About 1 in 10 women of reproductive age have endometriosis, and the pain can be treated even before the diagnosis is confirmed. Getting a diagnosis can take a long time, 4–12 years on average, because the symptoms look like other conditions. If pain is cancelling your plans, it's worth looking into now.
What is endometriosis, in plain words?
Tissue like the womb lining grows outside the womb: on the ovaries, tubes and pelvic lining, and sometimes the bladder or bowel. Each cycle it bleeds like the lining inside the womb, but the blood has nowhere to go. That leads to inflammation, adhesions (scar tissue that makes organs stick together) and pain.
How is it different from ordinary period pain?
Ordinary cramps last 1–2 days and are usually mild. With endometriosis, pain often worsens over the years, disrupts daily life, and can start before a period and last after it.
Pain can come on other days too: low in your tummy and back, during or after sex, or on the toilet. Other signs are very heavy periods, extreme tiredness and trouble getting pregnant.
How is it diagnosed?
The doctor will ask about your symptoms and whether close relatives have endometriosis, check your tummy and offer an internal exam. If an internal exam isn't right for you, say so: they can examine just your tummy. Next is usually an ultrasound, often a vaginal one, and sometimes an MRI.
Only a laparoscopy can confirm endometriosis for sure: a camera goes in through a small cut near your belly button. You don't need one before starting treatment, and during one, patches can often be removed straight away.
A pain diary helps: the days, pain from 0 to 10, where it hurts and what you had to cancel. Notes make the conversation with a doctor easier, because the dates and numbers speak for you.
What if a doctor says "everyone puts up with it"?
Ask what else can be checked, and ask for a referral to a gynaecologist. UK guidelines (NICE) say to refer when the first treatment hasn't helped, pain disrupts daily life, or it keeps coming back. Getting a second opinion from another doctor is completely ordinary too.
Common questions
Can endometriosis be treated?
There's no permanent cure yet, but pain and other symptoms can be kept under control. Options include painkillers, hormonal treatments like the pill or a hormonal coil, and sometimes surgery. You and your doctor choose together, and any pregnancy plans matter here.
Can you get pregnant with endometriosis?
Yes. Endometriosis UK, a British charity, estimates that 60–70% of women with endometriosis can get pregnant without medical help. If you're planning a pregnancy, tell your doctor early, because it changes which treatment fits.
Will hormonal treatment affect getting pregnant later?
No. UK guidelines (NICE) say that hormonal treatment for endometriosis reduces pain and has no lasting effect on fertility.
If it hurts a lot, is it definitely endometriosis?
Not necessarily. Adenomyosis, fibroids, a pelvic infection and irritable bowel syndrome can cause similar pain, which is why a doctor looks for the cause.
In short
- Keep a pain diary: the days, how bad, what you cancelled
- A clear scan doesn't settle it if the pain continues
- If you're not heard, ask for a gynaecologist referral
Source: WHO: Endometriosis
Educational content; it does not replace professional medical advice.