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Endometriosis is a chronic health condition that can affect the uterus, ovaries, fallopian tubes and other areas of the body. It occurs when tissue similar to the lining of the uterus grows outside the uterus, potentially causing inflammation, pelvic pain, scar tissue and fertility-related difficulties.
Despite being relatively common, endometriosis can take time to diagnose because its symptoms may resemble those of other conditions. Some people experience severe pain during menstruation, while others have digestive discomfort, pain during intercourse or difficulty becoming pregnant. Some people have no noticeable symptoms at all.
According to the World Health Organization (WHO), endometriosis affects approximately 1 in 10 women of reproductive age worldwide. Understanding its symptoms, available diagnostic methods and treatment options can help people recognise when to seek medical advice.
Endometriosis is a condition in which tissue similar to the endometrium, the lining inside the uterus, grows outside the uterus. These growths are often found around the ovaries, fallopian tubes, pelvic lining and other pelvic structures. In some cases, they can occur outside the pelvis.
This tissue can respond to hormonal changes during the menstrual cycle. The resulting inflammation and irritation may contribute to pain, scar tissue and adhesions, which are bands of tissue that can cause nearby organs to stick together.
Endometriosis is a chronic condition. Although there is currently no definitive cure, various treatments can help manage symptoms and improve quality of life.
Endometriosis symptoms vary from person to person. Some people experience symptoms mainly around their periods, while others have persistent pain throughout the month.
Common symptoms include:
Not everyone experiences all these symptoms. The severity of pain also does not necessarily indicate how extensive the condition is.
The exact cause of endometriosis is not fully understood. Researchers have investigated several possible mechanisms, but no single explanation accounts for every case.
Potential contributing factors include:
One proposed explanation involves menstrual fluid moving backwards through the fallopian tubes into the pelvic cavity. This is known as retrograde menstruation. However, this alone cannot explain all cases of endometriosis.
Oestrogen plays an important role in endometriosis because the condition is influenced by hormonal activity. Hormonal changes can affect the activity of endometriosis lesions and contribute to inflammation and pain.
Researchers are investigating how immune system activity may affect the body's ability to recognise and remove endometriosis-like tissue growing outside the uterus.
Endometriosis can occur more frequently in some families. Having a close relative with the condition may increase the likelihood of developing it, although family history does not guarantee that someone will develop endometriosis.
Researchers continue to study how stem cells, inflammation, tissue repair and other biological processes may contribute to the development and progression of endometriosis.
Endometriosis can affect people from the beginning of menstruation through menopause. However, symptoms, diagnosis and disease progression vary considerably.
Factors associated with a higher likelihood of endometriosis may include:
Having one or more of these factors does not confirm endometriosis. A healthcare professional can assess symptoms and determine whether further investigation is appropriate.
Diagnosing endometriosis involves assessing symptoms, medical history and examination findings. Depending on the situation, a healthcare professional may recommend imaging or further investigations.
No single routine blood test can reliably confirm or exclude endometriosis.
A gynaecologist may ask about menstrual patterns, pelvic pain, bowel or bladder symptoms, previous treatments and fertility concerns. A physical or pelvic examination may also be considered.
An ultrasound uses sound waves to create images of the pelvic organs. It can help identify ovarian endometriomas, which are cysts associated with endometriosis, and some forms of deep endometriosis.
However, a normal ultrasound does not rule out endometriosis because small or superficial lesions may not be visible.
MRI may be used when more detailed images are needed, particularly when deep endometriosis is suspected or treatment planning requires additional information.
MRI is not necessary for everyone and cannot identify every type of lesion.
Laparoscopy is a surgical procedure in which a small camera is inserted through a small incision to examine the pelvic cavity. It can allow a surgeon to identify endometriosis lesions and, when appropriate, obtain tissue samples or treat visible disease.
Current clinical guidance recognises that endometriosis may sometimes be diagnosed and managed based on symptoms and imaging without requiring surgery in every case. A normal scan does not necessarily exclude the condition.
Laboratory tests may help investigate symptoms, assess related conditions or identify other possible explanations for pain or heavy menstrual bleeding. However, laboratory testing has limitations when it comes to diagnosing endometriosis itself.
| Test or Investigation | Why It May Be Considered | Important Limitation |
|---|---|---|
| Complete Blood Count (CBC) | Helps assess anaemia when menstrual bleeding is heavy | Does not diagnose endometriosis |
| Ferritin | Helps evaluate iron stores when iron deficiency is suspected | Does not identify endometriosis lesions |
| Pregnancy Test | May help assess pregnancy-related causes of pelvic pain | Does not diagnose endometriosis |
| CA-125 | May be considered in selected clinical assessments | Not a reliable stand-alone diagnostic test for endometriosis |
| Pelvic Ultrasound | Helps identify ovarian endometriomas and some deep lesions | A normal scan does not exclude all endometriosis |
| MRI | Provides detailed pelvic imaging in selected cases | May not detect every lesion |
CA-125 is sometimes discussed in relation to endometriosis because its level may be elevated in some affected individuals. However, it can also rise in several other conditions and may remain normal in people who have endometriosis. It is therefore not recommended as a stand-alone test to diagnose or rule out the condition.
For information about available laboratory investigations, explore the VIP LABS Test and Parameter Directory. A healthcare professional can help determine which tests are relevant to an individual's symptoms.
