Endometriosis symptoms can occur as early as the onset of the menstrual cycle. However, the majority of people do not receive a diagnosis until they are between the ages of 30–40 years old.

Endometriosis occurs when cells similar to those that form the lining of the uterus grow outside the uterus. The condition can cause several symptoms, including chronic pelvic pain, painful periods, and infertility.

Though it can occur at nearly any age, most people receive a diagnosis between the ages of 30–40 years old. Additionally, a person may only realize the symptoms later in life, even if endometriosis has been present for several years.

This article reviews what endometriosis is, whether a person can develop it later in life, and more.

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. Click here to learn more.

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Endometriosis is a common health problem affecting about 11% of females between the ages of 15–44 years old. The most common symptoms are chronic pelvic pain and painful periods.

Though endometriosis may occur when a person starts having periods, the majority of people do not receive a diagnosis until they are between the ages of 30–40 years old. People also may not realize they may have it until later in life.

According to a 2017 study, the average time between first experiencing endometriosis symptoms and receiving a diagnosis was 4.4 years in the United States in 2012.

While it is possible for a person to develop endometriosis later in life, it is more likely that they have already had undiagnosed endometriosis for a number of years.

Learn more

Learn more about endometriosis.

The delay in diagnosis is partly due to similarities between endometriosis and other common diseases, and partly because a person needs surgery to diagnose the condition.

Another important factor is that family, friends, and healthcare professionals may dismiss some of the symptoms of endometriosis as typical period pain. This may cause a person to delay seeking a diagnosis.

Despite endometriosis being a common health problem for females, a 2021 article states that many feel healthcare professionals dismiss or invalidate their concerns regarding endometriosis pain. This can contribute to the difficulty of receiving a prompt diagnosis.

Another factor that may cause late diagnosis is that many females start taking hormonal birth control during their teenage years and early adulthood.

For example, the oral contraceptive pill can make periods lighter, more regular, and less painful, masking the main symptoms of endometriosis. Because of this, some people do not notice endometriosis symptoms until they stop taking the pill.

Some people do not experience painful symptoms and may only realize they have endometriosis if they try to get pregnant later in life. This is because endometriosis can cause fertility problems.

Surgeons diagnose endometriosis by performing a laparoscopy, which is a minimally invasive procedure. The surgeon inserts a small camera with a light into a person’s abdomen to look for evidence of endometriosis.

Endometriosis can be difficult to see on imaging tests such as ultrasound scans. However, some people develop endometriomas, also known as chocolate cysts, on their ovaries. A healthcare professional can diagnose endometriosis if these are present.

Scheduling and preparing for this surgery can be a lengthy process and can involve a significant waiting period.

Learn more about diagnostic laparoscopy for endometriosis.

Females can develop endometriosis at any time after their first menstrual cycle.

The most common age of diagnosis is between 30–40 years old. However, similarities between endometriosis and a variety of other conditions can sometimes cause lengthy delays in diagnosis.

People who are most likely to develop endometriosis include those who have:

  • short menstrual cycles of 27 days or less
  • menstrual periods that last more than 7 days
  • never had children
  • health issues that block the typical flow of menstrual blood
  • a close family member with the condition

Race and ethnicity may also affect who develops endometriosis. According to a 2022 review of studies, researchers noted that white women are more likely than African American and Hispanic women to develop endometriosis.

However, the researchers warn that past studies have had biases that may affect the true numbers of the condition occurring in African American and Hispanic people.

African American and Hispanic people may also experience additional barriers to diagnosis. In addition to the dismissal of their symptoms, they may also experience systemic discrimination in healthcare settings. This may result in fewer reported cases.

Learn more about racism in healthcare, statistics, and more.

Endometriosis most often causes pain.

The pain may include:

In some cases, endometriosis may be asymptomatic, meaning a person does not experience symptoms. In these cases, a person may discover it when seeking help for suspected fertility issues.

A person can experience a variety of symptoms based on where endometriosis cells develop. In addition to pain and fertility issues, a person may experience bleeding or spotting between periods.

They may also develop digestive issues. These often occur during menstrual bleeding and can include:

A person may also experience fatigue, depression, and anxiety.

There are several types of endometriosis. Doctors classify them based on where the cells develop and grow into a lesion. They include:

  • cystic ovarian endometriosis, also known as endometriomas, found in the ovaries
  • superficial endometriosis, found mainly in the pelvic area
  • deeply infiltrative endometriosis, found in the bladder, bowel, and recto-vaginal septum

In rare cases, medical professionals may find endometriosis outside the pelvic area.

