Endometriosis
Endometriosis isn’t one disease — it’s many.
Diversity in immune responses, hormone receptor expression, and transcriptomic profiles all suggest that endometriosis manifests uniquely in each individual, requiring personalized diagnostic and therapeutic approaches.
One Size Does Not Fit All
Understanding Endometriosis
The Lotus Endometriosis Institute takes a unique stance on endometriosis that you are unlikely to find elsewhere. Recent molecular and genomic research strongly supports the notion that endometriosis is not a single disease entity, but a heterogeneous condition composed of distinct subtypes. Each of these subtypes have potentially different origins, clinical behavior, and treatment responses. Some of it is genetic, some of it you can influence, and some you cannot.
What is it?
Endometriosis is a condition where cells similar to the uterine lining (endometrium) grow outside the uterus, potentially into the pelvis or abdomen. The condition has varying severities and symptoms.
When can it happen?
Endometriosis can occur at any age. It can be found in your teens, early childhood, or even earlier in-utero as a fetus. The condition primarily affects middle aged women, but can also be post-menopausal.
Why does it occur?
The exact causes are not currently known, and they likely differ from person to person. Contributors possibly include embryologic müllerianosis, genetics & epigenetics, molecular translational changes, pelvic tissue transformation called metaplasia and more. It is most definitely "multi-factorial" and "polygenic".
Where can it spread?
Endometriosis can affect not only your pelvic organs and delicate structures, which include your bladder, ureters and rectum, but also outside your pelvis higher up in the abdomen. There it can involve your intestines. Endometriosis can spread literally anywhere in your body, including the lungs (metastatic) and beyond.
Common Issues
Symptoms
Endometriosis often presents with symptoms that can vary greatly in severity and impact, making it challenging to recognize early. While some people experience debilitating pain, others may have subtle signs that are easily overlooked or mistaken for common menstrual issues. Understanding the range of potential symptoms is the first step toward earlier diagnosis and effective treatment.
Pelvic / Abdominal Pain
Persistent or cyclical pain in the pelvis and lower abdomen is one of the most common symptoms, often worsening around menstruation but not limited to it.
Bloating
Abdominal bloating, sometimes called “endo belly,” can appear suddenly, feel severe, and fluctuate day to day.
Painful Sex
Discomfort or sharp pain during or after intercourse is common, often tied to inflammation, scarring, or adhesions.
Infertility
Endometriosis can interfere with fertility by affecting the ovaries, fallopian tubes, or pelvic environment, though many with the condition do conceive with treatment.
Urinary Frequency
Some experience urgency or frequent urination, particularly if lesions involve the bladder.
Painful Bowel Movements
Bowel movements may trigger cramping or sharp pain, especially during menstrual cycles.
Back and Leg Pain
Pain can radiate into the lower back, hips, or legs, reflecting how endometriosis affects surrounding nerves and tissues.
And Far More
Symptoms extend well beyond this list, with wide-ranging effects on the body and quality of life—making awareness and individualized evaluation essential.
Because Your Experience Matters
Every symptom tells a story—we are here to listen to yours.
We understand how overwhelming and isolating these symptoms can feel, and you don’t have to face them alone. At Lotus Endometriosis Institute, we combine world-class surgical expertise with integrative, whole-person care to uncover the true root of your pain. This unique approach gives you the best chance at lasting relief, restored health, and a better quality of life. Take the first step toward healing—reach out today and let us help guide you forward.
Different for Everyone
Subtypes & Stages
The ASRM (American Society for Reproductive Medicine), defines four stages of endometriosis. The stages are not necessarily proportional to pain or symptoms. Some patients exhibit less pain than others, even if they have a higher stage diagnosis. Additionally, the condition can be described by different "subtypes" including: superficial endometriosis (on peritoneal surface), deep infiltrating endometriosis (invading tissues), ovarian endometriomas ("chocolate cysts"), metastatic endometriosis (spread to distant areas), and malignant degeneration (rare but life-threatening).
Stage 1 - Minimal
There are small patches or implants either on or around the organs in the pelvis.
Stage 2 - Mild
Increasing number of implants but damage to the pelvic organs is still minimal with not much scarring or adhesions. Altogether, the implants are not more than ~5cm.
Stage 3 - Moderate
Implants are more widespread and are beginning to infiltrate the organs in the pelvic region, including pelvic side walls, ureters, and peritoneum. There is more scarring and adhesions and endometriomas (“chocolate cyts”) on the ovary.
Stage 4 - Severe
The disease is infiltrating and affecting several organs (e.g. bladder, rectum) in the pelvic region, as well as the ovaries. Anatomy is severely distorted with scars and adhesions, with fibrosis (like concrete) between organs. Larger and more endometriomas can be seen.
Insights for Your Health
Prevention and Detection
While the near future may bring molecular genetic insights into targeted prevention, today there is no reliable way to prevent endometriosis. In fact, there is a genetic predisposition which is not well understood. If you have a relative with endometriosis, you have a 5-7x risk of being affected. What those genetic switches are will be uncovered soon and prevention and treatment will be enhanced. Meanwhile, you can do a lot towards reducing the chances it will affect you and maybe decrease endometriosis progression. We provide integrative insights into endometriosis-reducing lifestyle-modifications, and they are as natural a strategy for endometriosis treatment as it gets.
Excision Surgery Leads the Way
Surgical Treatment
Surgery plays a central role in endometriosis care, serving as both a diagnostic tool and today’s gold-standard for initial treatment of pain relief, infertility, and suspicious masses. Because endometriosis can vary depending on where it is located—inside or outside the pelvis—and what stage it has reached, treatment must be carefully tailored to each individual. Minimally invasive excision surgery offers accurate diagnosis while providing effective symptom relief, but it should be strategically timed, as repeated procedures can increase scar tissue and risk. For the best outcomes, the benefits must always outweigh the risks, making timing and the expertise of the surgeon essential to every decision.
Reach Out
Have a question?
We understand that healthcare can be complex and overwhelming, and we are committed to making the process as easy and stress-free as possible.
Call Us
(424) 255-1340
Santa Monica, CA
2121 Santa Monica Blvd, Santa Monica, CA 90404
Operating Hours
9:00 am - 5:00 pm
Monday - Friday
Arroyo Grande, CA
154 Traffic Way, Arroyo Grande, CA 93420