Birth Control Options Compared
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Endometriosis: Symptoms and Diagnosis
The symptoms of endometriosis, from painful periods to pain with sex, why diagnosis often takes years, the tests used and treatment options to discuss.
Key takeaways
- Endometriosis affects roughly 1 in 10 women and girls of reproductive age worldwide.
- Period pain that disrupts daily life is not something you just have to live with.
- Diagnosis can start with symptoms, an exam and imaging; surgery isn’t always needed before treatment begins.
On this page
Endometriosis is a condition in which tissue similar to the lining of the uterus grows outside it, often on the ovaries, fallopian tubes and the lining of the pelvis, and sometimes on the bowel or bladder. This tissue responds to hormonal cycles, causing inflammation, pain and scar tissue. The World Health Organization estimates it affects roughly 10% of women and girls of reproductive age.
Common symptoms
- Painful periods that stop you from going to school or work, or aren’t helped by usual pain relievers
- Chronic pelvic pain, including between periods
- Pain during or after sex
- Painful bowel movements or urination, especially during your period
- Heavy or irregular bleeding
- Fatigue, bloating and nausea
- Difficulty getting pregnant
The amount of endometriosis doesn’t always match the level of pain. Some people with small areas have severe symptoms, and some with extensive disease have few.
Why diagnosis often takes years
Many people are told that painful periods are normal, and symptoms can overlap with bowel or bladder conditions. As a result, diagnosis is often delayed by years. If pain affects your daily life, say so clearly, and keep a symptom diary to bring to your appointment.
How endometriosis is diagnosed
| Step | What happens |
|---|---|
| Symptom history | Your clinician asks about pain, periods, sex, bowel and bladder symptoms |
| Pelvic exam | Checks for tenderness, nodules or cysts |
| Ultrasound | Can show endometriomas (ovarian cysts) and, with expert scanning, some deep endometriosis |
| MRI | Sometimes used to map deeper disease |
| Laparoscopy | Keyhole surgery to see and biopsy tissue; the only way to confirm it for certain |
A normal ultrasound doesn’t rule endometriosis out. ACOG supports making a clinical diagnosis from your symptoms and exam and starting treatment without waiting for surgery. Learn what to expect from a pelvic exam.
Treatment options
Treatment depends on your symptoms, age and whether you want to become pregnant.
- Pain relievers, such as NSAIDs, for mild pain.
- Hormonal treatments that reduce or stop periods: combined birth control pills, progestins (including hormonal IUDs), and medicines that lower estrogen, such as GnRH antagonists. Our birth control guide explains several of these methods.
- Surgery to remove endometriosis tissue and cysts, usually by laparoscopy. Symptoms can return, and hysterectomy isn’t a guaranteed cure.
- Supportive care, including pelvic floor physical therapy and pain management.
For fertility, options include surgery and assisted reproduction, depending on your situation. A reproductive endocrinologist can advise.
Living with endometriosis
Endometriosis is a long-term condition, but many people find a treatment plan that works. Chronic pain can take a toll on mood, sleep and relationships, so ask about support for those too. Prepare for appointments with our list of questions to ask your gynecologist.
Frequently asked questions
Can endometriosis be cured?
There’s no cure yet, but treatments can control symptoms well for many people. Symptoms often ease after menopause.
Does endometriosis cause infertility?
It can make getting pregnant harder, but many people with endometriosis conceive naturally or with treatment.
Is endometriosis the same as PCOS?
No. They’re different conditions, though both can affect periods and fertility. Read about PCOS signs, tests and treatment.
Sources
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