Endometriosis: Symptoms, Diagnosis and Practical Care

If your periods are so painful they stop you from living normally, or you have pelvic pain outside your cycle, endometriosis might be the cause. It’s common, often missed, and not just “bad cramps.” Knowing what to look for and what actually helps can change things fast.

Endometriosis happens when tissue like the lining of the uterus grows outside the uterus. That rogue tissue still reacts to hormones, so it bleeds and causes inflammation, scars, and pain. The amount of pain doesn’t always match how much tissue there is—small spots can cause big problems.

Common signs to watch for

Here are clear symptoms that should make you see a doctor: very painful periods that get worse over time, pain during or after sex, chronic pelvic pain, heavy bleeding or spotting, and trouble getting pregnant. Other clues are painful bowel movements or urination during your period, and severe fatigue. If these sound familiar, don’t shrug them off.

How doctors find it

Diagnosis starts with a good chat about your symptoms and a pelvic exam. Imaging like transvaginal ultrasound or MRI can spot larger cysts (endometriomas) and help rule out other causes. The only way to be certain is laparoscopy, a small surgery where the doctor looks inside and can remove or biopsy lesions. Blood tests like CA-125 are not reliable on their own but may support the picture.

Treatment depends on how bad your symptoms are, whether you want to get pregnant, and what you prefer. For many, simple pain control works first: NSAIDs such as ibuprofen, used as directed, often help. Hormone treatments can reduce or stop the growth—combined birth control pills, progestins, the levonorgestrel IUD, and GnRH agonists are common options. Each has pros and cons, so talk with your doctor about side effects and long-term plans.

Surgery is for people who don’t get relief from medicine or who have fertility problems. Surgeons aim to remove lesions and scar tissue while preserving organs. A hysterectomy can be considered in severe, persistent cases when other treatments fail and when future pregnancy is not desired.

Practical things that help day to day: heat packs, light exercise like walking or yoga, pelvic physiotherapy, good sleep, and tracking your cycle to spot patterns. Some people find dietary changes—reducing inflammatory foods and alcohol—help a bit, though results vary. Mental health matters too; chronic pain wears you down, so counselling or peer support can be useful.

Fertility: endometriosis can reduce fertility but many people still conceive naturally, especially with early treatment. Fertility treatments such as IVF are effective if needed.

When to see a doctor? If pain limits your life, if pain gets worse, or if you struggle to conceive, book an appointment. Early assessment and a clear plan can prevent years of suffering and improve quality of life.

Want reliable resources? Look for national endometriosis societies, clinics that specialise in pelvic pain, and patient support groups online. You don’t have to manage this alone—help and options are available.