FAQs: Get Your Endometriosis Questions Answered
From diagnosis delays to treatment options, find straightforward answers to the questions you have about endometriosis.
FAQs: Get Your Endometriosis Questions Answered
From diagnosis delays to treatment options, find straightforward answers to the questions you have about endometriosis.
What is endometriosis, and is it considered a menstrual disease?
Endometriosis is a systemic, inflammatory condition characterized by tissue similar to the lining of the uterus growing in other parts of the body. Endometriosis has been found in every organ. It is not simply a menstrual disease, yet is often mischaracterized as such, even by reputable sources.
Approximately how many people are affected by endometriosis, and what are some common symptoms they may experience?
Endometriosis affects approximately 1 in 10 people born with female reproductive organs. Common symptoms include, but are not limited to, pelvic pain any time during the month, a wide range of GI symptoms, urinary symptoms, fatigue, debilitating periods and more depending on where the endometriosis lesions are located in the body.
What is the average diagnostic delay for endometriosis, and what factors contribute to this delay?
Symptoms often start early in life, but due to cultural taboos, misinformation and a historical lack of emphasis in medical education, they may be ignored or misdiagnosed by caregivers, healthcare consumers and practitioners alike. The average diagnostic delay is 7-10 years.
When can endometriosis symptoms begin, and what percentage of teenagers withchronic pelvic pain may have the condition?
Endometriosis symptoms may begin as early as when puberty starts. Endometriosis symptoms can present before menstruation, during menstruation, and/or after menstruation. An estimated 70% of teens with chronic pelvic pain go on to be later diagnosed with endometriosis.
What constitutes a "red flag" regarding pelvic pain, and what action should be taken if someone experiences this?
Red flag: If you or your patient regularly feels pain during or around periods, and this pain is bad enough to interfere with usual activities, this is a red flag - it is not normal and should be investigated further as soon as possible. (If you do not have this, it doesn't mean that you don't have endometriosis).
Identified risk factors for developing endometriosis.
Risk factors for endometriosis include a mother or sister having the disease (7x increased risk), early onset of menses, short or frequent menstrual cycles, Mullerian abnormalities, autoimmune conditions and more. However, many people develop endo who have none of these risk factors.
Is a hysterectomy considered a cure for endometriosis, and is pregnancy a cure?
Hysterectomy is not a cure for endometriosis. A disease characterized by tissue found outside of the uterus is not cured by removal of the uterus, ovaries and/or tubes and cervix. Over 100,000 hysterectomies are performed each year in the United States for endometriosis and most of them are unnecessary. Neither is pregnancy a cure for endometriosis.
Why are individualized, multi-disciplinary treatment plans needed for endometriosis, and which specialist should be consulted?
People with endometriosis need an individualized, multi-disciplinary treatment plan that may include specialized, incredibly difficult surgery. Most gynecologists are not trained in advanced endometriosis cases. Drug therapy may suppress symptoms, yet it does not eradicate endometriosis. Patients should be referred to an endometriosis specialist.
What are some common co-morbidities associated with endometriosis?
People with endometriosis have an increased risk of co-morbidities including allergies, asthma, and chemical sensitivities, autoimmune diseases such as multiple sclerosis and lupus, chronic fatigue syndrome and fibromyalgia, and certain cancers, such as ovarian and breast cancer.
How does endometriosis impact quality of life beyond physical symptoms, and what holistic approach is recommended?
Endometriosis often reduces quality of life and contributes to psychological distress. Unnecessary delays in diagnosis and gaslighting contribute to the negative mental health impacts of the disease. A holistic approach to care including mental health support can improve quality of life.
What is endometriosis, and is it considered a menstrual disease?
Endometriosis is a systemic, inflammatory condition characterized by tissue similar to the lining of the uterus growing in other parts of the body. Endometriosis has been found in every organ. It is not simply a menstrual disease, yet is often mischaracterized as such, even by reputable sources.
Approximately how many people are affected by endometriosis, and what are some common symptoms they may experience?
Endometriosis affects approximately 1 in 10 people born with female reproductive organs. Common symptoms include, but are not limited to, pelvic pain any time during the month, a wide range of GI symptoms, urinary symptoms, fatigue, debilitating periods and more depending on where the endometriosis lesions are located in the body.
What is the average diagnostic delay for endometriosis, and what factors contribute to this delay?
