Endometriosis and Autoimmune Disease: Understanding the Link
Explore how immune dysfunction may link endometriosis to autoimmune diseases such as lupus, RA, thyroid disease, celiac, MS, and IBD - evidence and care.
5 minute read
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Understand how autoimmune diseases intersect with endometriosis, including shared mechanisms, overlapping symptoms, and risks. Get guidance on implications for diagnosis, treatment options, and coordinating care with your healthcare team.
Overview
Autoimmune diseases occur more often in people with endometriosis than in the general population, even though endometriosis itself isn’t classified as primarily autoimmune. Immune dysregulation—changes in macrophages, T and B cells, cytokines, and autoantibodies—may help explain higher rates of thyroiditis, celiac disease, rheumatoid arthritis, psoriasis, lupus, and Sjögren’s syndrome. Because fatigue, joint aches, rashes, and bowel changes can mimic an endometriosis flare, separating overlapping symptoms from a true comorbidity is essential for timely care.
Guidance centers on when to consider targeted testing, red flags that warrant referral, and how to coordinate care with rheumatology, endocrinology, and gastroenterology. Discover how immunosuppressants and biologics interact with hormonal options for endometriosis, ways to protect bone and gut health, and implications for conception and pregnancy. For digestive autoimmune conditions and the microbiome, see IBS / IBD and Gut Health; for pain control and hormone choices, see Medical Management; for family‑building, see Fertility & Reproductive Health and Pregnancy.
Is endometriosis an autoimmune disease?
No. Endometriosis is not formally classified as an autoimmune disease, but it shares immune features such as chronic inflammation and altered antibody responses. This may change as we better understand immunomodulatory effects in endometriosis. However, these changes are linked with a higher likelihood of coexisting autoimmune conditions, so symptom-based screening is often appropriate.
Which autoimmune conditions most often coexist, and what symptoms should prompt testing?
Autoimmune thyroid disease, celiac disease, rheumatoid arthritis, psoriasis, lupus, and Sjögren’s are reported more frequently with endometriosis. Concerning signs include persistent fatigue, heat or cold intolerance, hair loss, joint swelling, photosensitive rashes, mouth/eye dryness, chronic diarrhea, or unexplained weight loss; initial tests may include TSH and thyroid antibodies, celiac serology (tTG‑IgA with total IgA), inflammatory markers, and symptom‑guided ANA panels.
Do autoimmune medications help endometriosis symptoms?
Treating an autoimmune disease can lower whole‑body inflammation and indirectly ease some pain or fatigue, but these medicines do not eradicate endometriosis lesions. Endometriosis usually requires excisional surgery for diagnosis and cornerstone therapy, along with targeted hormonal modulation; see Medical Management for options that can be coordinated alongside immunosuppressants or biologics.
Are hormonal treatments for endometriosis safe if I have an autoimmune disease?
Most progestogen‑based options (pills, injections, or the levonorgestrel IUD) are compatible with autoimmune therapies. Estrogen‑containing methods may be avoided in people with clotting risks such as antiphospholipid antibodies; medication plans are individualized with rheumatology or endocrinology input to balance symptom control and safety.
How do autoimmune conditions influence fertility and pregnancy with endometriosis?
Autoimmune diseases can add risks for infertility and miscarriage, but optimizing disease control often improves outcomes. Examples include normalizing thyroid function before conception, strict gluten‑free diet for confirmed celiac disease, and targeted evaluation for recurrent pregnancy loss; see Fertility & Reproductive Health and Pregnancy for detailed planning and monitoring guidance.
The Overlap Between Lupus and Endometriosis
Explore the link between lupus (SLE) and endometriosis: outcomes, key results, clinical implications, and priorities for future research.
3 minute read
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