Summary
Read the full fact sheet- Endometriosis is a condition where cells similar to those that line the uterus grow in other areas of your body, especially in your pelvis and reproductive organs.
- Endometriosis affects one in 10 women, and can cause severe pain and may affect fertility.
- Treatment with medicine, surgery or both can help symptoms.
- It's important to speak to your doctor if you have pelvic pain or painful periods.
On this page
About endometriosis
Endometriosis is a condition where cells similar to those that line the uterus grow in other areas of your body, especially around your ovaries and behind your uterus.
Endometriosis affects one in 10 women. It can sometimes cause severe pain and might reduce your fertility.
There are many treatment options available. Contact your doctor for a diagnosis and more information.
Symptoms of endometriosis
Endometriosis affects everyone differently. The severity of symptoms is often related to the location of endometriosis rather than the extent of the disease.
It's common for women to experience a slow and steady progression of symptoms.
Endometriosis can cause different types of pain. For example:
- painful periods
- pain during or after sex
- abdominal, lower back and pelvic pain
- pain during ovulation, including pain in the thighs or legs
- pain when going to the toilet to wee or poo
- pain that gets worse over time
- pain that stops you from doing things you usually do.
Endometriosis might also cause:
- bladder and bowel problems
- bloating around the time of your period
- tiredness
- mood changes
- vaginal discomfort
- reduced fertility
- asthma.
What causes endometriosis?
We don't know exactly what causes endometriosis, but there are some possible causes and risk factors.
Backwards menstruation
Your period normally flows out of your vagina, but sometimes it can flow back along your fallopian tubes into your pelvis. The blood, which contains endometrial cells, is absorbed by the body or broken down in 90% of women. In some women the cells can stick to areas outside the uterus, leading to endometriosis.
Your immune system
You can develop endometriosis if your immune system doesn't stop the growth of endometrial tissue outside your uterus.
Your family history
Women who have a close relative with endometriosis are 7 to 10 times more likely to get endometriosis.
Reducing your risk of endometriosis
Endometriosis can't be prevented, but some factors might reduce your risk. For example:
- you have irregular periods
- you breastfeed
- you have progestin-only hormone therapy.
The risk of endometriosis developing may also decrease with each pregnancy. This may be due to an increase in the progesterone hormone during pregnancy.
Getting a diagnosis
It can take time to diagnose endometriosis. The average time to get a diagnosis is 7 years. Most women are diagnosed after having a laparoscopy. This is the only way to confirm if endometrial tissue is present.
Ultrasound and MRI are being used more often to help diagnose endometriosis.
Managing endometriosis
After you are diagnosed with endometriosis, your gynaecologist will explain the different treatment options based on your symptoms and stage of life.
Medicines
Some people may be able to manage the symptoms and reduce any pain with medicines such as ibuprofen.
Hormone therapy
Hormone therapy may reduce the pain and severity of the endometriosis by suppressing the growth of endometrial cells and stopping any bleeding.
Options for hormone therapy include:
- the combined oral contraceptive pill
- progestogens
- gonadotrophin-releasing hormone (GnRH).
Ask your doctor about how they work and the possible side effects of each therapy.
Surgery
Surgery can improve symptoms and the quality of life for women with endometriosis.
The type of surgery you might need will depend on your situation. For example:
- laparoscopy – a commonly performed keyhole surgery via the abdomen
- laparotomy – open surgery for more severe endometriosis
- bowel surgery – if endometriosis has grown in the bowel.
A hysterectomy (removal of the uterus) may be required in extreme cases.
Make sure you understand the potential benefits and risks of each option before you decide.
Combined treatment
Surgery by laparoscopy is an effective way to treat endometriosis. But a combination of surgery and hormone therapy can improve outcomes.
Some studies have shown there is a delay in endometriosis recurring if the surgery is followed by treatment with some types of hormone therapy or the Mirena® intrauterine device (IUD).
Other therapies
There are different non-drug options for treating endometriosis, such as pelvic floor physiotherapy, psychology (specifically cognitive behavioural therapy) and diet, but few studies have been done to evaluate the benefits.
Many women use natural therapies (complementary medicine and therapies) to manage symptoms of endometriosis, like period pain and inflammation. While these medicines and therapies are popular, there isn't enough research to prove their effectiveness.
More information
For more detailed information, related resources, articles and podcasts, visit Jean Hailes for Women’s Health.
Where to get help
- Guideline on the management of women with endometriosis,, European Society of Human Reproduction and Embryology.
- Endometriosis: an overview of Cochrane Reviews, Brown J, Farquhar C 2014, Cochrane Database of Systematic Reviews 2014, vol. 3, no. CD009590.
- ‘Recurrence of endometriosis after hysterectomy’, Rizk B, Fischer AS, Lotfy HA 2014, Facts, Views and Vision in Obgyn, vol. 6, no. 4, pp. 219–227.
- ‘Medical management of endometriosis’, Rafique S, Decherney AH 2017, Clinical Obstetrics and Gynecology, vol. 60, no. 3, pp. 485–496.
- ‘Medical management of endometriosis’, Black K, Fraser IS 2012, Australian Prescriber, vol. 35, pp. 114–117.
- Endometriosis: advances and controversies in classification, pathogenesis, diagnosis, and treatment, Rolla E 2019, F1000 Research 2019, 8 (F1000 Faculty Rev): 529.
- Endometriosis – ABC Health and Wellbeing
- Endometriosis fact sheets - Royal Women's Hospital
- 'Prevalence of pain syndromes, mood conditions, and asthma in adolescents and young women with endometriosis', Smorgick N, Marsh CA, As-Sanie S, Smith YR, Quint EH, J Pediatr Adolesc Gynecol. 2013 Jun;26(3):171-175. DOI: 10.1016/j.jpag.2012.12.006
- 'The Familial Risk of Endometriosis among the Female Relatives of Patients with Endometriosis in Greece', Matalliotakis M, Goulielmos GN, Zervou MI, Matalliotaki C, Koumantakis G, Matalliotakis, Journal of Endometriosis and Pelvic Pain Disorders. 2017; 9(3): 184-187. doi: 10.5301/jeppd.5000290
- 'Reproductive and menstrual factors and risk of peritoneal and ovarian endometriosis', Candiani GB, Danesino V, Gastaldi A, Parazzini F, Ferraroni M, Fertil Steril. 1991; 56(2): 230-234.
- 'The protective effect of breastfeeding and ingesting human breast milk on subsequent risk of endometriosis in mother and child: a systematic review and meta-analysis', Youseflu S, Savabi-Esfahani M, Asgahari-Jafarabadi M, Maleki A, Breastfeeding Medicine, 2002; 17(10): 805-816
- 'Progestin-only pills may be a better first-line treatment for endometriosis than combined estrogen-progestin contraceptive pills', Casper RF, Fertil Steril. 2017; 107(3):533-536. doi: 10.1016/ j.fertnstert.2017.01.003
- 'Impact of endometriosis on quality of life and work productivity: a multicenter study across ten countries', Nnoaham KE, Hummelshoj L, Webster P, et al., Fertil Steril. 2011; 96(2): 366-373.e8. doi: 10.1016/ j.fertnstert.2011.05.090
- 'Laparoscopic surgery for endometriosis', Bafort C, Beebeejaun Y, Tomassetti C, Bosteels J, Duffy JM, Cochrane Database Syst Rev. 2020;10(10):CD011031. Published 2020 Oct 23. doi:10.1002/14651858.CD011031.pub3
- European Society of Human Reproduction and Embryology
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