Endometriosis (sometimes shortened to “endo”) is a condition where endometrial tissue that is usually found in the uterus grows in other parts of the pelvis, such as the ovaries and fallopian tubes. 

Many people around the world suffer from the effects of endometriosis, yet it can be difficult to identify. Here we explain the causes, symptoms, impact, and diagnosis and treatment methods. 

Symptoms and causes

The symptoms of endometriosis vary greatly, as does the intensity of them, which means that some people don’t even know they have it. These are the main symptoms you should look out for:

• strong period pains
• pain in your lower tummy or back, which usually worsens during your period
• pain during or after sex
• pain when going to the toilet during your period
• nausea, constipation, or diarrhea during your period
• blood in your urine during your period
• irregular periods, and/or heavy periods which soak through several pads/tampons etc, and perhaps even through your clothes
• difficulty getting pregnant

The causes of endometriosis are unclear. It could be genetic, or a problem with the immune system. It could also be linked to the menstrual cycle, or something else entirely – or a combination of all of these. At this stage, no one fully understands why endometriosis happens, which unfortunately may contribute to the problem of identifying it in people. 

Impact

Endometriosis can affect anyone with a uterus who has periods, and it can last for years. A main complication is impaired fertility, and approximately a third to a half of women with endometriosis have difficulty getting pregnant.

Endometriosis can be physically very painful for some people, to the point that they are unable to carry out their usual day-to-day activities. As a result, they might require time off from work or school to rest and recuperate. 

It can also lead to mental health problems, and some people consequently develop depression. 

Diagnosis

Many people report that their concerns are sometimes dismissed as 'bad period pains', rather than the specific condition of endometriosis. This is not right, and you deserve for your experience to be taken seriously so you can get the medical care you need. 

If you think you have endometriosis, make a diary of your symptoms (physical and emotional), noting when they happen and to what extent. Then make an appointment to see a health practitioner, and take this diary with you to help give them a better picture of your experience. 

As well as assessing your diary, the health practitioner may perform tests on your tummy or vagina, or an ultrasound, to diagnose you.

It can be difficult to identify endometriosis, as the only way to be completely sure you have it is to undergo a minimal invasive surgical procedure called a laparoscopy. This is where a tube is passed through a small cut in your tummy, so that a medical professional can see directly if and where excess tissue is forming. 

The laparoscopy is usually the final examination they will suggest performing, and it’s important to note that there are treatment methods that can be explored without or before having this procedure, which are outlined below.

Treatment

While there is no cure for endometriosis, there are treatment options to help manage the symptoms including:

• physical therapy, specifically for your pelvic floor
• painkillers (such as ibuprofen) 
• certain hormonal contraceptives (such as the Pill, and the IUS)
• surgery to cut away endometrial tissue (if you are living with infertility, this may also help increase your fertility)
• a hysterectomy (to remove part or all of the womb) – this is only for people for whom fertility is not a consideration

Your healthcare provider will be able to discuss all these options with you in full. 

It is worth bearing in mind that in some cases the symptoms of endometriosis might improve on their own. But in the meantime you do not need to suffer in silence – make an appointment with your healthcare provider to discuss endometriosis if you think you may have it. 

Illustrations by Violet Clair