symptoms.

However, estrogen plays an important role throughout your body. It helps maintain the health of your bones, heart and blood vessels, and brain.

Hormone replacement therapy (HRT) can be prescribed to increase estrogen levels in the body after menopause. But high estrogen levels lead to issues with endometriosis.

The key is finding the right balance to help manage endometriosis without affecting other areas of your health.

Endometriosis is a condition that occurs when endometrial-like tissue grows outside the uterus. It often causes painful, long, heavy periods. It can also lead to inflammation, scar tissue, and adhesions.

Endometriosis responds to hormone fluctuations that occur throughout the menstrual cycle. Many of the symptoms of endometriosis get worse during your period.

Treating endometriosis often includes reducing period frequency to alleviate symptoms.