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Endometriosis is a condition that affects millions of women worldwide, yet it remains shrouded in mystery. If you’ve ever spent hours scrolling forums, trying to decode medical jargon, or side-eyeing your doctor for another “we don’t fully understand it yet” response — you’re not alone. Many women who experience its painful symptoms often wonder about its nature and classification.
One of the biggest debates? Whether endometriosis is an autoimmune disease.
What type of disease is endometriosis classified as?
Endometriosis is primarily classified as a gynecological disorder. Right now, it’s categorized as a chronic inflammatory disease with a hormonal component.
It occurs when tissue similar to the lining of the uterus (endometrium) grows outside the uterus. This tissue can be found on the ovaries, fallopian tubes, and even in areas outside the pelvic region. Despite its classification, the nature of endometriosis is complex, and its effects extend beyond the reproductive system.
While it's not officially categorized as an autoimmune disease, endometriosis shares some characteristics with autoimmune conditions. This similarity has led to ongoing research and debate in the medical community about its true nature.
Does endometriosis affect your immune system?
Absolutely. And this is where things get interesting.
Research has shown that people with endometriosis often have an immune system that doesn’t quite do what it’s supposed to. In a healthy immune system, abnormal cells are flagged and destroyed. But in endometriosis, the immune system kind of drops the ball, letting those endometrial-like cells implant and thrive in places they shouldn’t.
A 1987 study found that women with endometriosis had abnormal immune responses, including increased levels of certain inflammatory markers. More recent research has backed this up, showing that people with endometriosis often have higher levels of inflammatory cytokines (aka immune system messengers that trigger inflammation) and lower levels of natural killer (NK) cells — the immune system’s assassins that normally destroy problem cells.
So, while endometriosis isn’t officially classified as an autoimmune disease, it does seem to involve immune dysfunction. The immune system isn’t attacking the body in the way it does with classic autoimmune diseases like lupus or rheumatoid arthritis, but it’s definitely misfiring.
Is autoimmune linked to endometriosis?
There’s a strong connection between endometriosis and autoimmune diseases, even if one isn’t directly causing the other. Studies suggest that people with endometriosis are more likely to have autoimmune conditions like Hashimoto’s, thyroiditis, rheumatoid arthritis, multiple sclerosis, and inflammatory bowel diseases like Crohn’s or ulcerative colitis.
A few studies have found that women with endometriosis had higher rates of autoimmune conditions compared to those without endo, suggesting a shared immune system dysfunction between these conditions.
And that’s not all — women with endometriosis often have higher levels of autoantibodies — antibodies that mistakenly target the body's own tissues. This is a hallmark of autoimmune diseases.
That might explain why so many people with endo also deal with chronic fatigue, joint pain, and systemic inflammation — symptoms commonly seen in autoimmune diseases.
The immune system's role in endometriosis
Understanding the immune system's role in endometriosis is crucial for both patients and healthcare providers. In a healthy immune response, the body should identify and eliminate misplaced endometrial tissue. However, in women with endometriosis, this process seems to be impaired.
Some theories suggest that the immune system might actually be helping endometriosis to thrive. Instead of attacking the misplaced tissue, certain immune cells might be nurturing it, providing blood supply and allowing it to implant in various locations throughout the body.
This complex interplay between endometriosis and the immune system highlights the need for a holistic approach to treatment — managing pain and hormonal symptoms while addressing the body's overall inflammatory and immune response.
Implications for treatment and management
The potential autoimmune connection in endometriosis opens up new avenues for treatment and management. Some researchers are exploring the use of immunomodulatory therapies — treatments that adjust the immune response — as a potential approach to managing endometriosis.
For women living with endometriosis, this research offers hope. It suggests that future treatments might go beyond hormonal therapies and surgery, targeting the immune system to provide relief and potentially slow the progression of the disease.
In the meantime, many women find relief through a combination of conventional treatments and lifestyle changes that support overall immune health. This might include anti-inflammatory diets, stress reduction techniques, and regular exercise.
How hormones influence the immune response in endometriosis
Hormones play a major role in endometriosis, but they also influence immune system behavior. Estrogen, in particular, has been found to promote inflammation and fuel the growth of endometrial tissue. Studies suggest that high estrogen levels may suppress immune responses that would normally clear out misplaced cells, allowing endometriosis to spread more aggressively.
Balancing hormone levels through medications, lifestyle changes, or dietary adjustments may help regulate both endometriosis progression and immune function.
The ongoing research into endometriosis and immunity
The relationship between endometriosis and autoimmune diseases is still being explored. Ongoing research is looking at genetic predispositions, immune system markers, and potential new treatments that target the immune system directly.
As more studies are conducted, there is hope for better diagnostic tools and innovative therapies that address the underlying immune dysfunction seen in endometriosis. Until then, continued advocacy and funding for endometriosis research remain crucial in pushing the field forward.
Ultimately, endometriosis may not fit neatly into the category of autoimmune disease, but its relationship with the immune system is undeniable. As we continue to unravel its mysteries, we move closer to better solutions for the women affected by this challenging condition.
Tassia O'Callaghan is an experienced content writer and strategist, having written about a vast range of topics from chemical regulations to parenting, for brands like Peanut App Ltd, Scary Mommy, Tally Workspace, and Office Christmas. She's an advocate for realistic sustainable living, supporting small businesses (author of A-Z of Marketing for Small Businesses), and equity across all walks of life. Follow her on LinkedIn or TikTok, or see more of her work on Authory or her website.
