Endometriosis
Tissue similar to the lining of the womb grows outside it — on the ovaries, pelvic lining and bowel — causing painful periods, pelvic pain and sometimes infertility.
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About 1 in 10 women of reproductive age; diagnosis is often delayed by 7–8 years.
Causes
- Retrograde menstruation, immune and genetic factors
Risk factors
- Family history
- Early periods, short cycles, heavy periods
Symptoms
- Severe period pain
- Chronic pelvic pain
- Pain during sex
- Painful bowel movements or urination during periods
- Difficulty conceiving
- Fatigue
Diagnosis — tests and examinations
- Clinical history
- Transvaginal ultrasound or MRI (endometriomas, deep disease)
- Laparoscopy with biopsy
Treatment
Medicines and medical treatment
- NSAIDs
- Hormonal treatment: combined pill, progestogens (dienogest), hormonal IUS
- GnRH analogues or antagonists (relugolix combination)
Operations and procedures
- Laparoscopic excision or ablation
- Removal of ovarian endometriomas
- IVF for infertility
- Hysterectomy for severe disease when fertility is not desired
Self-care, home remedies and lifestyle
- Heat and exercise
- Pelvic physiotherapy
- Support groups
Possible complications
- Infertility
- Ovarian cysts (endometriomas)
- Adhesions
- Bowel or bladder involvement
Prevention
- None known
Outlook
Chronic but manageable; symptoms usually improve after menopause.
When to see a doctor
See a doctor if period pain stops you doing normal activities.
Sources and further reading
These sources cover this condition. They have not been checked against every statement on this page.
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