Endometriosis Care

Experts in diagnosing and treating endometriosis

A female sitting enjoying the outdoors and smiling, illustrating her improved quality of life after being treated for endometriosis.

Experts in diagnosing and treating endometriosis

Our gynecologists and gynecologic surgeons have extensive training and experience in diagnosing and treating women living with endometriosis. At Scripps Health, we develop a personalized treatment plan for every woman and offer the most advanced treatments available, from lifestyle changes and medication to hormone therapy and minimally invasive robotic-assisted surgery, to relieve symptoms and improve quality of life.

What is endometriosis? 

Endometriosis occurs when the tissue that lines the uterus grows outside of the uterus. The tissue growth can spread into other pelvic organs, most often around the ovaries and fallopian tubes. This can create several medical concerns, including inflammation, cysts, lesions, adhesions and scar tissue. Endometriosis can cause severe pain, especially during menstruation.


Additionally, endometriosis is one of the leading causes of infertility. Inflammation damages the sperm or the egg, or interferes with their movements through the fallopian tubes and uterus.

Endometriosis risk factors

One in 10 women of childbearing age has endometriosis. It is most common in women in their 30s and 40s. The cause is unknown, but the risk of developing it is higher among women who have:


  • Never had children
  • Menstrual periods that last more than seven days
  • Short menstrual cycles (27 days or fewer)
  • A family member with endometriosis
  • A health problem that blocks normal flow of menstrual blood

What do symptoms feel like?

Many women with endometriosis do not experience symptoms and may not know they have the condition until they have a pelvic exam or fertility issues. In women who do have symptoms, these often include:


  • Pelvic pain, often during menstruation
  • Pain during or after sex
  • Heavy periods
  • Chronic lower back and abdominal pain
  • Digestive issues, such as diarrhea, constipation or bloating during menstruation

How is it diagnosed?

Scripps gynecologists diagnose endometriosis using one or more of the following procedures: 


  • Medical history: Your medical history includes information about your symptoms, other medical conditions you may have had, and information about other family members with health issues.
  • Physical exam and pelvic exam: The doctor will perform a physical and pelvic examination to look for abnormal tissue growth or other indications of endometriosis. 
  • Imaging tests: Imaging exams may include an MRI or CT scan to detect inflammation, tissue growth, cysts and other signs of endometriosis.
  • Laparoscopic exploratory surgery: This minimally invasive surgical procedure allows the surgeon to examine the pelvic organs and structures using a camera inserted through a very small incision in the abdomen or pelvis.

Comprehensive treatment options for endometriosis

Early treatment can slow or halt the progression of endometriosis, which can help reduce pain, restore fertility and improve quality of life.


Endometriosis treatment depends on several factors, including:


  • Age
  • Severity of symptoms
  • Severity of disease
  • Pregnancy plans
  • Response to treatments


Endometriosis treatment may include lifestyle changes, medication, surgery or a combination of these.

Pain medicine

When pain is the main symptom, the first treatment is usually pain medication. Nonsteroidal anti-inflammatory drugs (NSAIDs) can be used to manage pain. If these are not effective, stronger prescription medications may be recommended.

Hormone therapy

Hormone treatment can help control pain by suppressing the production of hormones that stimulate endometrial tissue growth. Hormone therapy can include methods like birth control pills, IUDs, hormone injections and more. However, hormone therapy is not appropriate for women trying to conceive.

Surgical treatments

If pain is severe, endometriosis specialists may recommend surgery, especially when other methods prove ineffective. Surgery may be a minimally invasive or open procedure depending on each patient’s goals and medical profile.


  • Endometrial ablation is a minimally invasive procedure that uses a heat source such as a laser to burn away endometrial cells that have grown outside of the uterus.
  • Hysterectomy is usually an option when other treatments are not effective and preserving fertility is not a concern. Robotic-assisted hysterectomy is a minimally invasive procedure that combines the precision of robotic technology with the skills of a trained surgeon. Women who are not able to have a minimally invasive hysterectomy may have open surgery.
  • Minimally invasive gynecologic surgery, including robotic and laparoscopic surgery, can remove the tissue associated with the condition and help improve fertility. The surgeon makes several small incisions in the pelvis and inserts a tiny camera and surgical instruments into the surgical area, enabling them to excise and remove lesions, tissue growth and scar tissue. Robotic surgery is a minimally invasive procedure with an added layer of technology for better visualization. Because laparoscopy does not remove other uterus or other reproductive organs, it may be recommended for women who want to be able to become pregnant.

Natural remedies

Lifestyle changes and natural remedies can help relieve some of the symptoms of endometriosis. Regular exercise and a lower amount of body fat help decrease the amount of estrogen circulating throughout the body. Avoiding large amounts of alcohol and caffeine can also help, as both can raise estrogen levels.