endometriosis pain screening test preparation

Overview

Endometriosis is a condition where tissue similar to the lining of the womb grows in other places, like the ovaries or fallopian tubes. This can cause pain, especially during periods. A screening test helps doctors check for signs of endometriosis to find out if you might have it.

Yes, endometriosis is fairly common. Many people have it without knowing, because symptoms vary.

It mainly affects people of reproductive age, typically from their teens to their 40s. It can also affect transgender men and non-binary people who have a uterus.

Symptoms

Common symptoms

• Severe period pain that stops you doing daily activities
• Pain in your lower tummy or back before and during your period
• Pain during or after sex
• Pain when peeing or pooping during your period
• Feeling sick, having diarrhea, or constipation during your period
• Heavy periods or bleeding between periods
• Trouble getting pregnant

Symptoms in children

• Endometriosis can start in teenagers. Symptoms include very painful periods that don't get better with painkillers, and missing school because of period pain.

Symptoms in older adults

• Symptoms may improve after menopause, but some people still have pain. Hormone therapy can sometimes make symptoms worse.

Causes

Main causes

• The exact cause isn't fully known. One theory is 'retrograde menstruation' where womb-lining cells flow backwards into the pelvis instead of out of the body.
• Genetics may play a role – it can run in families.
• The immune system may not clear these cells properly.

Risk factors

• Starting your period at a young age (before age 11)
• Having short menstrual cycles (less than 27 days)
• Having a close relative (mother, sister) with endometriosis
• Never having given birth
• Having a condition that blocks the flow of period blood

When to see a doctor

See a doctor urgently if:

• If you have severe pain that doesn't get better with over-the-counter pain relief (like paracetamol or ibuprofen) and stops you from doing normal things
• If you have new or worsening pain that concerns you

Book a routine appointment if:

• If you have painful periods that are affecting your quality of life
• If you have pain during sex, pain when pooping or peeing, or heavy periods
• If you are having trouble getting pregnant and think you might have endometriosis

Diagnosis

Diagnosing endometriosis often starts with talking about your symptoms and having a pelvic exam. The doctor may then recommend tests to look for signs of endometriosis.

Tests that may be done

• Pelvic ultrasound: uses sound waves to make images of your womb and ovaries. It can spot cysts but not always small endometriosis patches.
• MRI scan: gives a detailed picture of your pelvic organs and may show deeper endometriosis.
• Laparoscopy: a small operation where a thin tube with a camera is put into your tummy through a tiny cut. This is the only way to confirm endometriosis. The doctor can also take a small tissue sample (biopsy).

What to expect at your appointment

Before your screening test, your doctor will explain how to prepare. For an ultrasound, you may need a full bladder. For laparoscopy, you'll likely need to fast (not eat or drink) for several hours before. The doctor will give you specific instructions. If you feel nervous, it's okay to ask questions.

Treatment

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

Self-care at home

• Use a hot water bottle or heat pack on your tummy or back to ease pain.
• Take over-the-counter pain relief like paracetamol or ibuprofen, following the instructions on the packet.
• Try gentle exercise like walking or stretching – it can release endorphins, which are natural painkillers.
• Practice relaxation techniques such as deep breathing or meditation to help with pain and stress.

Medical treatments

Doctors may prescribe hormonal treatments such as the contraceptive pill, progestin-only pills, or hormone-releasing IUDs. These can help reduce or stop periods and ease pain. Some treatments block natural hormones to shrink endometriosis tissue. Pain relief medicines are also available. Your doctor will discuss the options and side effects.

When is surgery considered?

Surgery may be offered if pain is severe and other treatments haven't helped. The most common surgery is laparoscopy to cut away or burn off endometriosis patches. In very severe cases, a hysterectomy (removal of the womb) might be considered, but this is usually only if you do not want to become pregnant.

Living with this condition

Living with endometriosis can be challenging, but many people find ways to manage symptoms. Keeping a symptom diary can help you track pain and know what triggers it. This can also help your doctor adjust treatment.

Lifestyle tips

• Get enough rest, especially during your period.
• Learn to pace yourself – break tasks into smaller steps.
• Talk to your employer or school about flexible hours or time off if needed.
• Explore complementary therapies like acupuncture or pelvic floor physiotherapy. Always speak to your doctor first.

Diet and exercise

Some people find that reducing red meat, dairy, and gluten helps with pain. Eating more fruits, vegetables, and anti-inflammatory foods (like turmeric, ginger, and oily fish) may help. Gentle exercise like swimming, yoga, or walking can improve well-being. Listen to your body and avoid high-impact exercise when you're in pain.

Mental health and emotional wellbeing

Living with chronic pain can affect your mental health. You might feel anxious, frustrated, or depressed. It's important to talk about these feelings. If you feel overwhelmed, reach out to a therapist or counsellor. In a crisis, contact your local mental health helpline or emergency services.

Prevention

There is no known way to prevent endometriosis. But early diagnosis and treatment can help manage symptoms and prevent complications.

Screening programmes

There is no routine screening test for endometriosis in people without symptoms. If you have symptoms, see your doctor.

Complications

If left untreated

• Endometriosis can worsen over time, causing more pain and scarring (adhesions).
• It can lead to ovarian cysts (endometriomas).
• It can affect fertility – about 30-50% of people with endometriosis have trouble getting pregnant.

Long-term outlook

With proper care, most people with endometriosis can manage their symptoms and lead full lives. Treatments are improving, and many women become pregnant even with the condition. It's a long-term condition, but support and treatments are available.

Find support

International organisations

• World Endometriosis Society

Local organisations

• Endometriosis UK · UK

Helplines

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