What is endometriosis?
The womb is lined with tissue called the endometrium. In endometriosis, similar tissue grows in other places, such as on the ovaries, the fallopian tubes or the lining of the tummy. Each month this tissue reacts to hormones, which can cause pain, swelling and scarring (adhesions).
Sometimes it forms cysts on the ovaries, called endometriomas or "chocolate cysts".
Common signs
- Very painful periods that stop you doing daily activities
- Pain in the lower tummy or back, even between periods
- Pain during or after intercourse
- Pain when passing urine or stools during periods
- Heavy periods
- Difficulty getting pregnant
Some women have mild endometriosis with no pain at all. Period pain that is severe is not "normal" and is worth checking.
How endometriosis affects fertility
- Scarring can block or twist the fallopian tubes, so the egg and sperm can't meet.
- Cysts on the ovaries can reduce the number of eggs (egg reserve).
- Inflammation in the pelvis may affect the egg, sperm and embryo.
How it is diagnosed
Your doctor will ask about your symptoms and do an examination. An ultrasound scan can show cysts on the ovaries. A blood test (AMH) checks your egg reserve. Sometimes a keyhole operation (laparoscopy) is needed to see the endometriosis directly. See our fertility tests page.
Treatment options
The right treatment depends on your age, your symptoms, how severe the endometriosis is, and how long you have been trying.
- Pain relief and hormone medicines can ease pain. Note that hormone medicines usually stop ovulation, so they are not used while trying to conceive.
- Keyhole surgery (laparoscopy) can remove endometriosis or cysts in some women. Your doctor will weigh this carefully, because surgery on the ovaries can lower egg reserve.
- IUI with ovulation medicines may be suitable for milder endometriosis with open tubes.
- IVF is often advised for moderate to severe endometriosis, blocked tubes, low egg reserve, or when other treatment hasn't worked.
Things you can do
- Keep a diary of your pain and periods to show your doctor
- Don't wait too long to seek help if you are trying to conceive, as endometriosis can affect egg reserve over time
- Regular exercise and a balanced diet may help with general well-being
- Talk to us if pain is affecting your daily life or your relationship
Common questions about endometriosis
Can I get pregnant with endometriosis?
Yes. Many women with endometriosis get pregnant, some naturally and some with treatment. Your doctor will help you choose the right path.
Is severe period pain normal?
No. Mild cramps are common, but pain that stops you working, studying or sleeping should be checked by a doctor.
Will I always need surgery?
No. Many women do not need surgery. The decision depends on your symptoms, scan findings and fertility plans.