Can endometriosis cause weight gain?

Endometriosis is a chronic condition involving the tissue that lines your uterus to grow elsewhere. This can lead to lesions and severe pain as well as other symptoms, such as:

• heavy and irregular periods
• irregular bleeding
• bloating
• infertility

While pain is the most common symptom of endometriosis, some people notice weight gain alongside their other symptoms.

There is little research to support that endometriosis directly causes weight gain, but there may be other reasons why people report weight gain as a symptom of the condition.

Does endometriosis cause weight gain?

While many people notice weight gain alongside other symptoms of endometriosis, there is not yet any evidence that shows a direct link between the condition and weight gain.

However, other symptoms like fatigue and chronic pain can make daily functioning difficult during a flare-up. This is likely to affect your ability to exercise, which may lead to weight gain.

Research into weight changes with endometriosis is contradictory, with some studies noting endometriosis causes weight loss, especially if you experience chronic pain and nausea with the condition.

Bloating from endometriosis is a common yet uncomfortable and unpleasant symptom of endometriosis, affecting over 80% of people with the condition. This can often make you feel like you’ve gained weight, which people often call “endo belly.”

This can happen due to many factors, such as:

• a buildup of gases along your intestinal tract
• endometrial tissue that causes inflammation in your abdomen, leading to swelling and water retention
• small intestinal bacterial overgrowth (SIBO), which is common in people with endometriosis and causes bloating

How does endometriosis cause weight gain?

Endometriosis may lead to weight gain indirectly due to treatment and other conditions that can occur alongside the condition.

Hormone levels

Endometriosis is an estrogen-dependent condition, which means that endometrial-like tissue can worsen in response to estrogen exposure. This hormone is responsible for the uterine lining thickening during your monthly menstrual cycle. Estrogen can also lead to other symptoms like bloating and breast tenderness.

While estrogen does not typically cause weight gain, general hormonal imbalances can affect your metabolism and, therefore, your weight.

For example, during menopause, as estrogen levels drop, you may notice weight gain around the waist and hips.

Polycystic ovarian syndrome (PCOS)

PCOS is a common condition where you have higher-than-typical levels of male hormones. It can result in:

• irregular periods
• hair growth in unusual places
• weight gain — as many as 4 in 5 people with PCOS have obesity

A 2023 study exploring the ink between endometriosis and PCOS found that almost 1 in 20 women had both endometriosis and symptoms consistent with PCOS.

Medication side effects

Doctors often recommend hormonal birth control, such as the combined pill, to help slow endometriotic tissue growth outside your uterus.

Most forms of hormonal birth control are not associated with weight gain, though some may cause water retention. However, depo-provera has associations with weight gain. This is a monthly progesterone injection deep into the muscles.

Treatment for endometriosis

Endometriosis is difficult to diagnose, and there is currently no cure. However, several treatments, including medications and surgical procedures, can help with symptoms, such as pain.

Medication options

Some medications that a doctor may prescribe include:

• Pain medications: Nonsteroidal anti-inflammatory drugs (NSAIDs) help lower inflammation, which causes pain and swelling. Examples include over-the-counter medications, such as ibuprofen (Advil).
• Hormonal birth control: Hormonal medications such as pills, vaginal rings, and intrauterine devices prevent fertility but can also stop the growth of endometrial tissue. Examples include levonorgestrel (Aviane) and norethindrone (Camila).
• Gonadotropin-releasing hormone (GnRH) agonists: These hormonal medications block estrogen production and include the injectable leuprorelin (Lupron Depot). This can prevent the stimulation of your ovaries, which induces medical menopause. However, this may cause side effects like hot flashes.

Surgical treatments

There are three main types of surgery that a doctor may recommend for people with endometriosis. These can include:

• Laparoscopy: This minimally invasive procedure helps determine if you have endometriosis. If a surgeon finds endometrial tissue growing outside the uterus, they may remove it during this procedure. It involves a small incision, which allows a camera to enter your abdomen.
• Laparotomy: This procedure involves a large incision across your abdomen. A doctor is only likely to suggest a laparotomy if a laparoscopy is unsuccessful and your condition is advanced.
• Hysterectomy: Hysterectomies are a last resort for someone with endometriosis and can involve removing the entire reproductive system or your uterus only. Removing your uterus will stop your periods while removing both ovaries results in menopause.

You can speak with a healthcare professional to find out which type of treatment is the most suitable for you and your lifestyle.

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Lifestyle measures

Various lifestyle measures can help reduce the severity of your symptoms and slow the progression of endometriosis.

These include:

• Avoiding alcohol: Inflammation can worsen endometriosis symptoms. If you drink alcohol, avoiding it can reduce inflammation levels and lower oxidative stress.
• Eating a healthy diet: A diet rich in anti-inflammatory minerals and vitamins, such as leafy greens and oily fish, can help. It may also be beneficial to avoid eating red meat.
• Lowering stress levels: Higher stress levels can worsen symptoms of endometriosis. Lifestyle practices such as getting enough sleep and regularly meditating can help lower your levels of stress.

Summary

Endometriosis is a severe and chronic condition that causes uterine tissue to grow elsewhere in the body.

While some people report weight gain as a symptom of endometriosis, there is a lack of scientific evidence to support it as a direct cause. However, many other factors can lead to weight gain, such as hormone levels and side effects from medications you may be taking.

If you find endometriosis symptoms affect your day-to-day life, consider speaking with a healthcare professional. They can put together a treatment plan that can help.

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