Symptoms often start early in life, but due to cultural taboos, misinformation and a historical lack of emphasis in medical education, they may be ignored or misdiagnosed by caregivers, healthcare consumers and practitioners alike. The average diagnostic delay is 7-10 years.
When can endometriosis symptoms begin, and what percentage of teenagers withchronic pelvic pain may have the condition?
Endometriosis symptoms may begin as early as when puberty starts. Endometriosis symptoms can present before menstruation, during menstruation, and/or after menstruation. An estimated 70% of teens with chronic pelvic pain go on to be later diagnosed with endometriosis.
What constitutes a "red flag" regarding pelvic pain, and what action should be taken if someone experiences this?
Red flag: If you or your patient regularly feels pain during or around periods, and this pain is bad enough to interfere with usual activities, this is a red flag - it is not normal and should be investigated further as soon as possible. (If you do not have this, it doesn't mean that you don't have endometriosis).
Identified risk factors for developing endometriosis.
Risk factors for endometriosis include a mother or sister having the disease (7x increased risk), early onset of menses, short or frequent menstrual cycles, Mullerian abnormalities, autoimmune conditions and more. However, many people develop endo who have none of these risk factors.
Is a hysterectomy considered a cure for endometriosis, and is pregnancy a cure?
Hysterectomy is not a cure for endometriosis. A disease characterized by tissue found outside of the uterus is not cured by removal of the uterus, ovaries and/or tubes and cervix. Over 100,000 hysterectomies are performed each year in the United States for endometriosis and most of them are unnecessary. Neither is pregnancy a cure for endometriosis.
Why are individualized, multi-disciplinary treatment plans needed for endometriosis, and which specialist should be consulted?
People with endometriosis need an individualized, multi-disciplinary treatment plan that may include specialized, incredibly difficult surgery. Most gynecologists are not trained in advanced endometriosis cases. Drug therapy may suppress symptoms, yet it does not eradicate endometriosis. Patients should be referred to an endometriosis specialist.
What are some common co-morbidities associated with endometriosis?
People with endometriosis have an increased risk of co-morbidities including allergies, asthma, and chemical sensitivities, autoimmune diseases such as multiple sclerosis and lupus, chronic fatigue syndrome and fibromyalgia, and certain cancers, such as ovarian and breast cancer.
How does endometriosis impact quality of life beyond physical symptoms, and what holistic approach is recommended?
Endometriosis often reduces quality of life and contributes to psychological distress. Unnecessary delays in diagnosis and gaslighting contribute to the negative mental health impacts of the disease. A holistic approach to care including mental health support can improve quality of life.
Neuroangiogenesis: Nerves & Blood Vessels Fueling Endo
How Nerves and Blood Vessels Fuel Endometriosis: Understanding Neuroangiogenesis
When we think of endometriosis, we often imagine painful periods, reproductive complications, or fatigue. But beneath these symptoms lies a deeper, more complex process—one that helps explain why this condition is so painful, why it often gets worse over time, and why standard treatments don’t always work.
That process is called neuroangiogenesis—a mouthful of a word that simply means the simultaneous growth of new nerves (neuro-) and blood vessels (-angiogenesis). And it’s changing the way experts understand and treat endometriosis.
What Is Neuroangiogenesis?
Dr. Vimee Bindra, a leading gynecologist and endometriosis specialist, puts it plainly:
“Neuroangiogenesis fuels the pain of endometriosis.”
In her article, she explains that endometriotic lesions aren’t passive—they actively create their own support systems. These lesions grow tiny blood vessels that bring in oxygen and nutrients, helping them survive even in hostile environments like the pelvis, bowel, bladder, or abdominal wall. But even more troubling, they also stimulate nerve growth—making the affected areas more sensitive and painful.
This explains why pain in endometriosis isn’t limited to menstruation. For many women, it’s constant. It flares during ovulation. It radiates into the legs or back. It worsens with movement, digestion, or intimacy.
Why? Because it’s not just inflammation—it’s nerve-driven pain. The same biological mechanisms that help our body heal after injury are being hijacked by endometriosis lesions to sustain and spread the disease.
The Science Behind It
Research supports this dual growth model:
Studies have found that vascular endothelial growth factor (VEGF), which encourages new blood vessel formation, is overproduced in endometriotic tissue.
At the same time, nerve growth factor (NGF) is elevated, helping lesions become densely innervated and hypersensitive.
