Endometriosis is a chronic condition in which tissue similar to the lining of the uterus grows outside the uterus. It most commonly affects structures within the pelvis, including the ovaries and the tissue surrounding the uterus, but it can also involve the bowel, bladder and, more rarely, other areas. Symptoms vary widely and do not always reflect the extent of the disease.
Common symptoms
- Severe menstrual pain that interferes with normal activities
- Persistent pelvic, lower abdominal or lower back pain
- Pain during or after sex
- Pain with bowel movements or urination, particularly during menstruation
- Heavy menstrual bleeding or bleeding between periods
- Fatigue
- Difficulty becoming pregnant
Some people with endometriosis have few or no symptoms. Similar symptoms can occur with adenomyosis, uterine fibroids, pelvic inflammatory disease, irritable bowel syndrome and other conditions.
Diagnosis
Assessment begins with a detailed history of symptoms and menstrual patterns. A pelvic examination, ultrasound or MRI may be used depending on the circumstances. Imaging can identify some forms of endometriosis but a normal scan does not rule it out. Laparoscopy can allow direct examination of the pelvis and, when appropriate, treatment or tissue sampling.
Treatment
Treatment is individualized according to symptoms, disease location, fertility plans and personal preferences. Options may include pain-relieving medicines, hormonal treatment and surgery. Hormonal treatments can reduce endometriosis-related pain but are not used to improve fertility while a person is actively trying to conceive. Fertility assessment or specialist support may be appropriate when pregnancy is difficult to achieve.
Endometriosis can also affect sleep, emotional wellbeing, relationships, work and education. Management of persistent pain and appropriate psychological or multidisciplinary support can therefore be an important part of care.
When to seek medical advice
Arrange an assessment if menstrual or pelvic pain interferes with daily life, symptoms persist or worsen, treatment is not helping, or you have difficulty becoming pregnant. Seek urgent medical care for sudden severe pelvic or abdominal pain, fainting, very heavy bleeding, or significant pain or bleeding during a possible pregnancy.
Related topics
Sources and further reading
Last reviewed: 4 September 2026. This page provides general health information and does not replace individual medical assessment or treatment.