Understanding Endometriosis

Evidence-based information to help you navigate endometriosis, from understanding symptoms to exploring management options.

What is Endometriosis?

Endometriosis is a condition where tissue similar to the lining of the uterus (endometrium) grows outside the uterus. These growths, called lesions or implants, can appear on the ovaries, fallopian tubes, bowel, bladder, and other areas within the pelvis. In some cases, endometriosis has been found in other parts of the body.

This tissue responds to hormonal changes during the menstrual cycle, but unlike the uterine lining, it has no way to exit the body. This can lead to inflammation, scarring, and various symptoms.

Key Facts

Affects an estimated 10% of women and people with uteruses of reproductive age globally

Can occur from the onset of menstruation through to menopause

Symptoms vary significantly between individuals

The cause is not fully understood, though several theories exist

There's currently no cure, but various management options are available

The Future

Types and Classifications

Endometriosis typically appears in three forms:

Healthcare providers may use staging systems (such as the revised American Society for Reproductive Medicine classification) to describe endometriosis. However, stage doesn't necessarily correlate with symptom severity - someone with Stage I endometriosis might experience more symptoms than someone with Stage IV.

Symptoms

Understanding the Range

Endometriosis symptoms vary greatly between individuals. Some people experience severe symptoms, whilst others have mild or no symptoms. The severity of symptoms doesn't always correlate with the extent of endometriosis.

Pelvic Pain

Pain before and during periods (dysmenorrhoea)
Pain during or after sexual intercourse (dyspareunia)
Chronic pelvic pain throughout the menstrual cycle
Pain that may radiate to the lower back or legs

Menstrual Changes

Heavy menstrual bleeding (menorrhagia)
Irregular periods
Spotting between periods
Prolonged periods

Bowel and Bladder Symptoms

Pain during bowel movements
Changes in bowel habits during menstruation
Bloating and digestive issues
Pain during urination
Increased urinary frequency or urgency

Other Recorded Symptoms

Chronic fatigue
Nausea
Difficulty conceiving
Lower back pain
Nerve pain or numbness

Symptom Patterns

Many people with endometriosis notice their symptoms follow patterns related to their menstrual cycle, though some experience symptoms throughout the month. Tracking symptoms over time can help identify these patterns and provide useful information for healthcare providers.

mportant Note: These symptoms can also occur with other conditions. If you're experiencing any of these symptoms, consult with a healthcare provider for proper evaluation.

Getting Diagnosed

The Diagnostic Journey

Diagnosis of endometriosis can be complex and often takes time. There's no simple test for endometriosis, and symptoms overlap with many other conditions.

Clinical Assessment

Your healthcare provider will typically begin with:
Detailed medical history
Discussion of symptoms and their impact
Physical examination, which may include a pelvic exam

Imaging Studies

Ultrasound: May show ovarian endometriomas but often cannot detect other types of endometriosis
‍MRI: Can provide more detailed images and may detect deep infiltrating endometriosis
Note: Many endometriosis lesions aren't visible on imaging

Laparoscopy

Currently considered the most definitive diagnostic method
A minimally invasive surgical procedure using a camera to view the pelvis
Allows for visual confirmation and tissue biopsy
Can be combined with treatment (excision or ablation of lesions)

Empirical Treatment

‍Some healthcare providers may suggest trying treatments before surgical diagnosis, particularly hormonal therapies, to see if symptoms improve.