endometriosis pain risk reduction

Overview

Endometriosis is a condition where tissue similar to the lining of the womb grows outside it, often around the ovaries, fallopian tubes, and pelvis. This tissue can become inflamed and cause pain, especially during periods.

Endometriosis is common. It affects roughly 1 in 10 people assigned female at birth, usually during their reproductive years.

It can affect anyone with a womb, from the teenage years through to menopause, though it is most often diagnosed in people in their 30s and 40s.

Symptoms

Common symptoms

• Severe period cramps that may stop you doing normal activities
• Long-term (chronic) pelvic pain
• Pain during or after sex
• Pain when using the toilet during a period
• Heavy or irregular periods
• Feeling sick or tired

Symptoms in children

• For teenagers, endometriosis often shows up as very painful periods that cause them to miss school or activities
• Pain may also happen outside periods
• Tummy pain or bloating

Symptoms in older adults

• After menopause, endometriosis symptoms usually improve, but some people still have pain
• Hormone replacement therapy (HRT) might affect symptoms, so any new or worsening pain should be checked

Causes

Main causes

• The exact cause is not known, but it may be linked to retrograde menstruation (menstrual blood flowing backward through the fallopian tubes) or to how hormones affect tissue
• It may also be related to problems with the immune system
• Genetics may play a part, as it often runs in families

Risk factors

• Starting periods at an early age
• Short menstrual cycles (less than 27 days)
• Heavy or long-lasting periods
• A family history of endometriosis
• Never having given birth
• Low body weight

When to see a doctor

See a doctor urgently if:

• See a healthcare provider within a day or two if you have pelvic pain that gets worse or doesn't settle
• If you have pain and a fever, tight feeling in your tummy, or are vomiting, get urgent care

Book a routine appointment if:

• Make a routine appointment if period pain disrupts your life, does not improve with over-the-counter pain relief, or if you have pain during sex or when going to the toilet
• Also see a doctor if you have trouble getting pregnant and think endometriosis may be involved

Diagnosis

A doctor will ask about your symptoms, examine your abdomen and pelvis if you agree, and may arrange tests. The only way to be certain is with a surgical procedure called a laparoscopy, where a thin tube with a camera looks inside your pelvis.

Tests that may be done

• Pelvic examination (internal check)
• Ultrasound scan (to look for cysts and other changes)
• MRI scan (in some cases)
• Laparoscopy (keyhole surgery) – the gold standard for diagnosis

What to expect at your appointment

Your doctor may start treatment based on your symptoms alone, before a confirmed diagnosis. If you have a laparoscopy, you will be under general anaesthetic, and any endometriosis tissue seen can often be removed at the same time.

Treatment

Treatment aims to reduce pain, slow the growth of endometriosis tissue, and improve fertility if needed. Your plan will depend on your symptoms, whether you want to become pregnant, and how the condition affects your life.

Self-care at home

• Use gentle heat, like a hot water bottle, on your lower tummy
• Try gentle exercise like walking, swimming, or stretching to ease pain
• Use relaxation techniques such as deep breathing or meditation
• Keep a diary of symptoms to identify triggers
• Rest on painful days and pace your activities

Medical treatments

Healthcare providers may offer hormonal treatments, such as contraceptive pills, progestogen-based options, or other medicines that affect hormones, to reduce the tissue's activity and pain. There are also non-hormonal pain medicines available over the counter or on prescription. Your doctor or pharmacist will discuss the safest option for you. Do not take any medicine without checking with them.

When is surgery considered?

If other treatments are not helpful, surgery may be suggested. This is usually keyhole surgery to remove or destroy endometriosis tissue. In more serious cases, sometimes the womb or ovaries are removed, but this is only considered after careful discussion, especially if you may want children in the future.

Living with this condition

Living with endometriosis can be challenging, but many people find their symptoms improve with a mix of medical care, self-care, and emotional support. Plan for painful days and don't be afraid to ask for flexible work or school arrangements if you need them.

Lifestyle tips

• Keep stress low – stress can make pain feel worse
• Try to keep a regular sleep pattern
• Find activities you can do on good days to stay active
• Consider complementary approaches like acupuncture or physiotherapy if they help (talk to your doctor first)

Diet and exercise

There is no one diet that works for everyone, but eating a balanced diet with plenty of fruit, vegetables, and whole grains may help reduce inflammation. Some people find cutting down on caffeine, alcohol, and processed foods eases symptoms. Regular moderate exercise, like walking or cycling, can improve energy and reduce pain.

Mental health and emotional wellbeing

Persistent pain can affect your mood, sleep, and relationships. It is normal to feel frustrated, anxious, or low. If you feel this way, talk to your healthcare provider, who can point you to counselling or support groups.

Prevention

There is no proven way to prevent endometriosis. However, getting treatment early and managing symptoms may stop the condition from having a big impact on your life. Being aware of your body and seeking medical advice when symptoms start is the best first step.

Complications

If left untreated

• Severe pain that affects your daily life
• Problems getting pregnant (infertility)
• Formation of ovarian cysts (endometriomas)
• Scarring and adhesions inside the pelvis
• Pain that continues or gets worse over time

Long-term outlook

With the right treatment and support, most people with endometriosis can manage their pain and live a full life. Even if there is no cure, symptoms can often improve. Many people find the condition eases after pregnancy or with the approach of menopause.

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