Endometriosis
This article is general health information for the selected condition. It is not a diagnosis and does not replace clinical judgement. If you have questions or need treatment advice, please consult a qualified healthcare professional.
What is endometriosis?
Endometriosis occurs when tissue resembling the lining of the womb grows outside the uterus, commonly on the ovaries, pelvic lining and bowel. It responds to hormonal cycles, bleeding and causing inflammation, scarring and pain. Diagnosis is frequently delayed by years, so persistent severe period pain deserves to be taken seriously rather than normalised.
Causes
- Retrograde menstruation with implantation of tissue
- Cellular transformation of pelvic lining cells
- Immune factors allowing deposits to persist
- Genetic predisposition
Symptoms
- Severe period pain that limits daily activity
- Chronic pelvic pain between periods
- Pain during or after sex
- Painful bowel movements or urination, often cyclical
- Heavy or irregular bleeding
- Difficulty becoming pregnant
- Fatigue
Risk factors
- Family history of endometriosis
- Early onset of periods
- Short menstrual cycles with heavy bleeding
- Never having given birth
- Structural outflow obstruction
Diagnosis
- Detailed symptom and menstrual history
- Pelvic examination
- Transvaginal ultrasound, which may show ovarian endometriomas
- MRI for deep infiltrating disease
- Laparoscopy, which remains the definitive method
Treatment
- Nonsteroidal anti inflammatory medicines for pain
- Combined hormonal contraception, often continuously
- Progestogens including the hormonal intrauterine system
- GnRH analogues with add back therapy
- Laparoscopic excision or ablation of deposits
- Fertility specialist input when conception is affected
- Pelvic physiotherapy and pain management support
Self care
- Use heat pads for pelvic pain
- Take pain relief early in the pain cycle rather than once severe
- Track symptoms against your cycle to show patterns
- Try low impact exercise, which helps pain for many
- Consider pelvic floor physiotherapy for muscle related pain
- Seek support, since chronic pain affects mood and relationships
When to see a doctor
Book an appointment if:
- Period pain that stops you doing normal activities
- Pain during or after sex
- Pelvic pain between periods
- Difficulty conceiving after trying for a year, or six months over 35
- Painful bowel movements or urination around your period
- Pain not controlled by simple painkillers
Some symptoms need emergency care rather than an appointment. See the warning signs listed above.
Prevention
- Endometriosis cannot currently be prevented
- Progression and pain can be limited by early diagnosis and treatment
- Continuous hormonal contraception can suppress cyclical activity
- Do not normalise severe period pain, since delay worsens outcomes
Outlook
Endometriosis is chronic but manageable. Hormonal treatment controls pain for many, and laparoscopic excision can give substantial relief, though symptoms recur in a proportion. It often improves after menopause. Fertility is reduced on average but many people conceive naturally or with assistance, so early discussion is worthwhile if pregnancy is planned.
Common questions
Why does diagnosis take so long?
Severe period pain is often dismissed as normal, symptoms overlap with bowel and bladder conditions, and imaging can appear normal in superficial disease. Average delay is commonly reported as several years.
Does endometriosis always cause infertility?
No. Many people with endometriosis conceive without help, although the condition does reduce fertility on average. Early discussion with a specialist is useful if conception is being considered.
Does a hysterectomy cure it?
Not necessarily. Deposits outside the uterus can remain and continue to cause pain, so hysterectomy is not a guaranteed cure and is considered only after fuller discussion of alternatives.
References
Important: Dard AI is not a medical device and does not diagnose, treat, or replace clinician judgement. This article is general information only. Always consult a qualified healthcare professional about diagnosis and treatment, and seek emergency care for severe or rapidly worsening symptoms.