In fact, some studies report that lesions have 10 to 50 times more nerve fibers than similar tissue in people without endometriosis.
This combination of angiogenesis and neurogenesis makes endometriosis uniquely painful—and uniquely difficult to treat with one-size-fits-all approaches.
Why It Matters
Pain is not just a symptom of endometriosis—it’s a sign of progression.
Neuroangiogenesis helps explain why:
Endometriosis pain doesn’t always correlate with the size of lesions.
Pain can continue even after menopause or a hysterectomy.
Hormonal treatments alone often fail to fully relieve symptoms.
Dr. Bindra emphasizes that neuroangiogenesis helps us reframe endometriosis not just as a hormonal or reproductive issue, but as a neurovascular condition—one that affects the immune system, the nervous system, and the vascular system all at once.
Understanding this has the potential to unlock better, longer-lasting solutions.
A New Direction for Treatment
This evolving science is already inspiring a shift in how endometriosis is treated:
1. Anti-Angiogenic Therapies
By targeting VEGF and other blood vessel growth signals, researchers hope to “starve” lesions and stop them from spreading. Some cancer drugs are being investigated for this purpose, including bevacizumab, which blocks VEGF.
2. Nerve-Targeted Treatments
Medications that calm overactive nerves—such as gabapentin, pregabalin, or even newer biologics aimed at NGF—may help reduce pain at its neurological source.
3. Precision Surgery
Excision surgery done by skilled specialists—especially when guided by lesion-mapping tools like the ENZIAN classification—can remove deep, infiltrating lesions and decompress trapped nerves. This type of surgery is different from ablation and requires specialized expertise, but it can offer significant relief.
As Dr. Bindra notes in her clinical work, identifying the exact location and depth of lesions—especially those invading nerves—is critical for improving surgical outcomes.
Hope on the Horizon
At Our Daughters Foundation, we believe that informed care is empowered care. And understanding neuroangiogenesis gives us all a better framework for navigating endometriosis.
It helps patients explain their pain.
It helps doctors pursue more targeted treatments.
And it helps researchers continue moving toward real, long-term solutions.
You are not imagining your pain. You are not overreacting. You are not alone.
“The more we learn about how endometriosis builds its own nerve and blood supply, the closer we get to stopping it at the source.” – Dr. Vimee Bindra
References
Dr. Vimee Bindra
“Neuroangiogenesis: How Nerves and Blood Vessels Fuel Endometriosis”
https://www.drvimeebindra.com/neuroangiogenesis-how-nerves-and-blood-vessels-fuel-endometriosis/Dr. Vimee Bindra (LinkedIn)
Quote: “Neuroangiogenesis fuels the pain of endometriosis…”
https://www.linkedin.com/posts/dr-vimee-bindra-basu-7514765b_letstalkendo-endometriosisawarenessmonth-activity-7305270488694501381-KtCYTokushige N, Markham R, Russell P, Fraser IS
“Nerve fibers in peritoneal endometriosis”
Human Reproduction, 2006.
https://doi.org/10.1093/humrep/del009Taylor RN, Yu J, Torres PB, Schickedanz AC, Park JK, Mueller MD
“Mechanistic and therapeutic implications of angiogenesis in endometriosis”
Reproductive Sciences, 2020.
https://doi.org/10.1177/1933719119899937Arnold J, Barcena de Arellano ML, Rüster C, et al.
“Immunologic alterations in endometriosis: current understanding and future therapeutic implications”
Journal of Clinical Medicine, 2020.
https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7349441/Ferrero S, Gillott DJ, Remorgida V, et al.
“Use of antiangiogenic agents to treat endometriosis: a review”
Gynecological Endocrinology, 2010.
https://doi.org/10.3109/09513590903247814Bindra V, et al.
“Clinical Characteristics and Locations of Lesions in Patients with Endometriosis Using ENZIAN Classification”
Journal of Obstetrics and Gynaecology of India, 2025.
https://pubmed.ncbi.nlm.nih.gov/40390882/
Join Us: Make a Difference Today
Your support can transform lives. Every donation helps us fund research, advocate for better care, and provide essential grants to women facing debilitating conditions.
Join Us: Make a Difference Today
Your support can transform lives. Every donation helps us fund research, advocate for better care, and provide essential grants to women facing debilitating conditions.
