endometriosis pain result meanings for patients

Overview

Endometriosis is a condition where tissue similar to the lining of the womb (the endometrium) grows outside the womb, such as on the ovaries, fallopian tubes, or the tissue lining the pelvis. This tissue reacts to hormone changes during your menstrual cycle, causing inflammation, pain, and sometimes scarring.

Yes, endometriosis is common. It affects about 1 in 10 women and people assigned female at birth of reproductive age worldwide.

Endometriosis most often affects people in their 30s and 40s, but it can start as early as the first menstrual period and can continue until menopause. It rarely occurs after menopause.

Symptoms

Common symptoms

• Painful periods (dysmenorrhea) that may get worse over time
• Pain during or after sex
• Pain with bowel movements or urination, especially during your period
• Heavy or irregular menstrual bleeding
• Chronic pelvic pain (pain in the lower belly or back) that lasts for more than 6 months
• Bloating, nausea, or fatigue during your period

Symptoms in children

• Period pain that is severe enough to make a teen miss school or activities
• Pain that does not get better with over-the-counter pain relief (like ibuprofen or naproxen — but do not name specific brands)
• Pain in the lower belly or back that is not related to periods

Symptoms in older adults

• Pelvic pain that may persist even after menopause, though it is less common
• Pain during sex that is new or worsening
• Fatigue or digestive issues that seem linked to the menstrual cycle even after periods stop (if on hormone therapy)

Causes

Main causes

• The exact cause is not known, but one theory is that during menstruation, some menstrual tissue flows backward through the fallopian tubes into the pelvis and implants there (retrograde menstruation).
• Another idea is that cells in the abdomen can change into endometrial-like cells due to genetic or immune system factors.
• Genetics may play a role — endometriosis can run in families.

Risk factors

• Having a first-degree relative (mother, sister, daughter) with endometriosis
• Starting your period at an early age (before age 11)
• Having short menstrual cycles (less than 27 days)
• Having heavy or long periods (more than 7 days)
• Never having given birth

When to see a doctor

See a doctor urgently if:

• You have pelvic pain that does not improve with rest and over-the-counter pain relief (following the label)
• You have pain that interferes with your daily life, work, or relationships
• You have heavy or abnormal bleeding that concerns you

Book a routine appointment if:

• You have any of the common symptoms that last for several months
• You are having trouble getting pregnant and suspect endometriosis
• You want to discuss treatment options to manage your pain
• Your symptoms are starting to affect your mood or mental health

Diagnosis

A doctor will start by asking about your symptoms, your menstrual cycle, and doing a pelvic exam. They may also order imaging tests like an ultrasound (using sound waves to look at your pelvis) but the only way to confirm endometriosis is with a laparoscopy (a minor surgery where a thin camera is inserted through a small cut in your belly to look for endometrial growths).

Tests that may be done

• Pelvic exam
• Ultrasound (transvaginal or abdominal) to check for cysts or large growths
• Magnetic resonance imaging (MRI) — a scan that gives detailed pictures of your organs
• Laparoscopy — a keyhole surgery that can see and sometimes remove endometriosis tissue

What to expect at your appointment

Diagnosing endometriosis can take time because symptoms overlap with other conditions. Your doctor will work with you step by step. If you have a laparoscopy, you will be under general anaesthetic (asleep), and your surgeon can often treat the endometriosis at the same time. After, you may feel tired and have some belly pain, but most people go home the same day.

Treatment

Treatment aims to manage pain, improve quality of life, and may help with fertility. There is no cure, but many treatments can help. Your doctor will recommend options based on your symptoms, age, and whether you want to become pregnant. Treatments include pain relief, hormone therapy, and surgery.

Self-care at home

• Use heat on your lower belly (hot water bottle or warm bath) during painful times
• Try gentle exercise like walking or stretching to reduce stiffness
• Practice relaxation techniques such as deep breathing or meditation
• Get enough rest and sleep, especially during your period
• Keep a symptom diary to track your pain and identify triggers

Medical treatments

Over-the-counter pain relievers like ibuprofen (follow the label and ask your pharmacist for advice) can help with mild to moderate pain. For more severe pain, a doctor may recommend hormone treatments such as the combined contraceptive pill, progestogen-only pill, or hormone intrauterine device (IUD). These can reduce or stop periods, which often helps with pain. Gonadotropin-releasing hormone (GnRH) agonists are another option that temporarily puts you into a menopause-like state to shrink endometrial growths. Always discuss risks and benefits with your doctor.

When is surgery considered?

If pain is severe or if you want to improve fertility, laparoscopic surgery can remove or destroy endometriosis growths. This is done by a specialist surgeon. In some cases, if other treatments do not work and you do not plan to have children, a hysterectomy (removal of the womb) may be considered, but this is a major decision and not a cure.

Living with this condition

Living with endometriosis means learning to manage pain and other symptoms. It can be helpful to plan your activities around your cycle, take breaks when needed, and communicate with your employer or school about your condition. You may need to adjust your schedule during your period.

Lifestyle tips

• Get regular, moderate exercise like swimming or yoga to improve blood flow and reduce pain
• Practice stress management — high stress can make pain worse
• Consider counselling or support groups to talk about your feelings and experiences
• Use a heating pad or warm compress for pain relief
• Try complementary therapies like acupuncture or pelvic floor physiotherapy — talk to your doctor first

Diet and exercise

Some people find that reducing processed foods, dairy, and red meat helps with inflammation, but there is no one-size-fits-all diet. Eating more fruits, vegetables, whole grains, and omega-3 fatty acids (from fish and nuts) may help. Staying active with low-impact exercises like walking, swimming, or gentle yoga can improve energy and reduce pain.

Mental health and emotional wellbeing

Chronic pain and fertility concerns can affect your mood, relationships, and self-esteem. It is normal to feel frustrated, anxious, or sad. Talking to a therapist or counsellor can help. Remember that your mental health is just as important as your physical health.

Prevention

There is no known way to prevent endometriosis because the exact cause is not clear. However, early diagnosis and treatment can help manage symptoms and reduce the risk of complications.

Screening programmes

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

Complications

If left untreated

• Chronic pelvic pain that can become worse over time
• Infertility (difficulty getting pregnant) — endometriosis can affect fertility in about 30-50% of people with the condition
• Ovarian cysts (called endometriomas) that can rupture and cause sudden severe pain
• Adhesions (internal scar tissue) that can cause organs to stick together, leading to pain and sometimes bowel or bladder problems

Long-term outlook

While endometriosis is a long-term condition, most people can manage their symptoms effectively with treatment. Many people become pregnant naturally or with help. Even if symptoms are severe, there are many options to improve your quality of life. Working closely with your healthcare team gives you the best chance of feeling better.

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