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Risk Factors for Endometriosis: Your Guide

Posted on December 06, 2021
Medically reviewed by
Dan Martin, M.D.
Article written by
Julie Scott, ANP-BC, AOCNP

It is estimated that endometriosis — a condition in which the endometrial tissue grows outside of the uterus — affects up to 10 percent of women during their child-bearing years. Although there is no specific known cause of endometriosis, several factors have been identified that may increase the risk of endometriosis. Knowing these risk factors for endometriosis can be an important aspect of your health.

Risk factors for endometriosis can be defined as hereditary, personal, or environmental.

Hereditary Risk Factors

Heredity risk factors are caused by genes that are passed on through your family. Experts have found that having female family members with endometriosis, such as a mother, sister, or aunt, can increase your risk of developing endometriosis.

An increased risk due to family history suggests there is a genetic link to endometriosis. This link is not fully understood but could be due to inherited genetic changes that lead to hormonal changes or the ability of certain cells to change into endometrial cells. Studies are ongoing to determine what genes may play a role in endometriosis.

Personal Risk Factors

Certain personal factors, often related to the hormones in your body, can increase the risk of endometriosis. These personal risk factors can include:

  • Having your first menstrual cycle before age 11
  • Going through menopause later in life
  • Heavy menstrual cycles lasting more than seven days
  • Experiencing shorter menstrual cycles, less than 27 days in length
  • Having high levels of estrogen in the body
  • Having a reproductive tract disorder that blocks the regular flow of menstrual tissue from the body
  • Low body weight

Higher Estrogen Levels

Another risk factor for endometriosis is never having given birth. During pregnancy, the menstrual cycle stops and estrogen levels decrease. For people who have never given birth, there has not been a pause in the menstrual cycle, and there was no break in estrogen levels.

Retrograde Menstruation

Endometriosis may be due to retrograde menstruation, in which menstrual fluid containing endometrial cells backs up into the fallopian tubes during menstruation. Retrograde menstruation can lead to the deposit of endometrial cells into other areas.

Environmental Risk Factors

Endometriosis can depend on the amount of estrogen in the body. There may be an association between endometriosis and chemical exposure in the environment that affects hormone production. Diet may also contribute.

For instance, dioxins are a group of chemical pollutants that can be found naturally as a result of events such as forest fires. Dioxins are also often a byproduct of paper production and manufacturing processes. Dioxin is also thought to interfere with normal processes of the female reproductive system and may lead to endometriosis.

One study demonstrated an association between endometriosis and exposure to organochlorine pesticides. Although these pesticides are no longer used in the United States, the chemicals have a long half-life and have contaminated waters and growing fields, allowing for continued exposure long after they were discontinued from use.

Another study identified an increased risk of endometriosis in people who ate a diet high in trans unsaturated fats and fats that come from animal sources.

Identifying the Symptoms of Endometriosis

If you have risk factors for endometriosis, keep an eye out for developing symptoms so that you can get early treatment.

Common symptoms of endometriosis can include:

  • Pelvic pain
  • Abdominal pain
  • Heavy periods
  • Bleeding in between periods
  • Bloating
  • Diarrhea or constipation
  • Chronic fatigue
  • Infertility

If you believe you have endometriosis, talk to your doctor or health care provider about diagnosis and treatment.

Talk With Others Who Understand

MyEndometriosisTeam is the social network for people with endometriosis. On MyEndometriosisTeam, more than 122,000 members come together to ask questions, give advice, and share their stories with others who understand life with endometriosis.

Have something to add to the conversation? Share your experience in the comments below, or start a discussion on MyEndometriosisTeam.

Dan Martin, M.D. is the scientific and medical director of the Endometriosis Foundation of America. Learn more about him here.
Julie Scott, ANP-BC, AOCNP is an adult nurse practitioner with advanced practice oncology certification, based in St. Louis, Missouri. Learn more about her here.

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