Endometriosis living in adults

Overview

Endometriosis is a condition where tissue similar to the lining of the womb grows in other places in the body, such as the ovaries, fallopian tubes, or the lining of the pelvis. This tissue can cause pain, heavy periods, and sometimes make it harder to get pregnant.

Yes, endometriosis is quite common. Around 1 in 10 people assigned female at birth have it.

It usually affects people of reproductive age, but symptoms can continue into menopause. It can also affect teenagers.

Symptoms

Common symptoms

• Painful periods that make it hard to do normal activities
• Pain in the lower tummy (pelvis) that is not just during your period
• Pain during or after sex
• Heavy periods that soak through pads or tampons
• Feeling very tired or exhausted
• Nausea, bloating, or diarrhea during your period
• Difficulty getting pregnant

Symptoms in children

• In teenagers, symptoms are similar to adults: severe period pain, painful periods even from the start, pelvic pain that lasts all month.
• They may also have bowel symptoms like pain when passing stool.

Symptoms in older adults

• After menopause, many people notice less pelvic pain, but fatigue, bladder or bowel problems, and painful sex may continue.
• Hormone replacement therapy (HRT) can sometimes make symptoms come back.

Causes

Main causes

• The exact cause is not fully understood, but it is thought that during menstruation, some womb lining tissue flows backwards through the fallopian tubes and implants in the pelvis, where it bleeds and causes inflammation.
• Hormones, like oestrogen, make the misplaced tissue grow and cause symptoms.
• Genetics may play a role – it can run in families.
• An issue with the immune system may stop the body from clearing out this misplaced tissue.

Risk factors

• Starting your period before age 11
• Short menstrual cycles (less than 27 days)
• Heavy or long periods (more than 7 days)
• A family history of endometriosis
• Low body weight or never having given birth

When to see a doctor

See a doctor urgently if:

• If you have severe pelvic pain that comes on suddenly or does not improve with simple pain relief
• If you have very heavy bleeding that makes you feel dizzy or weak
• If you have pain together with fever or chills

Book a routine appointment if:

• If your period pain is affecting your daily life or school/work
• If you have pain during sex or after
• If you have been trying to get pregnant for a year without success
• If you have pelvic pain that lasts more than a few months

Diagnosis

Getting a diagnosis usually starts with talking to a doctor about your symptoms and having a pelvic examination. The doctor may then suggest an ultrasound scan. The only way to know for sure if you have endometriosis is by a small operation called a laparoscopy (keyhole surgery) where a camera is used to look inside your pelvis.

Tests that may be done

• A detailed discussion of your symptoms and medical history
• A pelvic examination to feel for lumps or tender areas
• An ultrasound scan of your pelvis (often vaginal ultrasound) to see cysts or other changes
• Sometimes an MRI scan for a clearer image
• Laparoscopy – a surgical procedure where a thin camera is inserted through a small cut in your tummy to look for endometriosis tissue

What to expect at your appointment

Diagnosis can take several years because endometriosis symptoms are similar to other conditions. The process usually involves seeing your GP (general doctor) first. They may refer you to a gynaecologist (a specialist in women's health). For laparoscopy, you will have general anaesthetic and the doctor can sometimes treat the endometriosis tissue at the same time.

Treatment

There is no cure for endometriosis, but there are many treatments that can help manage symptoms and improve quality of life. The right treatment depends on your symptoms, your age, and whether you want to become pregnant.

Self-care at home

• Applying a hot water bottle or heat pad to your lower tummy or back
• Gentle exercise like walking, yoga, or stretching to reduce stiffness and pain
• Taking over-the-counter pain relief (ask your pharmacist for advice)
• Resting when you feel tired and planning rest days during your period
• Trying relaxation techniques like deep breathing or meditation for stress

Medical treatments

Doctors may recommend hormonal treatments that help reduce or stop periods, such as the combined contraceptive pill, the contraceptive patch, the contraceptive implant, or hormonal coils. These can make periods lighter and less painful. Other medicines that reduce oestrogen levels in the body can also be used for a limited time. Pain relievers such as ibuprofen or naproxen can help with cramps and inflammation. Always discuss the options with your doctor.

When is surgery considered?

If self-care and medical treatments are not enough, or if you have severe pain or large cysts, a doctor may recommend surgery. The most common operation is a laparoscopy to remove or burn away endometriosis tissue. In very severe cases, a hysterectomy (removal of the womb) may be considered, but this is a major decision and is not a cure – it is only for people who have completed their family and have severe symptoms.

Living with this condition

Living with endometriosis can be challenging, but many people manage well with the right treatment and support. It helps to plan your month: rest on heavy pain days, use heat packs, and keep a symptom diary to see what triggers your pain. Work or school may need adjustments – discuss flexible options with your employer or teacher.

Lifestyle tips

• Stay active – gentle exercise like swimming, yoga, or walking can reduce pain and improve mood
• Manage stress – try mindfulness, talking to a friend, or counselling
• Get enough sleep – chronic pain can disrupt sleep, so a good bedtime routine helps
• Some people find acupuncture or physiotherapy helpful

Diet and exercise

There is no one diet that works for everyone, but eating a balanced diet with plenty of fruits, vegetables, whole grains, and healthy fats (like olive oil and fish) may help reduce inflammation. Some people avoid processed foods, caffeine, and red meat. Regular exercise, even gentle movement, can help by releasing feel-good chemicals and reducing pain sensitivity.

Mental health and emotional wellbeing

Chronic pain and fertility concerns can affect your mood, self-esteem, and relationships. It is normal to feel frustrated, sad, or anxious. Talking to a psychologist or counsellor can be very helpful. Let your doctor know if you are feeling low – they can point you to support services.

Prevention

There is no known way to prevent endometriosis. The causes are not fully understood, so prevention is not possible at this time. However, early diagnosis and management can help stop symptoms from getting worse.

Screening programmes

There is no routine screening test for endometriosis. If you have symptoms, you should see your doctor.

Complications

If left untreated

• Chronic pain that limits daily activities
• Fertility problems – about 30–50% of people with endometriosis have difficulty getting pregnant
• Development of adhesions (bands of scar tissue) that can cause pain and make organs stick together
• Ovarian cysts (endometriomas) that may need surgery

Long-term outlook

With the right treatment, most people with endometriosis can manage their symptoms and lead full lives. Pain can often be controlled, and fertility treatments can help many conceive. It is a long-term condition, but ongoing support and good self-care make a big difference. Many find that symptoms improve after menopause.

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