Endometriosis can run in families, meaning your risk may be higher if a close relative has it. However, it is a complex condition influenced by multiple genes, hormones, and environmental factors.
If a first-degree relative—your mother, sister, or daughter—has endometriosis, your chance of developing it is about 5-10 times higher than someone with no family history.
Endometriosis can also cluster among second-degree relatives, like your grandmothers and aunts. If multiple family members have endometriosis, your risk may be further increased. However, family history doesn’t mean you will definitely develop endometriosis.
Endometriosis is a polygenic condition, meaning many genes, rather than a single gene, influence your risk. (In contrast, a mutation in one gene causes conditions like cystic fibrosis, where inheritance follows a more predictable pattern.)
Researchers have identified more than 30 genetic areas that share a link to endometriosis. These differences affect how your body handles hormones, inflammation (irritation and swelling), and tissue growth. When several genetic differences occur together, your risk for endometriosis rises.
Twin studies offer another way to understand genetic influence. Identical twins share all their genes, while fraternal twins share about half. If one identical twin has endometriosis, the other develops it about 20% of the time. In fraternal twins, the rate is closer to 10%. These findings suggest that genetics matter, but it is only part of the picture. Scientists estimate that genetics account for about half of the risk of endometriosis.
If you have a family history, watch for these signs and symptoms of endometriosis that warrant a conversation with your healthcare provider:
- Chronic pelvic pain (the area between your hips)
- Difficulty getting pregnant
- Digestive symptoms (belly pain, bloating, constipation, diarrhea, or nausea)
- Thigh or lower back pain
- Pain during sex (typically a deep pain)
- Painful bowel movements (pooping) or urination (peeing)
- Rectal bleeding
- Severe menstrual cramps
Besides family history, factors like hormones, immune function, and your environment can play a role in whether you develop endometriosis.
Your chance of developing endometriosis increases if you have:
- A condition that interferes with normal menstrual flow, such as uterine fibroids
- Early onset of periods (before age 11)
- Estrogen dominance or progesterone resistance
- Heavy or long periods that last more than seven days
- Low body mass index (BMI)
- Never been pregnant
- Short menstrual cycles (less than 27 days)
- Chronic stress
- Exposure to hormone-disrupting chemicals
If endometriosis runs in your family or your symptoms persist, these next steps can help you move forward with care:
- Get another opinion: If your provider does not address your concern, consider a second opinion or a referral to an endometriosis specialist.
- Share your family history with your provider: Include which close relatives have endometriosis or symptoms of endometriosis.
- Track your symptoms: Note pain locations and levels, cycle patterns, period bleeding amounts, and how symptoms impact your life.
- Discuss potential treatments: Ask your provider if hormonal birth control, prescription nonsteroidal anti-inflammatory drugs (NSAIDs) like Ponstel (mefenamic acid), or other treatments are an option for you.
