Endometriosis is a long-term condition where tissue similar to the lining of the womb grows outside it, causing inflammation and scarring. The World Health Organization estimates it affects around 10% of women of reproductive age. It can cause pain and make conceiving harder, but there are effective ways to manage it.
What is endometriosis?
In endometriosis, tissue similar to the womb lining grows in other places in the pelvis. It responds to monthly hormones, which can lead to inflammation, pain and scar tissue (adhesions) that may stick organs together.
Common places include the ovaries, the space behind the womb, the fallopian tubes and the lining of the pelvis. Less often it is found on the bladder or bowel.
Symptoms to look out for
- Severe period pain that stops you doing everyday things
- Heavy periods
- Pelvic pain at other times of the month
- Pain during or after sex
- Pain when passing urine or opening your bowels, especially during a period
- Bloating, nausea, tiredness, or difficulty getting pregnant
Symptoms differ widely, and some people have few or none. Pain that affects your life is worth discussing with a doctor; it is not something you simply have to accept.
How endometriosis is diagnosed
Diagnosis can take time because symptoms overlap with other conditions, such as irritable bowel syndrome. WHO notes delays of several years are common. Steps usually include:
- Talk and examinationYour doctor asks about your symptoms and cycle and may do a pelvic examination.
- ImagingUltrasound or MRI can show some types, such as cysts on the ovaries, but may miss small patches.
- LaparoscopyA camera passed through a small cut in the abdomen confirms the diagnosis and can treat areas at the same time.
WHO reports that diagnosis takes on average 4 to 12 years in many settings. Newer approaches such as symptom questionnaires are being studied. If you recognise the symptoms, keeping notes and asking directly about endometriosis can help.
How it can affect fertility
Endometriosis is one of the leading causes of infertility. Inflammation and scar tissue can interfere with how eggs and sperm move and meet, and cysts can affect the ovaries.
Many people with endometriosis do get pregnant, either naturally or with treatment. Hormone treatments for pain are usually stopped while trying to conceive, so plan this with your doctor.
Living with endometriosis
Endometriosis can start at puberty and continue until menopause. It can affect work, study, relationships and sleep, and WHO notes it is linked with depression and anxiety. These effects are real and deserve care.
WHO recommends a team approach where possible, combining medical treatment with options such as physiotherapy and cognitive behavioural therapy to help with long-term pain.
Treatment choice also depends on side effects, cost and your plans for pregnancy, so it is fine to revisit your plan as your life and goals change.
Treatment options
The right choice depends on your symptoms, the extent of disease, your age and whether you want to become pregnant now.
| Option | What it does | Trying to conceive? |
|---|---|---|
| Pain relief | Anti-inflammatory painkillers such as ibuprofen ease pain | Ask your doctor what is suitable |
| Hormonal treatment | Pills, progestins or GnRH medicines calm the tissue and pain | Usually not used, as they prevent pregnancy |
| Laparoscopic surgery | Removes patches, cysts and scar tissue | May be considered; discuss effects on the ovaries |
| IUI or IVF | Fertility treatment to help conception | Yes, an option when needed |
Symptoms can return after surgery, so ongoing care is common. Support with pain, fatigue and mood, such as physiotherapy or counselling, can also help.
- Keep a pain and period diary to show your doctor
- Tell your doctor if you plan to get pregnant soon
- Ask about support for pain and emotional health
- Assume severe period pain is normal
- Keep taking hormonal treatment while trying to conceive without advice
If you have endometriosis and are trying for a baby, a fertility specialist can help you weigh surgery, IUI and IVF for your situation.
Getting support and planning ahead
Endometriosis affects about 1 in 10 women worldwide and is most often diagnosed in the 20s and 30s. Cleveland Clinic describes it as one of the leading causes of infertility.
- Keep a symptom diaryNote pain, bleeding and how it affects work or sleep. Heavy bleeding can mean changing pads every 1–2 hours.
- Share it with your doctorA clear record helps decide on scans, MRI or laparoscopy.
- Talk about pregnancy plans earlyHormone treatments ease pain but also stop pregnancy while you take them, so timing matters.
- Ask about referralIf you are struggling to conceive, ask about seeing a fertility specialist.
Questions to ask at your visit:
- Do I need a laparoscopy to confirm the diagnosis, or are scans enough for now?
- Could surgery help my pain and my chances of pregnancy, and what are the risks?
- Which pain treatments are safe while I am trying to conceive?
- Are my ovaries or fallopian tubes affected?
Endometriosis can also affect the chest. Seek urgent care for chest pain, breathlessness or coughing up blood around your period.
When to see a doctor
- Period pain stops you working, studying or doing daily activities
- Painkillers do not control your pain
- You have pain during sex, or when passing urine or stools
- You have tried for 12 months if under 35, for 6 months if 35–39, or for less than 6 months if 40 or older
- You have been trying to conceive without success
- You have heavy periods or pelvic pain between periods
Questions & answers
Can endometriosis be cured?
There is currently no cure, but many people control symptoms well with medicines, surgery or both.
Can I get pregnant with endometriosis?
Yes, many people do. If it is taking time, fertility treatments such as IUI or IVF may help.
Will a normal ultrasound rule it out?
Not always. Small patches may not show on scans; laparoscopy is the definitive test.
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Sources
- Endometriosis fact sheet — World Health Organization
- Endometriosis — NHS
- Endometriosis — Cleveland Clinic
- Infertility: causes, diagnosis & treatment — Cleveland Clinic