Endometriosis is a common condition affecting approximately 1 in 7 Australian women and people assigned female at birth by the age of 44. Despite how common it is, many women live with symptoms for years before receiving a diagnosis because the symptoms are often normalised or mistaken for “bad periods.”

At its core, endometriosis occurs when tissue similar to the lining of the uterus grows outside the uterus. These endometriosis deposits can occur on the ovaries, fallopian tubes, bowel, bladder, pelvic lining and more rarely in other parts of the body.

This tissue responds to hormonal changes during the menstrual cycle, which can lead to inflammation, scarring, adhesions and significant pain.

What Is Endometriosis? Common Symptoms Many Women May Ignore

Painful Periods

Many women assume or are told for years that severe period pain is normal. While mild discomfort can occur with menstruation, pain that interferes with work, school, exercise, sleep or daily activities should not be ignored.

Symptoms may include:

  • Cramping that starts before the period

  • Pelvic or lower back pain

  • Pain severe enough to require regular medication

  • Nausea or fatigue during periods

Pain During Intercourse

Pain with deep penetration can be associated with endometriosis, particularly when disease involves tissues behind the uterus.

Chronic Pelvic Pain

Some women experience ongoing pelvic pain even outside their menstrual cycle.

Bowel or Bladder Symptoms

Endometriosis can sometimes affect the bowel or bladder, leading to:

  • Pain opening bowels during periods

  • Bloating

  • Diarrhoea or constipation around menstruation

  • Pain passing urine during periods

  • Lots of women with endometriosis have a prior or concurrent diagnosed of Irritable Bowel Syndrome (IBS)

Difficulty Falling Pregnant

Endometriosis may affect fertility in some women. However, many women with endometriosis are still able to conceive naturally.

Why Is Endometriosis Often Missed?

Many women are told their symptoms are “just bad periods” (unfortunately not uncommonly by doctors) or feel they need to tolerate pain because friends or family experience similar symptoms.

Unfortunately, delays in diagnosis are common. In Australia that delay is around 8 years.

If pelvic pain is affecting your quality of life, work, relationships, exercise or mental wellbeing, it is worth seeking assessment.

How Is Endometriosis Diagnosed?

Diagnosis starts with a detailed history and examination. Ultrasound can sometimes identify endometriosis, particularly ovarian endometriomas or deep infiltrating disease, but a normal ultrasound does not exclude endometriosis.

In some cases, laparoscopic surgery is recommended to diagnose and treat endometriosis.

Treatment Options

Treatment depends on symptoms, age, fertility goals and the extent of disease.

Options may include:

  • Anti-inflammatory medications

  • Hormonal treatments (e.g Mirena IUD, Slinda, Combined oral contraceptive pill and more)

  • Pelvic physiotherapy

  • Lifestyle modifications

  • Laparoscopic surgery

For many women, a tailored and multidisciplinary approach provides the best outcomes.

When Should You See a Specialist?

You should consider assessment if:

  • Period pain is impacting your daily life

  • You frequently miss work or school because of periods

  • You have persistent pelvic pain

  • Intercourse is painful

  • You are struggling with fertility concerns

  • You feel your symptoms have been dismissed or overlooked

Early assessment can help provide clarity, symptom relief and a long-term management plan.

If you are concerned about symptoms of endometriosis, speaking with your GP can be an important first step.

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The severity of symptoms does not always match the severity of disease. Some women with extensive endometriosis have minimal symptoms, while others with relatively mild disease may experience severe pain.

Common symptoms include:

Common Symptoms of Endometriosis

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This article is intended as general educational information only and does not replace individual medical advice.

References:
·  RANZCOG – Australian Living Evidence Guideline: Endometriosis
·  Australian Institute of Health and Welfare. Endometriosis in Australia: prevalence and hospitalisations