Endometriosis
Endometriosis is a chronic condition in which tissue similar to the lining of the uterus grows outside the uterus. It can cause pelvic pain, painful periods, pain with sex, bowel or urinary symptoms and fertility problems.
At a glance
Quick facts
- Category
- Chronic gynecologic condition
- Common site
- Pelvis
- Common symptoms
- Pelvic pain · painful periods
- Diagnosis
- Clinical assessment + imaging
- Fertility
- May be affected
- Cure
- No established cure
Dr. Sony Sherpa
Obstetrics & Gynecology · Patan Academy of Health Sciences
Reviewed for clinical accuracy, safety language and gynecology context.
Names & terminology
How this entity may be named or searched
- Canonical name
- Endometriosis
- Common shorthand
- “Endo” is used informally by some patients and communities.
- Related lesion term
- Endometrioma refers to an ovarian cyst caused by endometriosis; it is not a synonym for the whole condition.
- Important distinction
- Endometriosis is not the same as endometritis or endometrial cancer.
Structured entity profile
Clinical profile
What is endometriosis?
Endometriosis occurs when endometrium-like tissue grows outside the uterus, most often in the pelvis but sometimes elsewhere. The condition can cause inflammation and scar tissue, which can contribute to significant pain, reduced fertility and lower quality of life. [1]
Symptoms
Symptoms can include severe period pain, chronic pelvic pain, heavy bleeding, pain during or after sex, painful bowel movements, urinary symptoms, bloating, nausea and infertility. Some people have little or no symptoms. [1] [2]
SYMPTOM MATRIX
How endometriosis may present
Symptoms can be severe even when imaging findings are limited, and some people have few or no symptoms.
- Severe menstrual pain
- Chronic pelvic pain
- Heavy menstrual bleeding
- Pain during or after sex
- Infertility
- Pain with bowel movements
- Pain with urination
- Bloating or nausea
- Fatigue
- Few or no noticeable symptoms
- Sudden severe pelvic pain
- Heavy bleeding with dizziness or fainting
- Severe pain with fever
- Severe pain or bleeding during pregnancy
Urgent symptoms require assessment for acute causes; they should not automatically be attributed to endometriosis.
Diagnosis
Diagnosis begins with symptom history and examination. NICE recommends transvaginal ultrasound for suspected endometriosis when suitable, while recognizing that a normal examination or ultrasound does not exclude the condition. MRI and laparoscopy may be used in selected cases, particularly when deep disease is suspected. [2]
Diagnostic pathway
How endometriosis is assessed
Diagnosis is based on symptoms, examination and imaging; laparoscopy is not required in every case.
Assessment pathway reflects WHO and contemporary clinical practice; a normal scan does not by itself rule out endometriosis.
Treatment
Treatment is chosen around symptoms, preferences, fertility plans, risks and access. Options can include analgesics, hormonal treatment and surgery. NICE recommends discussing hormonal treatment such as combined hormonal contraception or a progestogen for suspected, confirmed or recurrent disease; surgery may be considered according to disease location and goals. [2]
Surgery is not automatically the first-line treatment for endometriosis. I consider it when symptoms do not respond to medical or hormonal treatment, when hormonal treatment is contraindicated, or when there are specific issues such as an endometrioma, significant anatomical distortion or fertility-related goals. Even after surgery, symptoms and lesions can recur, so when pregnancy is not the immediate goal, ongoing hormonal treatment may be considered to prolong symptom control.
Treatment & care hub
Treatment is guided by symptoms and fertility goals
There is no single treatment pathway for everyone; pain control, hormonal treatment, surgery and fertility care may be combined.
Pain management
Analgesic strategies may be used according to individual needs and contraindications.
Hormonal treatment
Hormonal therapies can reduce pain and disease activity for many patients.
Surgery
Laparoscopic surgery may remove endometriosis or adhesions when clinically appropriate.
Fertility care
Fertility assessment and assisted reproductive options may be considered when pregnancy is a goal.
WHO notes that treatment aims to control symptoms and limit long-term impact; fertility goals materially affect treatment choice.
Endometriosis and fertility
Endometriosis can be associated with infertility. Management when pregnancy is a priority differs from pain-focused treatment and may involve fertility specialists, surgery or assisted reproduction depending on the individual situation. [1] [2]
When surgery is used for infertility associated with endometriosis, one practical goal is to restore pelvic anatomy through adhesiolysis and treatment of visible endometriotic deposits.
Global estimate + African clinical studies
Endometriosis worldwide
The main statistic is a population-level global estimate. African clinical studies are shown separately because they use selected patient cohorts and different outcomes.
Endometriosis found at laparoscopy
115 of 239 women aged 18–45 scheduled for first diagnostic laparoscopy in Ibadan, 2008–2010. Not national prevalence.
PubMed study ↗Sexual dysfunction with confirmed endometriosis
108 women with confirmed endometriosis at a Nairobi tertiary hospital; 65.7% had sexual distress. Not prevalence.
PubMed study ↗Common questions
Frequently asked questions
Yes. Clinical assessment and imaging can support diagnosis, and treatment may begin without surgery in many cases.
No. NICE states that a normal pelvic examination or ultrasound does not exclude endometriosis.
There is currently no definitive cure, but medicines, surgery and multidisciplinary care can reduce symptoms and impact.
No. It is associated with fertility problems in some people, but many people with endometriosis can become pregnant.
Yes. Symptoms and lesions can recur, including after medical or surgical treatment.
Sources
Clinical statements in this reference are linked to named public-health, regulatory or guideline sources.
- 1. WHO. Endometriosis fact sheet, updated 15 October 2025. Source ↗
- 2. NICE. Endometriosis: diagnosis and management (NG73), updated 2024 with later link updates. Source ↗
- 3. PubMed / International Journal of Gynecology & Obstetrics. Endometriosis and associated symptoms among Nigerian women; diagnostic-laparoscopy cohort in Ibadan. Source ↗
- 4. AJOG Global Reports / PubMed. Sexual dysfunction in women with endometriosis in Kenya, 2026. Source ↗
This article is based on trusted medical sources and has been reviewed by a clinician. It is not a substitute for personalized medical advice.
Despite the reported sensitivity of MRI and transvaginal ultrasound, a normal scan cannot exclude endometriosis. In many patients, we may proceed with a trial of hormonal management based on the clinical picture even when imaging is normal. This is particularly important because superficial endometriosis can be more difficult to detect on imaging than deep disease.