What is endometriosis?
Written by Dr. Specialist Stine Andreassen
Specialist in Gynecology and Obstetrics, PhD in Obstetrics in 2015 and more than 15 years of clinical practice in Obstetrics and Gynecology
Endometriosis is a chronic condition where tissue similar to the lining of the uterus (the endometrium) grows outside the uterus.
This tissue can be found on the ovaries, fallopian tubes, the outside of the uterus, the bladder, the bowel, or other areas in the pelvis. In rare cases, it can occur outside the pelvic area. Like the uterine lining, this tissue responds to hormonal changes during the menstrual cycle. It can thicken and bleed. This can lead to inflammation, pain, scar tissue, and adhesions (organs sticking together).
Endometriosis is common, affecting about 1 in 10 women of reproductive age. It is a long-term condition, but treatment can help manage symptoms.
What are the symptoms of endometriosis?
Symptoms vary widely. Some women have severe pain, while others have mild or no symptoms. Common symptoms include painful periods, pelvic pain, pain during or after intercourse, painful bowel movements or urination, chronic lower back pain, fatigue, difficulty becoming pregnant. A key feature of endometriosis is pain that interferes with daily life — not “just normal period pain.”
How is endometriosis diagnosed?
Diagnosis can be challenging because symptoms overlap with other conditions. A doctor will usually start with a detailed discussion of symptoms and menstrual history, followed by a pelvic examination with an ultrasound scan. However, endometriosis does not always show up on ultrasound. Endometriosis can be confirmed through a minor surgical procedure called laparoscopy, where a small camera is inserted into the abdomen to look for endometriosis lesions. In many cases, treatment may begin based on symptoms and clinical suspicion, even without surgical confirmation.
How is endometriosis treated?
Treatment depends on symptom severity, age, and whether you wish to become pregnant.
Pain relief: Over-the-counter anti-inflammatory medications (such as ibuprofen) are often used for mild symptoms.
Hormonal treatment: Reduce or stop menstruation, which can reduce pain and slow the growth of endometriosis tissue: combined oral contraceptive pill, progestin-only treatments, hormonal IUD, other hormone-regulating medications,
Surgery: In some cases, surgery is recommended to remove endometriosis tissue, especially if pain is severe or fertility is affected.
Multidisciplinary support: Because endometriosis can affect many aspects of life, most women benefit from pelvic physiotherapy, pain specialists, psychological support and lifestyle adjustments (exercise, stress reduction)
Treatment should be individualized and regularly reviewed.
When should I see a doctor to discuss endometriosis symptoms?
You should consider seeing a doctor if:
Your period pain is severe and affects work, school, or daily life
Painkillers do not provide enough relief
You experience pain during intercourse
You have ongoing pelvic pain
You are trying to conceive without success
Your symptoms are worsening over time
Severe menstrual pain is not something you have to simply “live with.” If your pain limits your life, it deserves medical attention.
Why does endometriosis increase the risk of infertility?
Endometriosis can affect fertility in several ways. Inflammation caused by endometriosis can damage the ovaries or fallopian tubes, affect egg quality, cause inflammation that interfere with fertilization or implantation. However, many women with endometriosis can and do become pregnant – naturally or with medical assistance. The likelihood depends on the severity of the condition and individual factors. Early diagnosis and appropriate management can improve fertility outcomes.
Related resources
Read more about pelvic exams
Learn more about vaginal speculums
Learn more about the Vega vaginal speculum
FAQ – Endometriosis
-
Endometriosis is a chronic condition in which tissue similar to the lining of the uterus grows outside the uterus. These growths can occur on the ovaries, fallopian tubes, pelvic lining, and other areas of the pelvis, causing inflammation, pain, and sometimes fertility problems.
-
Symptoms vary from person to person but commonly include:
Painful menstrual periods
Chronic pelvic pain
Pain during or after sexual intercourse
Pain during bowel movements or urination
Heavy menstrual bleeding
Difficulty becoming pregnant
Some individuals with endometriosis may have few or no symptoms.
-
The exact cause of endometriosis is not fully understood. Several factors may contribute, including genetic predisposition, hormonal influences, immune system factors, and retrograde menstruation, where menstrual blood flows backward into the pelvic cavity.
-
Diagnosis usually begins with a review of symptoms and a gynecological examination. Additional investigations may include ultrasound imaging or other diagnostic tests. In some cases, a surgical procedure called laparoscopy may be used to confirm the diagnosis.
-
Yes. Endometriosis can affect fertility in some individuals by causing inflammation, scar tissue, or changes to the reproductive organs. However, many people with endometriosis are able to become pregnant naturally.
-
There is currently no cure for endometriosis, but symptoms can often be managed through medical treatment, pain management, hormonal therapies, or surgery. Treatment depends on symptom severity, age, fertility goals, and individual circumstances.