Common Symptoms

Endometriosis can present differently in every woman. Symptoms may include:

• Severe menstrual cramps or painful periods

• Chronic lower abdominal or pelvic pain

• Pain during or after sexual intercourse

• Pain while passing stool or urine, particularly during periods

• Heavy or irregular menstrual bleeding

• Abdominal bloating

• Difficulty conceiving

• Fatigue associated with persistent pain

The severity of pain does not always indicate the extent of endometriosis.

What is Endometriosis?

Endometriosis is a condition in which tissue similar to the lining of the uterus grows outside the uterus. It may involve the ovaries, fallopian tubes, pelvic lining and, in some cases, the bowel or urinary tract.

These areas respond to hormonal changes and may cause inflammation, scarring and adhesions, leading to pain and sometimes fertility problems.

How is Endometriosis Diagnosed?

Evaluation usually begins with a detailed history and gynaecological examination.

Depending upon the symptoms, investigations may include:

Pelvic Ultrasound
Helps identify ovarian endometriomas and other pelvic abnormalities.

MRI Pelvis
May be advised when deep endometriosis or involvement of surrounding organs is suspected.

Laparoscopy
In selected cases, keyhole surgery may be used to directly visualise and treat endometriosis.

Treatment can sometimes be started on the basis of symptoms and imaging without immediately proceeding to surgery.

Treatment is Personalised to You

There is no single treatment suitable for every woman. The treatment plan depends on:

• Severity of pain

• Age

• Location and extent of endometriosis

• Presence of ovarian cysts

• Previous treatments

• Desire for future pregnancy

• Effect of symptoms on everyday life

Endometriosis and Fertility

Many women with endometriosis conceive naturally. However, endometriosis may reduce fertility in some women by affecting the ovaries, fallopian tubes or pelvic anatomy.

If pregnancy is desired, treatment needs to be planned carefully.

Depending upon age, ovarian reserve, duration of infertility and severity of disease, management may include:

Natural conception with monitoring → Fertility assessment → Laparoscopic treatment when appropriate → Ovulation treatment / IUI in selected cases → IVF when required

The aim is not simply to treat endometriosis, but also to protect reproductive potential whenever possible.

When Should You Consult a Gynaecologist?

Consider evaluation if you experience:

• Period pain severe enough to interrupt normal activities

• Persistent pelvic pain

• Pain during intercourse

• Recurrent pain while passing stool during periods

• Difficulty becoming pregnant

• Known or suspected ovarian endometrioma

• Persistent symptoms despite previous treatment

Early assessment can help establish the cause of symptoms and guide appropriate management.

1. Medicines for Pain Relief

Anti-inflammatory pain medicines may be advised for painful periods and pelvic discomfort.

They help control symptoms but do not remove endometriotic lesions.

2. Hormonal Treatment

Hormonal therapy aims to suppress hormonal stimulation of endometriosis and reduce pain.

Options may include:

• Combined oral contraceptive pills

• Progesterone-based medicines

• Levonorgestrel intrauterine system

• GnRH agonists or antagonists in selected patients

• Other specialist hormonal treatments when required

The most appropriate option is selected according to symptoms, medical history and pregnancy plans.

3. Laparoscopic Surgery

Surgery may be considered when:

• Pain remains severe despite medical treatment

• A significant ovarian endometrioma is present

• Deep endometriosis is suspected

• Bowel or urinary tract involvement is present

• Diagnosis remains uncertain

• Endometriosis is affecting fertility in selected situations

Laparoscopic surgery allows endometriotic lesions, adhesions and ovarian endometriomas to be treated through small abdominal incisions.

A Treatment Plan Designed Around You

Endometriosis is often a long-term condition, and successful management requires more than simply controlling pain.

Treatment should balance:

Pain Control • Menstrual Health • Fertility Goals • Ovarian Health • Quality of Life

A personalised approach helps determine whether observation, medication, hormonal treatment, surgery or fertility treatment is most appropriate at each stage.