Endometriosis affects an estimated 190 million reproductive aged women and girls worldwide.
It is associated with severe, life-impacting pain during periods, sexual intercourse, bowel movements and/or urination, chronic pelvic pain, abdominal bloating, nausea, fatigue, and (sometimes) depression, anxiety, and infertility.
Endometriosis is a disease in which tissue similar to the lining of the uterus grows outside the uterus.
It can cause severe pain in the pelvis and make it harder to get pregnant.
Endometriosis can start at a person’s first menstrual period and last until menopause, though symptoms can persist post-menopause.
With endometriosis, tissue similar to the lining of the uterus grows outside the uterus. This leads to inflammation and scar tissue forming in the pelvic region and (rarely) elsewhere in the body.
The cause of endometriosis is unknown. There is no known way to prevent endometriosis. There is no cure, but its symptoms can be treated with medicines or, in some cases, surgery.
Endometriosis often causes severe pain in the pelvis, especially during menstrual periods. Some people also have pain during sex or when using the bathroom. Some people have trouble getting pregnant - and some have no symptoms.
For those who have symptoms, a common symptom is pain in the lower part of the belly (pelvis). Pain may be most noticeable:
Some people also experience:
Symptoms often improve after menopause, but not always.
A careful history of menstrual symptoms and chronic pelvic pain provides the basis for suspecting endometriosis. Endometriosis can often present symptoms that mimic other conditions and this may contribute to a diagnostic delay.
Ovarian cysts (endometrioma), adhesions, and deep nodular forms of endometriosis often require ultrasonography or magnetic resonance imaging (MRI) to detect. Histologic verification, usually following surgical/laparoscopic visualisation, can be useful in confirming diagnosis, particularly for the most common superficial lesions.
The need for histologic/laparoscopic confirmation should not prevent the commencement of empirical medical treatment.
Although several screening tools and tests have been proposed and tested, no biomarker is currently validated to accurately identify or predict individuals or populations that are most likely to have endometriosis.
Treatments to manage endometriosis can vary based on the severity of symptoms and whether pregnancy is desired. No treatments cure the disease, and are based on individual preferences and effectiveness, side effects, long-term safety, costs, and availability.
A range of medications can help manage endometriosis and its symptoms. Non-steroidal anti-inflammatory drugs (NSAIDs) and analgesics (painkillers) like ibuprofen and naproxen are often used to treat pain. Hormonal medicines like GnRH-analogues and contraceptive (birth control) methods can also help control pain. These methods include:
These methods may not be suitable for those wanting to get pregnant.
Fertility medicines and procedures are sometimes used for those having difficulty getting pregnant because of endometriosis.
Surgery is sometimes used to remove endometriosis lesions, adhesions and scar tissues. Laparoscopic surgery (using a small camera to visualize inside the body) allows doctors to keep incisions small.
Discuss your treatment options with a health care provider. You can prepare for your consultation using this form: your first consultation.
According to the World Health Organisation (WHO), the impact of endometriosis has significant social, public health, and economic implications - as demonstrated by WERF's studies on "the impact of endometriosis" and "the financial burden of endometriosis".
Endometriosis can decrease quality of life due to severe pain, fatigue, depression, anxiety, and infertility. Some individuals with endometriosis experience debilitating pain that prevents them from going to work or school. Painful sex due to endometriosis can lead to interruption or avoidance of intercourse and affect the sexual health of affected individuals and their partners.
WERF is working to encourage collaborative research to increase knowledge about endometriosis to improve diagnosis and treatments to improve the lives of those affected.