What are the Risk Factors for Endometriosis?

Endometriosis is a painful condition in which the tissue that lines the inside of the uterus, known as the endometrium, starts growing outside the uterus onto other organs. It can grow and spread to the fallopian tubes, ovaries, and even the tissue lining the pelvis. In some rare cases, endometrial tissue can also start to grow beyond the pelvic organs. Endometriosis affects more than ten percent of women, and it can happen to any women, but there are certain risk factors for endometriosis that increases your risk of getting this condition. Let us take a look at these risk factors for endometriosis.

Endometriosis is known to affect over 11 percent(1) of women who are menstruating and are between the ages of 15 to 50. While endometriosis can affect any women who are menstruating, there are certain risk factors that increase your chances of developing endometriosis.

What are the Risk Factors for Endometriosis?

What are the Risk Factors for Endometriosis?

Family History

Having a history of endometriosis in your family increases your risk of developing by nearly 7 to 10 times than those who do not have a family history of endometriosis.(2)

If the condition affects your immediate family members, such as your mother, sister, or grandmother, then this puts you at the greatest risk of also developing this condition. However, your chances of having endometriosis also increases even if your distant relatives, such as cousins, have this disorder.

Endometriosis is known to be passed down both maternally as well as paternally.

Factors that Interfere with the Normal Menstrual Cycle

One of the theories of what are the potential causes of endometriosis is retrograde menstrual flow. Retrograde menstrual flow means that the cycle moves backward. If you know that you have a certain medical condition that blocks, redirects or increases your menstrual flow, then this is also considered to be a risk factor for endometriosis.

Some of the conditions that can lead to retrograde menstrual flow are(3):

  • Obstructions in your vagina or the cervix
  • Increase production of estrogen
  • Uterine growth such as polyps or fibroids
  • Structural abnormality of the cervix, vagina, or the uterus
  • Asynchronous uterine contractions

Menstrual Exposure and Endometriosis

It is said that the more exposure you have to menstruation, the greater is the likelihood that you will develop endometriosis. Some of the factors that are known to increase your menstrual exposure and the risk of endometriosis as well include:

  • Beginning your first period before the age of 12 years itself
  • Having a gap of 27 days or lesser between each menstrual period(4)
  • Having periods that last for seven days or even longer every month

Pregnancy, during which you stop having your periods, actually lowers your risk. If, however, you do have endometriosis and successfully become pregnant, you will find that your symptoms of the condition will disappear during the period of pregnancy. It is common, though, for the symptoms to come back once the baby is born.

Disorders of the Immune System

Many types of immune system disorders are known to increase the risk of endometriosis. If you have a weakened or compromised immune system, then it becomes less likely to recognize the presence of misplaced endometrial tissue growing elsewhere in the body. Due to this, the scattered endometrial tissue begins to implant at wrong places, causing problems such as scarring, inflammation, and lesions.(5)

Age

Age is also a factor that impacts your risk of developing endometriosis. Since the condition involves the cells of the uterine lining, it is natural that any girl or woman who is old enough to menstruate is at a risk of developing endometriosis. However, in spite of this, it is known that endometriosis tends to be commonly diagnosed in women who are in their 20s and 30s.(6)

Medical experts believe that this particular age is at which most women try to conceive, and for many, infertility emerges as the primary symptom of endometriosis. After the diagnosis of infertility, many other symptoms of endometriosis also start becoming apparent.

This is usually the case in women who do not experience severe pain that is commonly associated with menstruation, and due to this, they do not seek any assessment by their doctor, that is, until the time they are trying to conceive.

Abdominal Surgery

In many cases, even abdominal surgery, even a routine surgery like a cesarean delivery or a hysterectomy, can cause endometrial tissue to become misplaced and start growing elsewhere. If this misplaced endometrial tissue does not get destroyed by the immune system, then it can cause endometriosis. This is why it is important that when you are discussing the symptoms of endometriosis with your doctor, you also review your surgical history.

How to Reduce the Risk of Endometriosis?

Since the exact cause of endometriosis remains unclear, it becomes difficult to understand how to prevent this condition.

It is possible to decrease the risk of developing endometriosis by reducing the amount of estrogen present in your body. One of the primary functions of the hormone estrogen is to thicken the lining of your uterus, which is known as the endometrium. It is this lining that is shed during your periods. If you have a high level of estrogen in your body, then your endometrium will be thicker, and it will cause you to have heavier bleeding. If you are having heavier than usual bleeding consistently, then this puts you at risk for developing endometriosis.

The best possible way to reduce your risk of developing endometriosis is to maintain a healthy lifestyle and diet. Being in good health also helps balance out the hormones in your body. To keep estrogen and other hormones at a normal or lower level, you can try the following:

  • Decrease your intake of caffeine
  • Reduce your intake of alcohol and keep it to a bare minimum if you are already at a risk
  • Exercise regularly
  • Increase your consumption of whole foods and fresh fruits and vegetables

Discuss your birth control medication with your doctor so that you can use one that contains less estrogen

Conclusion

Being aware of the risk factors for endometriosis will help you get ahead of the condition and manage your health better. This information enables you to come up with effective strategies for reducing your risk and also helps your doctor to diagnose your condition more accurately. Keep in mind that endometriosis is a condition that is easily misdiagnosed and knowing your risk factors for this disorder helps you and your doctor narrow down the causes of your symptoms.

Furthermore, a confirmed diagnosis also helps your doctor come up with better and more customized solutions for your condition, so it is always a good idea to discuss your risk factors for endometriosis with your doctor at the earliest.

References:  

  1. womenshealth.gov. (2019). Endometriosis | Womenshealth.gov. [online] Available at: https://www.womenshealth.gov/a-z-topics/endometriosis [Accessed 13 Aug. 2019].
  2. Endocenter.org. (2019). Do you have Endo? | Endometriosis Research Center. [online] Available at: https://www.endocenter.org/do-you-have-endo/ [Accessed 13 Aug. 2019].
  3. Fertilitypedia.org. (2019). Fertilitypedia – Retrograde menstruation. [online] Available at: https://fertilitypedia.org/edu/symptoms/retrograde-menstruation [Accessed 13 Aug. 2019].
  4. Wei, M., Cheng, Y., Bu, H., Zhao, Y. and Zhao, W., 2016. Length of menstrual cycle and risk of endometriosis: A meta-analysis of 11 case–control studies. Medicine, 95(9).
  5. Shigesi, N., Kvaskoff, M., Kirtley, S., Feng, Q., Fang, H., Knight, J.C., Missmer, S.A., Rahmioglu, N., Zondervan, K.T. and Becker, C.M., 2019. The association between endometriosis and autoimmune diseases: a systematic review and meta-analysis. Human reproduction update, 25(4), pp.486-503.
  6. Nnoaham, K.E., Webster, P., Kumbang, J., Kennedy, S.H. and Zondervan, K.T., 2012. Is early age at menarche a risk factor for endometriosis? A systematic review and meta-analysis of case-control studies. Fertility and sterility, 98(3), pp.702-712.

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