Ehlers–Danlos Syndrome and Endometriosis: Understanding the Connection
New research suggests these conditions may occur together more often than previously recognized—but understanding the overlap requires looking beyond pelvic pain alone.
For someone living with endometriosis, another diagnosis can bring both relief and questions. It may help explain symptoms that never seemed to fit, while adding another layer to an already complicated health journey.
One condition receiving increasing attention is Ehlers–Danlos syndrome (EDS), a group of disorders affecting connective tissue. Much of the discussion around endometriosis involves the hypermobile form, known as hEDS.
Is there a connection? Published research suggests an association, although findings vary. Researchers have not established that EDS causes endometriosis—or that endometriosis causes EDS.
What does the published research show?
A 2026 study in the Journal of Women’s Health compared medical records from 50,809 women with EDS with those of 50,809 age-matched women without EDS. Researchers found increased rates of many gynecologic diagnoses. The published study summary identifies endometriosis among the conditions reported more frequently in patients with EDS.
This is an important finding, but medical-record studies have limitations. Diagnoses depend on what clinicians recognize and document, and diagnostic codes do not always distinguish EDS subtypes clearly. The study supports an association; it does not explain why the conditions occur together.
A 2025 global survey published in the Journal of Clinical Medicine also reported substantial overlap. Endometriosis was reported by 18.5% of participants in the hEDS group and 12.1% in the hypermobility spectrum disorder group. Because these were survey findings, participant selection and self-report may influence the results. These figures should not be interpreted as the percentage of all people with hEDS who have endometriosis.
Earlier research offered a different picture. A 2016 clinical study of 386 women with hypermobility-type EDS found diagnosed endometriosis in approximately 6%. However, heavy menstrual bleeding and painful periods were very common. The authors concluded that endometriosis was not unusually prevalent in their cohort, despite the considerable overlap in symptoms.
Together, these studies show why the answer is still developing: newer research suggests increased coexistence, while earlier findings were less clear.
Similar symptoms do not always mean the same diagnosis
Painful periods, heavy bleeding and pain with intercourse can occur in people with hEDS, including those without diagnosed endometriosis. This makes careful evaluation especially important.
A patient’s symptoms deserve attention without assuming that one diagnosis explains everything. Having EDS should not automatically rule out endometriosis. Likewise, having endometriosis should not close the conversation about other contributors to pain.
For patients, a useful question is:
“Could more than one condition be contributing to what I am experiencing?”
That question encourages a broader assessment while keeping each diagnosis grounded in appropriate clinical evaluation.
What can patients bring to the conversation?
If you have diagnosed or suspected EDS alongside endometriosis, consider discussing:
Which symptoms follow your menstrual cycle and which occur throughout the month.
Your history of joint hypermobility, instability or an existing connective tissue diagnosis.
Heavy bleeding, pain with intercourse and how symptoms affect everyday activities.
What improved with previous treatment—and what persisted.
How your clinicians can coordinate their assessments and recommendations.
The purpose is to help your care team understand the full pattern of your symptoms.
ELYSARA’s approach: listening to the whole patient
At ELYSARA Endometriosis Management, our approach begins with listening to your history, your concerns and the ways symptoms affect your life.
When endometriosis and a connective tissue condition may coexist, we support a coordinated approach that considers gynecologic care alongside other appropriate evaluations and supportive services. Recommendations are individualized to your needs and the findings of your treating clinicians.
Supportive care does not replace the evaluation or treatment of either condition. It can be part of a broader plan built around your symptoms, function and goals.
You deserve care that remains curious, takes your symptoms seriously and allows room for more than one explanation.
To learn about ELYSARA’s approach to coordinated endometriosis care, visit ManageMyEndo.com or call 631-629-4144.
This article provides general education and is not a diagnosis or an individualized treatment recommendation.
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Published research
Imbroane MR, Kim H, Akesson C, Richards EG. Assessing the Risk of Gynecologic and Obstetric Diagnoses in Patients with Ehlers–Danlos Syndromes. Journal of Women’s Health. 2026;35(6):567–573. Read the publication.
Defining the Chronic Complexities of hEDS and HSD: A Global Survey of Diagnostic Challenges, Life-Long Comorbidities, and Unmet Needs. Journal of Clinical Medicine. 2025;14(16):5636. Read the publication.
Hugon-Rodin J, et al. Gynecologic symptoms and the influence on reproductive life in 386 women with hypermobility type Ehlers-Danlos syndrome: a cohort study. Orphanet Journal of Rare Diseases. 2016;11:124. Read the publication.
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