Endometriosis
Endometriosis is a chronic inflammatory condition where tissue resembling endometrium occurs outside the uterus, commonly causing cyclical pelvic pain.
Key points
- Severe period pain, pain with sex, bowel or bladder pain around menstruation and infertility can occur in different combinations.
- Ultrasound identifies ovarian endometriomas and some deep disease, but a normal scan does not exclude endometriosis.
- Hormonal suppression treats pain for many people but does not improve fertility while ovulation is suppressed.
The listings below are not suitable for every goal; pregnancy plans, clot risk, symptom pattern and previous treatment affect selection.
Establishing a working diagnosis
History and pelvic examination guide targeted ultrasound or MRI. Laparoscopy can confirm and treat disease but is not mandatory before every trial of medical management. Other causes such as adenomyosis, bowel disease and bladder pain may coexist.
Aligning treatment with goals
NSAIDs may reduce menstrual pain but carry gastrointestinal and kidney risks. Combined hormonal or progestogen treatment suppresses cycling and can reduce symptoms. Surgery is considered for selected persistent pain, endometrioma, organ involvement or fertility plans, with recurrence and ovarian-reserve implications discussed.
When to seek urgent care
Seek urgent care for sudden severe or one-sided pelvic pain, fainting, fever with pelvic pain, repeated vomiting, very heavy bleeding, or pain and bleeding when pregnancy is possible.




