Endometriosis Should Be Reclassified as a Whole-Body Disorder, Experts Say : ScienceAlert

Endometriosis is a chronic, painful condition impacting 10% of women globally. It arises when tissue similar to the uterine lining, known as lesions, grows in other parts of the body, typically within the pelvic region.

Treating endometriosis poses significant challenges. The usual approaches focus on either preventing lesion development or surgically removing them. However, symptoms often persist even after surgical removal of the lesions, as noted in studies.

Historically, endometriosis has been viewed as a gynecological issue. Yet, increasing evidence suggests this perspective oversimplifies the disease’s complexity.

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Endometriosis seems to affect more than just the reproductive organs. Research increasingly indicates it impacts immune function throughout the entire body.

Identifying it as a systemic, immune-related condition could clarify why its symptoms extend well beyond pelvic pain, and why treatment often struggles to alleviate these symptoms effectively.

A Disease of the Entire Immune System

Inflammation is a natural immune response to injury or illness and plays a significant role in the menstrual cycle. However, when inflammation becomes chronic or unchecked, issues arise, as seen in autoimmune diseases like rheumatoid arthritis, where the immune system reacts excessively without any real threat.

Chronic inflammation is pivotal in endometriosis, and its effects may be more extensive than previously recognized.

According to recent research, the immune response in endometriosis appears to permeate the bloodstream and other body systems, potentially explaining the widespread symptoms.

Individuals with endometriosis have immune cells that seem less effective at clearing lesions.

Additionally, those with the condition often exhibit elevated levels of immune proteins like IL-6 and IL-1β in their bloodstream. These cytokines, or cell messengers, are released to promote inflammation.

This dysfunction allows lesions to persist and grow, with broader effects throughout the body, leading to a wide array of symptoms.

For example, many with endometriosis endure severe fatigue, cognitive issues (commonly known as “brain fog”), and widespread pain. These symptoms, often as impactful as pelvic pain, are seldom highlighted in clinical guidelines.

Systemic inflammation provides a convincing reason for these symptoms. The circulating cytokines are known to affect brain function and energy balance.

Elevated cytokine levels, including IL-6, are associated with reduced concentration, disrupted sleep, and fatigue in some autoimmune and chronic pain conditions.

These processes might also be occurring in endometriosis, suggesting that the less visible symptoms could be biological results of persistent inflammation, rather than secondary effects of pain.

The dysfunction within the immune system may also shed light on emerging research indicating a link between endometriosis and autoimmune diseases.

In 2025, a large study involving 330,000 endometriosis patients and 1.2 million controls (those without the condition) was conducted.

The results showed that those with endometriosis had roughly double the risk of being diagnosed with autoimmune diseases—such as rheumatoid arthritis, lupus, multiple sclerosis, or Hashimoto’s disease—within two years of their endometriosis diagnosis.

This finding does not classify endometriosis as an autoimmune disease but suggests shared mechanisms such as chronic inflammation, disrupted immune cell activity, and challenges in the immune system’s ability to properly recognize the body’s tissues.

These overlapping characteristics reinforce the argument for viewing endometriosis as a systemic immune disorder.

Reconsidering Endometriosis

This perspective could revolutionize endometriosis diagnosis, treatment, and understanding, potentially bringing us closer to effective solutions.

Current treatments mainly focus on the reproductive system. However, if endometriosis involves broader immune dysfunction, therapies targeting immune pathways may provide more enduring relief.

Viewing endometriosis as a systemic condition can also empower patients.

This reframing may help them recognize that symptoms like fatigue, joint pain, cognitive issues, and immune sensitivity are not imagined or unrelated. Instead, they are integral to the condition’s biology.

Understanding this can aid patients in advocating for themselves in healthcare environments, where systemic symptoms are often overlooked or given lower priority.

This systemic view also encourages patients to explore complementary management strategies focused on reducing inflammation or enhancing overall wellbeing.

While not a cure, many find gentle exercise, stress management techniques, and heat-cold contrast therapy beneficial for managing pain or inflammatory episodes.

Related: Huge Study Finds Swathe of Genetic Risk Factors For Endometriosis

Research increasingly demonstrates that endometriosis is not just a reproductive issue or a “bad period.” It is a multi-system, inflammatory disorder with extensive health implications throughout the body.

Recognizing endometriosis as a systemic immune disease is an essential step toward improving treatments, enhancing support, and ultimately achieving better health outcomes.

April Rees, Lecturer, Biochemistry & Immunology, Swansea University and Laura Elizabeth Cowley, Senior Research Officer and Data Scientist, Health Data Science, Swansea University

This article is republished from The Conversation under a Creative Commons license. Read the original article.