Endometriosis
Sources consulted
This article is original patient-education content.
- WHO—Health topics A–Z(2024)
- NHS—Health A to Z(2024)
- CDC—Health topics(2024)
Based on international clinical guidelines
Overview
Endometriosis is a condition where tissue similar to the lining of the womb grows in other places in the body, like the ovaries or fallopian tubes. This tissue can cause pain and other symptoms, especially during periods.
Key facts
- Affects about 1 in 10 women and people assigned female at birth during their reproductive years.
- Symptoms can vary widely – some people have severe pain, while others have none.
- It can cause infertility, but many people with endometriosis do become pregnant.
Yes, endometriosis is a common condition affecting around 1 in 10 women and people assigned female at birth during their reproductive years.
It mainly affects women and people assigned female at birth, usually between the ages of 25 and 40, but it can also affect teenagers and younger people.
Symptoms
- Sudden, severe abdominal pain that is not like your usual period pain
- Heavy bleeding that soaks through a pad or tampon every hour
- Pain with vomiting or fever
- Chest pain or difficulty breathing (rarely, endometriosis can affect the lungs)
- ⚠Pain that is not controlled with usual over-the-counter pain relievers
- ⚠Pain that causes you to miss work or school
- ⚠New or worsening symptoms that affect your daily life
Common symptoms
- Pelvic pain, especially during periods
- Pain during or after sex
- Heavy or irregular periods
- Painful bowel movements or urination during periods
- Difficulty getting pregnant
- Fatigue
- Bloating or nausea during periods
Symptoms in children
- Severe period pain that interferes with school or activities
- Pain that does not get better with over-the-counter pain relief
- Irregular or heavy periods early in adolescence
Symptoms in older adults
- Symptoms may improve after menopause, but some people still experience pain or other issues, especially if on hormone therapy.
- Bloating, fatigue, or pelvic discomfort may continue even without periods.
Causes
Main causes
- The exact cause is unknown, but it is believed to involve retrograde menstruation (when menstrual blood flows back through the fallopian tubes into the pelvis) and immune system factors.
Risk factors
- Early onset of menstruation (before age 11)
- Short menstrual cycles (less than 27 days)
- Heavy or long periods (over 7 days)
- Family history of endometriosis
- Never having given birth
When to see a doctor
See a doctor urgently if:
- If you have severe pain that suddenly gets worse
- If you have heavy bleeding that soaks through pads quickly
- If you have pain with fever or vomiting
Book a routine appointment if:
- If you have pelvic pain that affects your daily life
- If you have pain during sex or bowel movements
- If you are having trouble getting pregnant
- If your periods are very heavy or irregular
Diagnosis
Diagnosis often starts with a discussion of your symptoms and a pelvic exam. Your doctor may then suggest imaging tests, and the only way to confirm endometriosis is with a surgical procedure called laparoscopy.
Tests that may be done
- Pelvic exam
- Ultrasound (transvaginal or abdominal)
- Magnetic resonance imaging (MRI)
- Laparoscopy (keyhole surgery with a camera)
What to expect at your appointment
Your doctor will ask about your symptoms, menstrual cycle, and family history. They may examine your pelvis and order an ultrasound. If endometriosis is suspected, a laparoscopy might be recommended – this is a minor surgery done under general anaesthetic to look inside your pelvis and take a biopsy if needed.
Treatment
Treatment aims to manage symptoms and improve quality of life. Options include pain relief, hormonal treatments, and surgery. The best plan depends on your symptoms, age, and whether you want to become pregnant.
Self-care at home
- Applying heat (like a hot water bottle or bath) to the lower abdomen
- Gentle exercise like walking or yoga
- Relaxation techniques such as deep breathing or meditation
- Getting enough rest and sleep
- Using over-the-counter pain relievers as directed by a pharmacist or doctor
Medical treatments
Your doctor may suggest hormonal treatments, such as the combined oral contraceptive pill, progestogen-only treatments, or GnRH analogues. These help reduce the growth of endometrial tissue and ease pain. Pain relief options include non-steroidal anti-inflammatory drugs (NSAIDs) and other painkillers. Always discuss the benefits and risks with your doctor.
When is surgery considered?
Surgery may be considered if symptoms are severe or if you are having trouble getting pregnant. Laparoscopic surgery can remove or destroy patches of endometriosis. In some cases, a hysterectomy (removal of the womb) may be recommended, but this is usually a last resort and does not always cure symptoms. Discuss all options with your specialist.
Living with this condition
Living with endometriosis can be challenging, but many people manage well with a combination of treatments and lifestyle adjustments. Keeping a symptom diary can help you track patterns and triggers.
Lifestyle tips
- Find a healthcare provider who listens and understands
- Join support groups (online or in-person)
- Plan ahead for painful days – rest when you need to
- Talk to your employer or school about flexible arrangements
- Consider complementary therapies like acupuncture or physiotherapy
Diet and exercise
A balanced diet rich in fruits, vegetables, and whole grains may help reduce inflammation. Some people find that reducing red meat, dairy, or gluten helps, but there is no one-size-fits-all diet. Regular gentle exercise like walking, swimming, or yoga can ease pain and improve mood.
Mental health and emotional wellbeing
Chronic pain and fertility concerns can affect your mental health. It is normal to feel frustrated, anxious, or depressed. Talk to your doctor about counselling or support groups. If you are feeling overwhelmed, reach out for help.
Prevention
There is no known way to prevent endometriosis, but early diagnosis and treatment can help manage symptoms and reduce complications.
Complications
If left untreated
- Chronic pelvic pain
- Infertility
- Ovarian cysts (endometriomas)
- Adhesions (scar tissue that can cause organs to stick together)
- Fatigue and depression
Long-term outlook
Endometriosis is a long-term condition, but with the right care, most people can manage their symptoms and lead full lives. Treatments can improve pain and fertility outcomes. Research is ongoing, and many people find that symptoms improve after menopause.
Find support
International organisations
Local organisations
- Endometriosis UK ↗ · United Kingdom
- Endometriosis Foundation of America ↗ · United States
Helplines
External links open third-party websites. Ruqelo Health is not responsible for external content. Listing an organisation does not imply endorsement.
Always verify with your doctor
Health guidelines vary by country and region. The information in this article is based on international clinical guidelines but may not reflect the specific guidelines, medications, or practices in your country. Always discuss your health concerns with your own doctor or healthcare provider, and refer to your local national health guidelines where available.
Important notice This information is for educational purposes only. It does not replace professional medical advice, diagnosis, or treatment. Always consult a qualified healthcare provider about your specific situation. If you are experiencing a medical emergency, call your local emergency services immediately.