Endometriosis is a chronic condition that can worsen over time. Untreated endometriosis can cause pain, bloating, excess menstrual bleeding, digestive distress, and can also affect a person’s fertility.

When endometriosis tissue grows outside the uterus, it can affect other organs — especially the ovaries and reproductive structures. It may also affect the urinary and digestive systems.

The exact effects of untreated endometriosis depend on the severity of the condition and how long it remains untreated.

In many cases, it causes infertility or reduced fertility. It may cause damage to surrounding organs, pain during urination and bowel movements, chronic inflammation, and more.

Read on to learn about the risks of untreated endometriosis, complications, and how to manage the condition.

A note about sex and gender

Sex and gender exist on spectrums. This article will use the terms “male,” “female,” or both to refer to sex assigned at birth. Learn more.

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Endometriosis is a chronic condition affecting people assigned female at birth.

It causes tissue similar to the uterine lining to grow outside the uterus. This tissue can form adhesions and cysts, and it can damage organs.

Because endometriosis tissue swells and bleeds similarly to the uterine lining, it can cause significant pain and inflammation during a person’s menstrual cycle. People with endometriosis often report chronic pelvic pain (CPP), heavy periods, bleeding between periods, and infertility.

Endometriosis is one of the most common gynecologic conditions. It affects around 10% of reproductive-age people assigned female at birth.

In addition, it is a leading cause of infertility, playing a role in at least half of infertility cases.

Endometriosis is notoriously difficult to diagnose, and people with the condition often face long diagnostic and treatment delays. According to a 2019 study, the median wait time from the onset of symptoms to diagnosis is 8 years. This often contributes to worsening symptoms as the condition progresses.

Untreated endometriosis can cause worsening symptoms, and it can also lead to serious complications. The specific symptoms depend on which organs or organ systems the endometriosis tissue travels to.

Some common symptoms include the following:

Pelvic pain

The endometrial tissue that grows outside the uterus may adhere to various structures in the body, such as the digestive tract, bladder, and other organs in the lower abdomen.

This can cause significant pain. It may also cause periods that are very heavy or painful, painful bleeding between periods, and CPP.

Infertility

Endometriosis can damage the reproductive organs and affect fertility. For example, adhesions and endometriosis tissue can damage the uterus, making it more difficult for a fertilized egg to implant.

It may also damage the ovaries, affecting egg quality and making it harder for a person to become pregnant.

Endometriosis causes about 50% of infertility cases. However, if people are not able to conceive naturally, they may be able to using alternative methods such as intrauterine insemination or in vitro fertilization (IVF).

Childbirth complications

According to a 2017 systematic review of 24 studies, endometriosis increases the risk of complications related to childbirth and pregnancy. Researchers found that compared with a control group, people with endometriosis had a higher risk of:

Bowel and bladder problems

Endometrial adhesions can wrap around the intestines, bladder, and rectum. They can cause incontinence, trouble urinating or having a bowel movement, and pain.

For example, some people with endometriosis experience gastrointestinal distress before and during their menstrual periods. They might experience constipation, diarrhea, and pain during bowel movements or urination.

Chronic inflammation

Endometriosis tissue that grows outside the uterus secretes inflammatory chemicals. This can cause chronic inflammation throughout the body, potentially increasing the risk of chronic illnesses and chronic pain.

Untreated endometriosis can be painful, affect a person’s quality of life, and may increase the risk of developing certain chronic diseases.

One of the main risks of untreated endometriosis is worsening chronic pain. This pain can be debilitating and may not respond to typical pain relief strategies such as medication, rest, and heat.

A 2020 study of people with CPP found that it had a significant negative effect on their social lives, romantic relationships, work, and education. It can also affect a person’s mental health — research links CPP with higher rates of depression and anxiety.

Another risk of endometriosis is chronic inflammation. This is a risk factor for many diseases, including cancer and heart disease. Although research has not shown a direct causal link between endometriosis and diseases such as cancer, experts believe they may have connections.

Long-term, untreated endometriosis can also cause organ damage. When endometriosis tissue adheres to various structures in the abdomen, it can stick the structures together, causing various health complications.

There is no cure for endometriosis. Instead, treatment focuses on managing symptoms, preventing disease progression, and reducing the risk of serious complications.

In people who do not want to become pregnant in the immediate future, the main treatment is hormonal birth control. This can suppress a person’s menstrual cycle, meaning they bleed less each month and reducing further endometrial adhesions. This can help manage a person’s symptoms.

Because a common symptom of endometriosis is pain, a doctor may also recommend nonsteroidal anti-inflammatory drugs (NSAIDs) to manage this.

The second line of treatment is to take gonadotropin-releasing hormones. These hormones stop ovulation, which can significantly suppress disease progression. However, doctors are often wary of prescribing them because they cause symptoms similar to menopause, including the potential loss of bone mineral density.

Doctors can also surgically remove endometrial adhesions and excess endometrial tissue. Surgery is also the only way to definitively diagnose endometriosis, and doctors typically perform this as laparoscopic (keyhole) surgery.

Many people have endometriosis symptoms and do not realize it. A person should contact a doctor if they have the following symptoms:

  • CPP
  • difficulty getting or staying pregnant
  • heavy, painful periods
  • large blood clots with periods
  • abdominal pain or digestive issues

A person with endometriosis should contact their doctor if:

  • they want to try to get pregnant
  • their symptoms get worse
  • treatment does not seem to be working

Endometriosis is a chronic medical condition that may get worse with time, especially without treatment.

No treatment can cure this condition. However, various medical interventions may help prevent it from getting worse. Treatment can help to alleviate chronic pain, improve quality of life, and reduce the risk of serious organ damage.