Anyone can develop endometriosis. However, the rates vary greatly based on a person’s sex assigned at birth.

Endometriosis affects roughly 190 million people who were assigned female at birth (AFAB) worldwide. That’s about 10% of AFAB people globally.

Endometriosis affects people assigned male at birth (AMAB) on a much lesser scale. A total of 16 cases have been documented. That’s significantly less than 1% of AMAB people globally.

“It’s very rare but possible for people assigned male at birth to experience endometriosis,” says Laura Purdy, MD, OB-GYN, chief medical officer at Wisp, a telehealth platform focused on sexual and reproductive health.

Intersex people can also have endometriosis. At the time of publication, there’s only one documented case of endometriosis in an intersex person.

However, given that endometriosis is not sex-specific and that much of the research on the condition has been centered on cisgender women, it’s reasonable to assume that the condition affects more intersex people than that.

Yes. People of any gender identity can develop endometriosis. This means people who are nonbinary, agender, bigender, omnigender, or any other identity can develop endometriosis, too.

Because much of the reporting and scientific research on endometriosis have looked exclusively at cisgender women, the rates of the disease among men, transgender, and other-gendered people have not been well reported.

The exact cause of endometriosis isn’t known. However, experts think the hormone estrogen is involved.

One 2020 study found that high estrogen levels are often seen in people with endometriosis. Cisgender women and other AFAB folks typically have a higher level of estrogen than people of another sex, and it’s possible this could affect individual risk.

Indeed, in cases where AMAB folks develop endometriosis, “it’s most likely due to [estrogen] hormone therapy,” notes Purdy.

You may also be more likely to develop endometriosis if you:

“The signs and symptoms, as well as the intensity, location, and duration of those symptoms, vary person to person,” says Heather Jeffcoat, a doctor of physical therapy who specializes in sexual dysfunction, pain, and incontinence, and author of “Sex Without Pain: A Self-Treatment Guide to the Sex Life You Deserve.”

“The most common way endometriosis presents, regardless of whether you’re assigned male or female at birth, is abdominal and pelvic pain,” notes Jeffcoat.

Other symptoms can include:

That said, it’s possible to have endometriosis even if you’re not experiencing any of the aforementioned symptoms, explains Jeffcoat. Or, if you are not experiencing them all the time.

“Not everyone with endometriosis has symptoms,” she says. “Sometimes the condition is discovered by random chance when a patient has another procedure, for instance.”

The gold standard for endometriosis diagnosis is something called a laparoscopic surgical biopsy, says Jeffcoat.

This surgery allows doctors to remove any growths, adhesions, or abnormal tissues that endometriosis may have caused and test them to see whether it is endometriosis.

While laparoscopy is the only way to be certain whether you have endometriosis, it’s invasive.

As such, sometimes clinicians will try to gather additional information with a pelvic exam, ultrasound, or MRI before recommending laparoscopy.

Endometriosis is an idiopathic condition. This means there are no known causes and also no specific ways to prevent it.

Estrogen levels are thought to be higher in people with endometriosis, leading some experts to believe that doing things to lower (or manage) your estrogen levels can help control the disease and slow its growth.

There’s some thought that limiting animal products and alcohol, regularly moving your body, and maintaining a moderate body weight can help decrease your estrogen levels.

As always, it’s best to consult a healthcare professional before making any major changes to your diet or exercise routine — especially with the intent of altering your hormone levels.

Endometriosis is most common among AFAB people with menstrual irregularities who have immediate family members with the disease.

However, endometriosis doesn’t discriminate based on sex, gender, genitals, genetics, or anything else. In other words, anyone can develop endometriosis.

So, if you think you do or could have endometriosis, consult a healthcare professional. They will be able to make an endometriosis diagnosis or discern whether there’s another underlying condition causing your symptoms.

Gabrielle Kassel (she/her) is a queer sex educator and wellness journalist who is committed to helping people feel the best they can in their bodies. In addition to Healthline, her work has appeared in publications such as Shape, Cosmopolitan, Well+Good, Health, Self, Women’s Health, Greatist, and more! In her free time, Gabrielle can be found coaching CrossFit, reviewing pleasure products, hiking with her border collie, or recording episodes of the podcast she co-hosts called Bad In Bed. Follow her on Instagram @Gabriellekassel.