Several conditions can cause pelvic pain, painful periods or heavy menstrual bleeding. Their symptoms may overlap, which is why medical evaluation is important.
| Condition | Common Features | How It Differs |
|---|---|---|
| Endometriosis | Painful periods, chronic pelvic pain and possible fertility difficulties | Tissue similar to the uterine lining grows outside the uterus |
| Uterine Fibroids | Heavy menstrual bleeding, pelvic pressure or an enlarged uterus | Noncancerous growths develop in or around the muscular wall of the uterus |
| Adenomyosis | Painful periods, heavy bleeding and sometimes an enlarged uterus | Tissue similar to the uterine lining grows into the muscular wall of the uterus |
| Pelvic Inflammatory Disease | Pelvic pain, abnormal discharge or fever in some cases | Infection and inflammation affect the upper reproductive tract |
| Ovarian Cysts | Pelvic discomfort, bloating or sudden pain in some cases | Fluid-filled or other cysts develop in or on an ovary |
These conditions can sometimes occur together. Symptoms alone may not be enough to distinguish them, so a healthcare professional may recommend an examination and appropriate investigations.
Treatment depends on symptoms, disease location, response to previous treatment, possible side effects and whether pregnancy is a current or future goal.
There is no single treatment that works for everyone. Options may include the following.
Pain-relieving medicines may help reduce menstrual cramps and pelvic discomfort. The choice of medicine depends on individual health factors, other medications and potential risks.
A healthcare professional or pharmacist can advise on suitable options, particularly for people with stomach, kidney or other medical concerns.
Hormonal treatments may reduce pain and the activity of endometriosis lesions. Options can include certain contraceptive pills, progestogen-based treatments and other hormone-modulating medicines.
These treatments may help manage symptoms but do not necessarily remove existing lesions or provide a permanent cure. Some hormonal treatments also prevent pregnancy while they are being used.
Surgery may be considered when symptoms remain troublesome despite other treatment, when particular lesions require treatment or when individual fertility-related circumstances make surgery appropriate.
Laparoscopic surgery can be used to remove or destroy endometriosis lesions and treat certain adhesions. The potential benefits and risks should be discussed with a specialist, as symptoms may recur after surgery.
People experiencing infertility associated with endometriosis may benefit from an individualised fertility assessment. Depending on the circumstances, options may include surgery, fertility medication or assisted reproductive technologies such as in vitro fertilisation (IVF).
The most suitable approach depends on factors such as age, ovarian reserve, the extent of disease and other fertility considerations.
Some people find that appropriate physical activity, pelvic floor physiotherapy, psychological support and symptom tracking help them cope with chronic pain.
These approaches may complement medical treatment but should not be viewed as substitutes for necessary assessment or treatment.
Yes. Endometriosis can affect fertility in some people, but it does not mean that pregnancy is impossible.
Inflammation, adhesions and changes involving the ovaries or fallopian tubes may interfere with the processes involved in conception. However, many people with endometriosis do become pregnant.
If pregnancy is a priority, it is helpful to discuss fertility goals with a gynaecologist before choosing a treatment. Some hormonal treatments used to control endometriosis symptoms prevent conception while they are being taken, so treatment choices may differ for people who are actively trying to become pregnant.
There is currently no proven method that reliably prevents endometriosis. Its exact causes remain uncertain, and the condition cannot always be avoided through lifestyle changes.
Recognising persistent symptoms and seeking timely medical assessment can help people access appropriate care. Keeping a record of menstrual pain, bleeding patterns and related symptoms may also help during consultations.
A healthy lifestyle may support general well-being, but no specific diet, supplement or exercise routine has been proven to prevent or cure endometriosis.
Consider arranging a medical assessment if you experience:
Seek urgent medical care for sudden severe pelvic or abdominal pain, fainting, heavy bleeding with weakness or dizziness, or severe pain when pregnancy is possible. These symptoms can indicate conditions that require prompt evaluation.
1. What is the main symptom of endometriosis?
Painful menstruation and chronic pelvic pain are common symptoms. Some people also experience pain during intercourse, painful bowel movements, heavy bleeding or difficulty becoming pregnant. Others may have few or no symptoms.
2. Can a blood test confirm endometriosis?
No routine blood test can reliably confirm or rule out endometriosis. Blood tests may help investigate related problems, but diagnosis usually relies on symptoms, clinical assessment and appropriate imaging. Surgery may be considered in selected cases.
3. Is CA-125 elevated in endometriosis?
CA-125 may be elevated in some people with endometriosis, but it is not specific to the condition. It can also rise for other reasons and may be normal in people who have endometriosis. It should not be used alone to diagnose the condition.
4. Can endometriosis be cured permanently?
There is currently no definitive cure. Medicines and surgery can help manage symptoms, but symptoms may persist or return. Treatment aims to improve quality of life and address individual health and fertility needs.
5. Can someone with endometriosis get pregnant?
Yes. Many people with endometriosis become pregnant naturally, although the condition can make conception more difficult for some. A fertility specialist can help assess individual circumstances and discuss suitable options.
Endometriosis is a chronic condition that can cause painful periods, persistent pelvic pain, digestive or urinary symptoms and fertility difficulties. Because these symptoms can overlap with other health conditions, recognising the pattern and seeking appropriate medical assessment are important steps towards effective management.
Diagnosis may involve a medical history, examination, ultrasound, MRI or laparoscopy depending on the situation. Laboratory tests can help assess related concerns, but no routine blood test can reliably diagnose or exclude endometriosis on its own.
With an individualised treatment plan, appropriate follow-up and support, many people can manage their symptoms and improve their quality of life.