Endometriosis: What You Should Know

Endometriosis is one of the most common and most under-diagnosed conditions in women's health. It affects an estimated 1 in 9 women of reproductive age, yet it takes an average of 7 to 10 years to receive a diagnosis. That gap matters, because early identification and management can significantly reduce the impact of the condition on quality of life and fertility.

This guide covers what endometriosis is, what causes it, how to recognise the symptoms, and how cycle tracking can support your understanding and care.

What Is Endometriosis?

Endometriosis occurs when tissue similar to the lining of the uterus grows outside the uterus. This tissue, called the endometrium, can develop on the ovaries, fallopian tubes, pelvic lining, intestines, bladder, and in some cases more distant organs such as the lungs.

Like the uterine lining, this tissue responds to hormonal changes across the menstrual cycle: it thickens, breaks down, and bleeds. But because it has no way to leave the body, it causes inflammation, scarring, and adhesions. Over time, this can lead to chronic pain, organ dysfunction, and fertility challenges.

What Causes Endometriosis?

The exact cause of endometriosis is not yet fully understood. Current research points to a combination of hormonal, genetic, and immunological factors.

• Hormonal factors: An imbalance between oestrogen and progesterone is thought to promote the abnormal growth of endometrial tissue outside the uterus. Oestrogen appears to drive the growth of lesions, which is why hormonal treatments that reduce oestrogen are often used to manage the condition.
• Genetic factors: Endometriosis tends to run in families. Women with a first-degree relative with the condition have a significantly higher risk of developing it themselves.
• Immunological factors: A healthy immune system would normally identify and eliminate abnormal tissue. In women with endometriosis, this process appears to be impaired, allowing lesions to establish and grow.

Symptoms of Endometriosis

Symptoms vary considerably between women and do not always correlate with the severity of the condition. Some women with extensive endometriosis have minimal symptoms; others with small lesions experience debilitating pain.

Common symptoms include:

• Severe menstrual pain (dysmenorrhea) that is not relieved by standard painkillers
• Pelvic pain outside of menstruation
• Pain during or after sexual intercourse
• Pain with bowel movements or urination, particularly during menstruation
• Bleeding between periods
• Bloating, nausea, or fatigue around menstruation
• Difficulty conceiving

If your period pain is severe, worsening over time, or interfering with daily life, it is worth speaking with a gynaecologist. Severe period pain is not something you should simply accept.

Diagnosis

Endometriosis can be difficult to diagnose because its symptoms overlap with other conditions, and it cannot be detected through a standard blood test or pelvic exam alone.

The diagnostic process typically involves:

• Medical history: A detailed discussion of your symptoms, cycle patterns, and family history
• Physical examination: Including pelvic assessment to identify tenderness or abnormalities
• Imaging: Transvaginal ultrasound or MRI can identify some forms of endometriosis, particularly ovarian cysts (endometriomas)
• Laparoscopy: The definitive diagnostic method, in which a small camera is inserted through the abdomen to directly visualise and biopsy lesions

Diagnosis often requires persistence. If your symptoms are being dismissed, seeking a second opinion from a specialist with experience in endometriosis is entirely reasonable.

Treatment Options

Treatment depends on the severity of symptoms, the location of lesions, and whether fertility is a priority. Options include:

• Pain management: Anti-inflammatory medications such as ibuprofen can help manage mild to moderate pain
• Hormone therapy: Treatments that reduce oestrogen levels or suppress the menstrual cycle can slow lesion growth and reduce pain
• Surgery: Laparoscopic excision or ablation of lesions is often the most effective treatment for moderate to severe endometriosis
• Naturopathic and lifestyle support: An anti-inflammatory diet, targeted supplementation, stress management, and regular gentle exercise can all support symptom management alongside medical treatment

Common Myths About Endometriosis

Myth: Severe period pain is normal. Painful periods are common, but debilitating pain is not normal and is not something you should push through. It is a signal worth investigating.

Myth: Endometriosis only causes period pain. The condition can cause pain throughout the cycle, during sex, and with bowel or bladder function. Symptoms extend well beyond menstruation.

Myth: Only older women get endometriosis. Endometriosis can affect women of any age, including teenagers. Early diagnosis leads to better outcomes.

Myth: Pregnancy cures endometriosis. Pregnancy may provide temporary symptom relief for some women, but it is not a cure. Endometriosis can return after pregnancy.

Cycle Tracking with Endometriosis

Understanding your cycle is particularly valuable when you have endometriosis. Tracking your symptoms alongside your cycle helps you identify patterns, anticipate difficult days, and provide your healthcare provider with concrete data about your cycle progression.

Daysy measures your basal body temperature each morning and uses a self-learning algorithm to identify your fertile and infertile days. For women with endometriosis, this data is useful in several ways:

• Confirming whether ovulation is occurring, which is an important indicator of hormonal health
• Identifying cycle irregularities that may be linked to disease progression or treatment response
• Providing detailed cycle data to share with your gynaecologist or specialist
• Supporting fertility planning if conception is a goal

Endometriosis is strongly influenced by hormonal changes across the cycle. The more clearly you can see those patterns, the better positioned you are to manage them.

A note from Period Wisdom Boutique

Endometriosis is a condition that has been under-researched, under-diagnosed, and too often dismissed. If you are living with symptoms that are affecting your quality of life, you deserve answers and proper care. Understanding your cycle is one of the most practical steps you can take toward getting them.