What Is Endometriosis?
Endometriosis occurs when tissue similar to the uterine lining (endometrium) grows outside the uterus — on the ovaries, fallopian tubes, bowel, bladder or peritoneum. Like the uterine lining, it bleeds during periods but the blood has nowhere to escape, causing pain, inflammation and scar tissue.
Symptoms
- Painful periods (dysmenorrhoea) — often severe, disabling
- Chronic pelvic pain
- Pain during or after sex
- Pain with bowel movements or urination (during periods)
- Heavy menstrual bleeding
- Bloating
- Difficulty conceiving (infertility) in some women
Diagnostic Tests
| Test | Role |
|---|---|
| CA-125 blood test | Elevated in many women with endometriosis but not specific or sensitive enough for diagnosis alone |
| Pelvic ultrasound | Can detect endometriomas (chocolate cysts on ovaries) |
| MRI pelvis | Best non-surgical imaging for deep infiltrating endometriosis |
| Laparoscopy | Gold standard — surgical visualisation and biopsy confirms diagnosis |
Treatment
- Hormonal suppression: combined pill, progestins, Mirena coil, GnRH analogues
- Pain management: NSAIDs, nerve pain medications
- Surgery: laparoscopic excision or ablation of endometriotic tissue
- For infertility: IVF or surgical correction of tubal/ovarian disease
FAQs
Why does endometriosis take so long to diagnose?
Symptoms are often dismissed as 'bad periods'. Definitive diagnosis requires laparoscopy. Increased awareness is helping reduce diagnostic delays.
Does endometriosis always cause infertility?
No — many women with endometriosis conceive naturally. Severe cases or those affecting the tubes/ovaries have higher infertility risk.
Does menopause cure endometriosis?
Menopause usually causes lesions to regress, but endometriosis can persist in some women — especially on HRT.
Medical Disclaimer: Endometriosis should be managed by a gynaecologist with specialist experience. Do not accept being told 'painful periods are normal' — seek further investigation.