A difficult condition, endometriosis can be very painful. Symptoms include pain and excessive menstrual cramps, fatigue, painful urination or bowel movements during menstrual periods, and others. If you feel you are experiencing these symptoms or would like an evaluation, make an appointment with one of our expert physicians. Our specialists are fellowship trained with the experience to help you understand your body and recommend customized treatment solutions.

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What is endometriosis?

The tissue that lines the uterus is called the endometrium. Normally, if a woman doesn’t get pregnant, this tissue is shed each month during her period. In endometriosis, tissue that looks and acts like endometrial tissue implants outside the uterus. Each month, this misplaced tissue responds to the hormonal changes of the menstrual cycle. It builds up, breaks down, and bleeds. But, the blood has nowhere to go. This causes surrounding tissue to become inflamed or swollen. It can also cause scar tissue, chronic pain, and heavy periods.

Endometriosis is a main cause of infertility in women. This can happen if the tissue implants in the ovaries or fallopian tubes.  Tissue can also implant on other organs in the pelvis.

What causes endometriosis?

The cause of endometriosis is not clear. It may be that during a woman’s period, some of the tissue backs up through the fallopian tubes into the abdomen. Another theory suggests genes are to blame. Current research is also looking at the role of the immune system.

What are the risk factors for endometriosis?

While any woman may develop endometriosis, the following women seem to be at an increased risk for the disease:

  • Women who have a mother, sister, or daughter with the disease
  • Women who gave birth for the first time after age 30
  • White women
  • Women with an abnormal uterus

What are the symptoms of endometriosis?

While each woman may experience symptoms differently, these are the most common symptoms:

  • Pain, cramps which may be felt in the abdomen or lower back during your period
  • Pain during sex
  • Abnormal or heavy menstrual flow
  • Infertility
  • Fatigue
  • Painful urination during your periods
  • Painful bowel movements during your periods
  • Other gastrointestinal problems, such as diarrhea, constipation, and/or nausea

The amount of pain a woman has isn’t always related to the severity of the disease. Some women with severe disease may have no pain. Other women with a milder form of the disease may have severe pain or other symptoms.

How is endometriosis diagnosed?

First, your doctor will review your medical history. You will also have a physical exam and a pelvic exam.

A laparoscopy is done to diagnose endometriosis. This uses a thin tube with a lens and a light at the end. It’s inserted into an incision in the abdominal wall to see into the pelvic area. The health care provider can often find the locations, extent, and size of the misplaced tissue.

Other tests may include:

  • Biopsy. For this test, a small tissue sample is removed from the body and examined.
  • Ultrasound. This imaging test uses high-frequency sound waves to create an image of the organs.
  • Computed tomography (CT scan). For this imaging test, X-rays and a computer are used to make images (often called slices). It can find problems that may not show up on an ordinary X-ray.
  • Magnetic resonance imaging (MRI). This imaging test provides a two-dimensional view of organs or tissue.

How is endometriosis treated?

Your health care provider will consider your age, overall health, symptoms and other factors when advising what treatment is best for you. Whether you hope to become pregnant will also play a role in your options.

Treatment options include medicine, surgery, or both. If symptoms are mild, you may only need pain medicine. In other cases, hormone-based medicine, such as birth control pills, will stop ovulation and slow endometriosis.

Several options can be used to remove the implants. Doctors may be able to remove abnormal tissue growths using a laparoscope. In other cases, open surgery is needed. Surgery to remove the uterus is also an option.

What are the complications of endometriosis?

Endometriosis can make it very hard or impossible for a woman to get pregnant. Sometimes surgery can help. But, in a few cases, women may remain infertile.

Living with endometriosis

Simple steps that can help ease the pain of endometriosis include:

  • Rest, relaxation, and meditation
  • Warm baths
  • Prevent constipation
  • Regular exercise
  • Use of hot water bottle or heating pad on your abdomen

Key points

  • Endometriosis is common in women of during the years they can have children.
  • It causes tissue that looks and acts like endometrial tissue to implant outside the uterus. 
  • Treatment  may include medicine, surgery, or both. 
  • It can make it very hard or impossible for a woman to get pregnant.

Next steps

Tips to help you get the most from a visit to your health care provider:

  • Before your visit, write down questions you want answered.
  • Bring someone with you to help you ask questions and remember what your provider tells you.
  • At the visit, write down the names of new medicines, treatments, or tests, and any new instructions your provider gives you.
  • If you have a follow-up appointment, write down the date, time, and purpose for that visit.
  • Know how you can contact your provider if you have questions.

