The results supported the strong causal effect of ADAMTS13 on the decreased risk of endometriosis (IVW: OR = 0.42, 95%CI: 0.30–0.58, P = 2.85e − 7; WM: OR = 0.44, 95%CI: 0.30–0.66, P = 5.76e − 5) (Fig. 3, Additional file 1: Table S6, Additional file 2: Fig. S5). Here, ADAMTS13 is linked to endometriosis.