Written on April 14, 2023 by Sendra Yang, PharmD, MBA. To give you technically accurate, evidence-based information, content published on the Everlywell blog is reviewed by credentialed professionals with expertise in medical and bioscience fields.
Table of contents
What is endometriosis?
Endometriosis is a common health issue affecting women, especially between the ages of 30 and 40 [1,2]. It is a chronic disease that results when the endometrial tissue that lines the uterus grows outside of it, leading to inflammation and scarring [1-3]. Endometriosis is most often found on the ovaries, fallopian tubes, tissues holding the uterus, and exteriors of the uterus . Growths can also be found on the vagina, cervix, vulva, bowel, bladder, and rectum. It is infrequent that endometriosis grows on parts of the body like the lungs, brain, or skin.
In the United States, up to 10 million people are estimated to have endometriosis, and over 11% of Americans between 15 and 44 years old are affected [1,2]. According to the World Health Organization, endometriosis is found to affect about 190 million women and girls of childbearing age worldwide .
What causes endometriosis?
The exact cause of endometriosis is unknown . However, it is thought that endometriosis occurs due to [1-3]:
- Menstrual period issues. When women experience retrograde menstruation, tissue flows toward the fallopian tube and other areas, such as the pelvis.
- A genetic component. Having a first-degree relative with endometriosis can increase the risk of the disease in women.
- Estrogen hormones in women. Estrogen encourages the implantation of endometrial tissue through the proliferation of endometrial cells and the stimulation of inflammation.
- Surgeries such as cesarean sections or hysterectomies. During such surgeries, endometrial tissue can be mistakenly picked up or moved to different body areas.
Symptoms of endometriosis
The most common symptom of endometriosis is pain. However, the kinds of pain women experience with endometriosis may vary . The types of pain may include [1,3,4]:
- Extremely painful menstrual cramps that can worsen over time
- Chronic pain in the lower back and pelvis
- Painful sex
- Intestinal pain
- Pain during bowel movements or urination when on menstrual periods
Women with endometriosis can also experience bleeding or spotting between menstrual cycles, infertility, or digestive issues such as diarrhea, constipation, bloating, or nausea [1,4]. Additionally, the disorder can have social implications, decreasing the quality of life for women because of severe pain, fatigue, anxiety, depression, and infertility .
Sometimes after menopause, the painful symptoms of endometriosis improve as the body reduces the production of estrogen hormones and the growths slowly get smaller .
Factors that may contribute to weight gain
Whether endometriosis directly causes weight gain is still a matter of debate, and there are different opinions among researchers and healthcare providers [5,6]. Studies have shown that as body mass index (BMI) increases, the risk associated with endometriosis decreases . As BMI declines, endometriosis risk is elevated . However, other findings suggest that obesity is associated with a heightened endometriosis disease severity .
Indirect association of weight gain with endometriosis
Even though endometriosis is not directly connected with weight gain, some indirect factors could contribute to weight gain in women with the condition. Potential indirect causes of weight gain from endometriosis include:
- Hormonal imbalance: Estrogen has a significant impact on endometriosis [8,9]. Women with endometriosis have been shown to have increased levels of estrogen, which can affect menstrual cycles, energy levels, and weight changes .
- Medications: Some medications can help treat endometriosis . First-line therapies such as oral contraceptives have weight gain as a common side effect.
- Bloating: A less commonly reported symptom of endometriosis is abdominal bloating or swelling that can contribute to extra weight [4,10].
- Pain: A commonly reported symptom of endometriosis is various types of pain. Continuous chronic pain can promote a sedentary lifestyle by limiting physical activity, affecting the ability to exercise regularly and leading to weight gain .
Other potential causes of weight gain
Potential causes of generalized weight gain may be due to lifestyle changes, environment, or other medical conditions . Examples include insufficient sleep, too much stress, an unhealthy diet, limited physical activities, and chronic diseases like obesity.
Contact your healthcare provider
If you have questions about your weight or notice that you have been gaining more weight, contact your healthcare provider. You can consult with them on a care plan to help you achieve your health goals. Everlywell provides access to weight care online, a telehealth option where you can speak with a healthcare provider from the comfort of your own home. You can partner with a certified clinician to discuss your weight-related questions and concerns. As part of your care plan, you and your clinician can also consider an at-home lab test for your hormone levels.
The importance of sleeping well in weight loss
What is obesity?
Is obesity a disease?
- Endometriosis. Office on Women’s Health. URL. Accessed April 14, 2023.
- Edi R, Cheng T. Endometriosis: evaluation and treatment. American Family Physician. URL. Published September 30, 2022. Accessed April 14, 2023.
- InformedHealth.org. Institute for Quality and Efficiency in Health Care (IQWiG); 2006. Endometriosis: Overview. URL. Updated October 19, 2017.
- Endometriosis. World Health Organization. URL. Accessed April 14, 2023.
- Liu Y, Zhang W. Association between body mass index and endometriosis risk: a meta-analysis. Oncotarget. 2017;8(29):46928-46936. doi: 10.18632/oncotarget.14916. URL.
- Hong J, Yi KW. What is the link between endometriosis and adiposity? Obstet Gynecol Sci. 2022;65(3):227-233. doi: 10.5468/ogs.21343. URL.
- Holdsworth-Carson SJ, Dior UP, Colgrave EM, et al. The association of body mass index with endometriosis and disease severity in women with pain. J Endometr Pelvic Pain Disord. 2018;10(2)79-87. doi:10.1177/2284026518773939. URL.
- Chantalat E, Valera MC, Vaysse C, et al. Estrogen receptors and endometriosis. Int J Mol Sci. 2020;21(8):2815. doi: 10.3390/ijms21082815. URL.
- Goetz TG, Mamillapalli R, Taylor HS. Low body mass index in endometriosis is promoted by hepatic metabolic gene dysregulation in mice. Biol Reprod. 2016;95(6):115. doi: 10.1095/biolreprod.116.142877. URL.
- Luscombe GM, Markham R, Judio M, Grigoriu A, Fraser IS. Abdominal bloating: an under-recognized endometriosis symptom. J Obstet Gynaecol Can. 2009;31(12):1159-71. doi: 10.1016/s1701-2163(16)34377-8. URL.
- Okifuji A, Hare BD. The association between chronic pain and obesity. J Pain Res. 2015;8:399-408. doi: 10.2147/JPR.S55598. URL.
- Healthy weight, nutrition, and physical activity. Centers for Disease Control and Prevention. URL. Published June 3, 2022. Accessed April 14, 2023.