Douglas T. Carrell, Ph.D., H.C.L.D.

Doug Carrell received his Ph.D. degree in reproductive physiology from the University of Utah in 1995, after receiving a M.S. degree in cellular and developmental biology from Brigham Young University. Dr. Carrell has worked in the area of research and treatment of human infertility for 30 years. Dr. Carrell is the clinical laboratory director of t... Read More


Andrology, In Vitro Fertilization, Reproductive Endocrinology & Infertility


Andrology & IVF Laboratories (801) 581-3740

Mark Dassel, M.D.

Mark W. Dassel, M.D. is an Assistant Professor and women's health provider, with a special interest in Minimally Invasive Gynecology. Dr. Dassel received two B.S. degrees and an M.D. degree from the University of Kentucky. He completed an Obstetrics & Gynecology residency program at the Phoenix Integrated Residency in OB/GYN and a 2 year fello... Read More

Jessie A. Dorais, M.D.

Jessie Dorais, M.D. as a Clinical Assistant Professor, in the Division of Reproductive Endocrinology and Infertility. Dr. Dorais received a Bachelor of Science degree in Biology from Brigham Young University in 2003, and her M.D. from the University of Illinois, College of Medicine in 2007. She completed her Obstetrics & Gynecology residency ... Read More

James M. Hotaling, M.D., M.S., FECSM

Dr. Hotaling has significant training in both the clinical aspects of male fertility and genetic epidemiology and he is currently the only fellowship trained male infertility/andrology expert in Utah. He completed a 6 year residency in urology at the University of Washington, elected to pursue a year of sub-specialty training in male infertility ... Read More

Erica B. Johnstone, M.D.

Erica B. Johnstone, M.D., M.H.S., is a gynecologist and reproductive endocrinologist in the Division of Reproductive Endocrinology and Infertility. Dr. Johnstone clinical interests include reproductive endocrine disorders and all types of infertility, and she also works with hormonal disorders in children and adolescents. Her research interests in... Read More

William R. Keye, M.D.

William R. Keye, M.D., is a board-certified physician specializing in obstetrics and gynecology, as well as reproductive endocrinology and infertility. He received his medical degree from the University of Minnesota, and was an original member of the University of Utah’s I.V.F.(in vitro fertilization) team. He served as Director of that team until ... Read More


Reproductive Endocrinology & Infertility


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Andrew K. Moore, M.D.

Dr. Moore is pleased to bring the University of Utah’s world-class reproductive medicine closer to home for Utah Valley and southern Salt Lake county residents. He has office hourse each week in South Jordan and Orem. Dr. Moore's clinical interests include the full breadth of reproductive endocrinology and fertility treatment, as well as speciali... Read More

C. Matthew Peterson, M.D.

Matthew Peterson, M.D., is a Reproductive Endocrinologist in the University of Utah Department of Obstetrics and Gynecology. Dr. Peterson received his undergraduate degree, magna cum laude from Brigham Young University in 1977 and his M.D. from the University of Utah in 1981. His residency training in obstetrics and gynecology was accomplished at M... Read More

Reproductive Medicine services are available at the Utah Center for Reproductive Medicine as well as multiple locations through out the state of Utah, including Centerville, Orem, South Jordan and Park City. Our reproductive endocrinologists offer a wide range of services including:

  • Infertility counseling
  • Infertility monitoring and treatment
  • IUD insertion and removal
  • Annual gynecological exams
  • Endocrinology
  • Diagnosis and treatment of polycystic ovary syndrome
  • In vitro fertilization
  • Treatment of endometriosis
  • Pediatric and adolescent gynecology services

Our highly trained reproductive endocrinology specialists are experts in both the treatment and research of infertility and our clinic consistently boasts one of the highest success rates in the nation.

Neighborhood Health Center Locations:

Utah Center for Reproductive Medicine 675 Arapeen Way, Suite 205
Salt Lake City, Utah 84108-1237
University of Utah Health Care
Centerville Health Center
26 South Main
Centerville, Utah 84014
Dixie Regional Medical Center 544 South 300 East
St. George, UT 84770
McKay Dee Hospital 4401 Harrison Blvd.
Ogden, UT 84403
University of Utah Health Care
Redstone Health Center
1743 W. Redstone Center Drive, #115
Park City, Utah 84098
University of Utah Health Care
South Jordan Health Center
5126 W. Daybreak Parkway
South Jordan, 84095
Utah Valley Regional Medical Center
Woman’s and Children’s Clinic
1034 N 500 W
Provo, Utah 84604