March marks Endometriosis Awareness Month, an important time to shed light on a condition that affects millions of women worldwide. As a menopause specialist, I see first hand how endometriosis impacts not only reproductive health but also overall well-being. Despite its prevalence, many women go undiagnosed for years, often suffering in silence. In this blog, we’ll discuss the symptoms, how to get a diagnosis, and the management options available including what this means for fertility.
What is Endometriosis?
Endometriosis is a chronic condition where tissue similar to the lining of the uterus (the endometrium) grows outside the womb, commonly on the ovaries, fallopian tubes, and even the bladder or bowel. This misplaced tissue responds to hormonal changes just like the uterine lining, meaning it thickens, breaks down, and bleeds each cycle. However, because this tissue has no way to exit the body, it can lead to pain, inflammation, and scar tissue formation.
Symptoms to Watch For
Endometriosis symptoms can vary from mild to severe, and they often overlap with other conditions, making diagnosis challenging. Some key symptoms include:
Pelvic pain—typically worse during menstruation but can occur at any time.
Heavy or irregular periods—long, heavy, or painful periods are common.
Pain during or after sex—deep pelvic pain can occur due to endometrial implants.
Painful bowel movements or urination—especially during menstruation.
Bloating (‘endo belly’)—some women experience severe bloating.
Fatigue—chronic pain can be exhausting.
Fertility issues—some women only discover they have endometriosis when struggling to conceive.
Getting a Diagnosis
Unfortunately, many women wait years for a diagnosis, often being told their pain is ‘normal’ or misdiagnosed with other conditions like IBS or pelvic inflammatory disease. The gold standard for diagnosing endometriosis is laparoscopy, a keyhole surgery where a camera is inserted into the abdomen to look for endometrial implants. However, doctors may use ultrasound and MRI to rule out other conditions before recommending surgery.
Management & Treatment Options
There is no cure for endometriosis, but treatments aim to manage symptoms and improve quality of life. Options include:
1. Pain Management
Over-the-counter pain relief—NSAIDs like ibuprofen can help with inflammation.
Hormonal treatments—the contraceptive pill, Mirena coil, or progesterone-only therapy can help suppress the menstrual cycle and reduce symptoms.
2. Surgical Interventions
Laparoscopic excision surgery—removes endometriosis tissue and can provide long-term relief.
Hysterectomy—considered only in severe cases when other treatments have failed and a woman is not planning to have children.
3. Lifestyle & Alternative Approaches
Anti-inflammatory diet—reducing processed foods and increasing omega-3s may help.
Pelvic physiotherapy—can improve mobility and ease pain.
Acupuncture and mindfulness—some women find these complementary therapies beneficial.
Endometriosis and Fertility
Endometriosis can impact fertility by causing inflammation, scarring, and adhesions around the reproductive organs. However, many women with endometriosis can still conceive naturally or with assistance. Fertility treatments like IVF, hormonal therapies, or surgery to remove endometrial implants can improve chances of conception. If you’re trying to conceive and have endometriosis, consulting a fertility specialist can help tailor a plan suited to your needs.
Endometriosis is a complex condition that requires a personalised approach to management. Whether you’re dealing with debilitating pain, fertility concerns, or just want answers about your symptoms, speaking to a specialist is the first step. If you suspect you have endometriosis, advocate for yourself—early intervention can make all the difference.