Gynaecology
Endometriosis: understanding the pain and personalising care
Endometriosis is the presence of tissue similar to the lining of the uterus outside the uterus. It can cause pelvic pain, sometimes cyclical, and may be associated with fertility problems.
Written by the Polycrabat Sevamed team · Published on
In brief
- Very painful periods, pain during intercourse, when opening the bowels or when urinating, persistent pelvic pain: these symptoms may point to endometriosis, although the intensity of the pain does not reflect the extent of the lesions.
- Specialised ultrasound and MRI can locate certain lesions, but normal imaging does not rule out all forms of endometriosis.
- The care pathway combines pain relief, hormone treatments, support for any fertility plans and, in selected situations, surgery.
Which symptoms point to the diagnosis?
Very painful periods, pain during intercourse, when opening the bowels or when urinating, or persistent pelvic pain may lead to a consultation. The intensity of the pain does not necessarily reflect the extent of the lesions. Other diseases can cause similar symptoms; listening carefully to the clinical history is therefore essential.
Which tests are useful?
A gynaecological examination, a specialised ultrasound and, depending on the case, an MRI can help locate certain lesions. Normal imaging does not rule out all forms of endometriosis. Tests are chosen according to the symptoms, any pregnancy plans and the question to be answered, rather than repeated without a clear purpose.
What treatment options are there?
Treatment may combine appropriate painkillers, hormone treatments and pain management. Surgery is discussed in selected situations, with its potential benefits and risks. It is not automatically necessary to make a diagnosis or relieve pain.
What is the link with fertility?
Endometriosis can be associated with difficulty conceiving, but many people with the condition can become pregnant. Age, other fertility factors and life plans guide referral to a specialised team. Care may include support for fertility plans.
Useful questions to ask
- Do my pains (periods, intercourse, urination or bowel movements) justify a specialised ultrasound or an MRI?
- Which pain treatment options are suitable for me, and with what side effects?
- Do I have pregnancy plans that should be taken into account, and should I be referred to a specialised team?
Frequently asked questions
Does a normal ultrasound rule out endometriosis?
No. Some lesions are not visible on imaging.
Is surgery always necessary?
No. It is discussed according to the symptoms, the lesions and the goals.
This content provides general medical information. It does not replace a consultation or a personalised decision by your care team. In case of serious or sudden symptoms, contact the emergency services in your country or a doctor without delay.
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How is the response to treatment assessed?
Follow-up measures pain, the ability to work, sleep and the side effects of treatments. If the goals are not met, the diagnosis and the strategy are reviewed with the patient. Multidisciplinary follow-up can be useful when pain affects sleep, work or daily life.