What is endometriosis?
In endometriosis, tissue similar to the endometrium (the uterine lining) grows in places it shouldn't β on the ovaries, fallopian tubes, the outer surface of the uterus, and the pelvic lining. Each cycle this tissue responds to hormones, bleeds, and has nowhere to drain, causing inflammation, scarring, and adhesions.
Symptoms beyond "bad cramps"
- Pelvic pain that starts before the period and lasts longer than normal cramps
- Pain during or after sex (dyspareunia)
- Pain with bowel movements or urination, especially during the period
- Heavy or irregular bleeding
- Chronic fatigue, bloating ("endo belly")
- Difficulty getting pregnant
Why diagnosis takes years
Symptoms overlap with normal periods, IBS, and bladder conditions, and severe period pain is too often normalized. The average delay from first symptoms to diagnosis is 7-10 years. Tracking your symptoms in detail (timing, severity, triggers) gives your doctor the pattern they need.
How it's diagnosed
A specialist reviews your symptom history and does a pelvic exam. Ultrasound or MRI can detect ovarian endometriomas (cysts), but the only definitive diagnosis is laparoscopy β keyhole surgery that lets the surgeon see and biopsy the tissue. You do not need surgery to start treatment, though.
Treatments that reduce pain
First line: NSAIDs for pain, and hormonal options (combined pill taken continuously, progestin-only pills, hormonal IUD, or GnRH analogues) to suppress the cyclic bleeding that drives inflammation. Surgery (laparoscopic excision) removes lesions and can improve both pain and fertility. Lifestyle: anti-inflammatory diet, regular movement, pelvic-floor physiotherapy, and stress/sleep support help many women alongside medical treatment.
Endometriosis and fertility
Endometriosis can affect fertility, but most women with it still conceive β many naturally, others with surgery or assisted reproduction. If you're trying to conceive, tell your specialist early so the treatment plan protects fertility.