Understanding endometriosis

Endometriosis is a condition where tissue similar to the uterine lining grows outside the uterus, commonly on the ovaries, fallopian tubes, or pelvic lining. It's staged from 1 (minimal) to 4 (severe), based on the extent and location of tissue growth. Importantly, the intensity of your pain doesn't always match the severity of the disease — some women with advanced-stage endometriosis have minimal symptoms, while others with mild disease experience significant pain. This is part of why the condition is so often under-diagnosed.

Common symptoms

• Pelvic pain, particularly around your period
• Painful periods (dysmenorrhea)
• Pain during intercourse
• Heavy menstrual bleeding
• Difficulty conceiving
• Fatigue, and sometimes digestive symptoms like constipation, diarrhea, or nausea, especially around your period

How endometriosis is diagnosed

• 1

  A detailed history

  Including your specific symptoms and whether endometriosis runs in your family, since there's a hereditary component.

• 2

  A pelvic exam

  To check for tenderness, cysts, or other signs.

• 3

  Imaging

  Ultrasound or MRI to look for abnormal tissue growth.

• 4

  Laparoscopy

  Considered the gold standard for diagnosis, using a thin camera to directly view the pelvic organs, with a tissue sample sometimes taken for confirmation. Read more about laparoscopy →

Treatment options

• 1

  Pain Management

  NSAIDs like ibuprofen help manage inflammation and pain, working best when started early in your cycle.

• 2

  Hormonal Therapy

  Birth control pills, hormonal IUDs, or other hormone-based treatments can suppress the growth of endometrial tissue and manage symptoms effectively — though this manages the condition rather than curing it.

• 3

  Lifestyle Adjustments

  A healthy diet, regular exercise, and stress management can meaningfully help reduce symptoms for some women.

• 4

  Laparoscopic Excision Surgery

  The gold standard surgical treatment — lesions are completely removed rather than just burned on the surface (ablation), which reduces the chance of recurrence. This can significantly reduce pain and improve fertility outcomes.

• 5

  Hysterectomy

  Reserved for severe cases where other treatments haven't been effective — see our dedicated hysterectomy page for details on this procedure.

Endometriosis and fertility

Endometriosis is one of the more common causes of infertility, and early diagnosis and treatment can help preserve fertility rather than letting the condition progress. If you're experiencing both symptoms of endometriosis and difficulty conceiving, this is worth raising together during your evaluation, rather than as two separate concerns.

Reducing your risk and managing symptoms

• Don't normalize severe period pain — seek medical evaluation early rather than waiting.
• Maintaining a healthy weight can help, since excess body fat is linked to higher estrogen levels that can fuel tissue growth.
• Regular exercise may help lower estrogen levels and reduce inflammation.
• Limiting alcohol and caffeine has been associated with lower estrogen levels in some studies.
• Hormonal contraception may help slow progression for those not currently planning pregnancy.