Experts do not know the exact cause of endometriosis. However, some have ideas on what causes it. They include:

  • issues with menstrual period flow, including retrograde menstrual flow, in which menstrual blood flows back up into the fallopian tubes and implants endometrial cells outside the uterus
  • problems with the immune system
  • surgery, such as having a cesarean delivery or hysterectomy
  • the use of hormonal medication
  • having a close family member with the condition
Learn more

Learn more about endometriosis.

It is not always possible to prevent endometriosis, as experts do not know the exact cause. For example, some people may inherit the genes that cause the condition, so there is no way to prevent the development of the condition in these people.

However, the presence of estrogen in the body may increase the risk of developing endometriosis. To reduce their estrogen level, a person can try to:

  • limit alcohol consumption, if applicable
  • manage their weight through diet and exercise
  • reduce caffeine consumption
  • consider using hormonal birth control to decrease estrogen

To detect or rule out endometriosis, doctors will likely:

  • perform a pelvic examination
  • order imaging tests to look for cysts, another possible cause of pain
  • perform a laparoscopy to check for endometriosis tissue

A laparoscopy is the only way to be sure a person has endometriosis.

Seeing the tissue during the surgery may be enough for a professional to diagnose endometriosis. However, sometimes a surgeon may need to take a sample of the tissue and send it for examination in a lab.

A doctor may also diagnose the condition by prescribing hormone medication. If symptoms clear with the medication, a doctor may be able to diagnose endometriosis.

Treatment for endometriosis often involves hormonal medication, surgery, and lifestyle changes.

People who do not wish to become pregnant may take birth control pills to help prevent menstrual periods and reduce pain. They may also use a hormonal intrauterine device (IUD) to help reduce painful menstrual cycles.

Doctors may also prescribe gonadotropin-releasing hormone agonists. This medication shuts down the ovaries and causes temporary menopause to stop ovulation and reduce hormone levels. However, once a person stops taking the medication, ovulation will resume, meaning they may be able to conceive.

In severe cases, or when other methods do not ease symptoms, a doctor may surgically remove the endometrial cells. They may then recommend a person continues hormonal treatment following the surgery.

A person may also wish to try alternative therapies, such as acupuncture or pain medications, to help manage the pain.

If gastric issues occur, a person may find that changing their diet can help prevent issues. Limiting processed foods, red meats, and dairy may help some people.

A person may find that reaching or maintaining a moderate weight through diet and exercise reduces their symptoms.

Learn more

Learn more about endometriosis treatment and management.

There is no cure for endometriosis. However, medications and lifestyle changes can help manage symptoms.

For some, menopause may help clear the condition. Others may find that taking hormonal treatments for menopause causes their symptoms to worsen or come back.

A person should talk with a doctor about managing their symptoms.

A person should consider contacting a doctor if they experience symptoms that could indicate endometriosis.

Since it can often cause symptoms similar to irritable bowel syndrome and other gastric conditions, a doctor will need to rule these out as possible causes.

If a person is age 35 years or younger and is concerned about fertility, they should visit a doctor after trying for 1 year to become pregnant.

People over the age of 35 years may wish to talk with a doctor after 6 months of trying to conceive.

The following sections provide answers to frequently asked questions about endometriosis.

Can a person suddenly develop endometriosis?

Endometriosis is a chronic condition that develops and progresses over a long period of time. It can develop during early adolescence and gradually progress as a person reaches adulthood.

A person can have endometriosis and experience no symptoms for a long time before suddenly experiencing symptoms later in life.

While a person can experience endometriosis symptoms suddenly, the condition itself develops over several years.

The exact cause of endometriosis is not known. However, it is most likely due to abnormal menstrual flow.

Can endometriosis occur at any age?

Endometriosis can occur at nearly any age. However, it has links to the menstrual cycle. It can start between the ages of around 15–44 years old.

Symptoms may clear after a person experiences menopause. However, hormonal treatments may cause symptoms to continue.

Endometriosis can occur in any person who experiences a menstrual cycle.

Most people receive a diagnosis between the ages of 30–40 years old. However, this could be due to late diagnosis and does not necessarily mean endometriosis develops suddenly at that age.

People seeking an endometriosis diagnosis may come across barriers to healthcare, such as healthcare professionals or family members dismissing or invalidating their symptoms.

Diagnosing endometriosis can also be a complicated process, and it may take a number of years to receive a definitive answer.

Additionally, many people may not experience symptoms, which may delay diagnosis even further.

Treatment typically involves hormonal medications. However, there is no cure for the condition. A person may also need additional medications and therapies to help reduce their symptoms.