America is bulging at its waistline and according to the Centers for Disease Control, nearly one-third of women in the United States are heavy. As girth increases, a woman’s chances of getting endometriosis, a painful disease of the reproductive organs, proportionately rises. Being overweight is one of many factors that may contribute to having endometriosis.

Endometriosis is a common health problem in women. In fact, according to the National Women’s Health Information Center, endometriosis is prevalent in women, affecting up to 5 percent of women of childbearing age. This means that endometriosis affects more than 13 million women in the U.S. Endometriosis can appear in any woman but is most frequently diagnosed in women in their 30s and 40s.

Endometriosis is a condition in which the tissue lining the uterus or womb, known as the endometrium, implants and begins to grow outside the uterus on other nearby organs and surfaces. It is most often found on the fallopian tubes, ovaries, the lining of the pelvic cavity, and the outer surface of the uterus. Growths from endometriosis can also exist in the vagina, bladder, bowel, and cervix. According to the U.S. Department of Health and Human Services, in extreme but rare cases, endometriosis has been found in the brain or lungs.

Symptoms of endometriosis may include pain in the lower back, abdomen, and pelvis especially during the menstrual period. Other symptoms can be pain during or after sex, intestinal pain, painful urination or bowel movements during menstruation, spotting between periods, and an inability to get pregnant. Some women with endometriosis have no symptoms at all.

When a woman is diagnosed with endometriosis, the symptoms are categorized in two ways: pelvic pain, which most often occurs during the menstrual cycle, and infertility.

According to the Cleveland Clinic, approximately 30 to 40 percent of endometriosis patients develop infertility as a consequence of their condition. A diagnosis of even minimal or mild endometriosis can negatively affect a woman’s ability to get pregnant.

There are three potential approaches to the treatment of endometriosis. Some doctors may recommend ibuprofen for pain relief or, if needed, stronger prescription painkillers. Endometriosis may also effectively be treated with medications that decrease estrogen, but this approach can only be used in women who do not want to get pregnant because this treatment, like the birth control pill, will prevent pregnancy. The third approach to treatment is surgical. Endometriosis can be both diagnosed and eliminated, in some cases, through the use of a small surgical scope. Pain relief can be immediate but the procedure is not always successful. Fertility can be improved with a surgical approach as well but this is not usually a lasting effect. In vitro fertilization is often the best option for women who have severe endometriosis and fertility problems.

To reduce your chances of getting endometriosis, The National Women’s Health Information Center recommends exercising regularly, avoiding excessive use of alcohol and caffeine, and keeping a lower amount of body fat.

In addition to being overweight, research shows that there is a link between endometriosis and the presence of other diseases such as asthma, allergies, some cancers, and auto-immune diseases.

It is unclear what causes endometriosis but there are a number of theories. The prevailing theory is that endometrial tissue makes its way into the pelvis through the fallopian tubes. While one’s immune system ordinarily would eliminate this misplaced tissue, some women’s immune systems are not able to do so. Some experts think there may be a genetic component since the disease often runs in families.

If you have symptoms of endometriosis, talk to your OB/GYN. Your doctor may recommend a pelvic exam, ultrasound, or laparoscopy to determine the presence of endometriosis or to rule out other conditions as the culprit.

Janet L. Kennedy, M.D. is a reproductive endocrinologist at the Northwest Center for Reproductive Sciences in Kirkland. Contact her at 425-284-4400.