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In reviewing the causes of endometriosis, it is important to first understand the regular menstrual cycle and how hormones in the body affect the menstrual cycle and the uterus itself. 1  The endometrium is the inner layer of uterine tissue that is shed during menstruation. The thickness of the endometrial layer is related to the egg-producing (ovulatory) cycle and the hormonal levels that regulate this cycle. 2  The endometrium is at its thinnest immediately following menstruation and thickens during the first two weeks of the menstrual cyle.
If a fertilized egg does not implant in the lining, then the uterus will shed the endometrium; this shedding initiates menstrual bleeding, otherwise known as your period. The menstrual cycle normally lasts from 21 to 35 days - although teens and women in their 40s may have longer, irregular cycles up to 45 days.