What Is Endometriosis?
Endometriosis is a condition where tissue similar to the lining of the uterus grows in other places. These growths may develop on the ovaries, fallopian tubes, pelvic lining, bowel, bladder, or other nearby structures. This tissue responds to your monthly hormone cycle much as the uterine lining does. It builds up and breaks down with no way to leave the body which can contribute to inflammation, scarring, adhesions, chronic pelvic pain, and fertility challenges.
Endometriosis is a long-term condition, and it is a genuine physical disease, not a matter of a low pain threshold. It affects roughly 1 in 10 women of reproductive age.
Condition At A Glance
Quick Facts About Endometriosis
- Estimated Prevalence
- Approximately 1 in 10 women of reproductive age
- Most Common Age at Diagnosis
- Teens through the 40s
- Body Systems Affected
- Reproductive, gastrointestinal, urinary, musculoskeletal, endocrine
- May Affect
- Menstrual cycles, fertility, pelvic organs, bowel, bladder, quality of life
- Role of Laboratory Testing
- Helps evaluate hormone health, exclude other conditions with similar symptoms, and support a comprehensive clinical evaluation
You Are Not Imagining It
Many women with endometriosis spend years being told that severe period pain is normal or that the problem is stress. Getting to a diagnosis often takes far longer than it should, and that experience can be exhausting and isolating.
Period pain that regularly interferes with your life, keeping you home from work or school, or not responding to ordinary pain relief, is not something you simply have to accept. It is worth investigating, and it deserves to be taken seriously.
Although endometriosis is common, it can be difficult to recognize because symptoms vary widely. Some women experience severe pain, while others have few or no symptoms. Early evaluation and individualized care can help improve quality of life and support long-term reproductive health.
Common Signs and Symptoms
Symptoms vary widely, and the amount of pain does not necessarily match how much endometriosis is present. Some women have significant symptoms with little visible disease, and some have very few symptoms at all. Common experiences include:
- Painful periods, often severe
- Ongoing pelvic pain, including between periods
- Pain during or after sex
- Pain when passing urine or opening your bowels, particularly during your period
- Heavy or unpredictable bleeding
- Bleeding between periods
- Chronic lower back pain
- Difficulty getting pregnant
- Persistent fatigue
- Bloating, nausea, or changes in bowel habits
Because these symptoms overlap with other conditions, including bowel and bladder problems, endometriosis is often mistaken for something else along the way.
When Should You Seek Medical Evaluation?
- Period pain that disrupts work, school, or daily activities
- Pelvic pain that persists beyond your menstrual cycle
- Pain during intercourse
- Difficulty becoming pregnant after trying to conceive
- Heavy menstrual bleeding or bleeding between periods
- Symptoms that are worsening over time
What Causes Endometriosis?
The cause is not fully understood, and research is ongoing. Several factors are thought to contribute, including the flow of menstrual blood in the pelvis, inflammation, the immune system's response, hormonal influences, genetics and environmental factors. Endometriosis often runs in families. Importantly, nothing you did caused this.
How Is Endometriosis Diagnosed?
Diagnosis has changed in recent years, and this is good news for anyone facing a long wait for answers.
Your doctor will start with a careful discussion of your symptoms and history, followed by a physical examination. Imaging, usually a specialized pelvic ultrasound, and sometimes an MRI, is then used to look for signs of endometriosis.
For many years, keyhole surgery (laparoscopy) was considered the only way to confirm the diagnosis. Current guidelines have moved away from that. Surgery is now generally reserved for situations where imaging does not give a clear answer or where treatment has not helped. This means many women can begin treatment sooner, without waiting for an operation.
One important point: a normal scan does not rule out endometriosis. Smaller areas of disease often do not appear on imaging, so your symptoms remain central to the picture.
Why Laboratory Testing Matters
We want to be straightforward with you about this, because there is a lot of confusing information available. At present, there is no blood test that can diagnose endometriosis or rule it out. Major medical guidelines specifically advise against using blood markers, including CA-125, for that purpose. Research into a reliable blood test is active and promising, but it is not there yet.
That does not mean blood testing has no value in endometriosis care. It has a real and useful role, just a different one than diagnosis:
- Ruling out other causes. Thyroid problems and hormone imbalances can produce overlapping symptoms, and are worth checking.
- Checking for anemia. Heavy or prolonged bleeding can lower your iron levels and contribute to fatigue.
- Helping evaluate an ovarian cyst. If a scan finds a cyst, certain markers help your doctor assess it and decide on next steps.
- Understanding your fertility picture. If you are thinking about pregnancy, tests of ovarian reserve can inform those conversations.
- Following your progress. Some markers help track how you are responding to treatment over time.
MDL’s Endometriosis Testing
MDL’s endometriosis testing is designed to support your care team around the diagnosis, by ruling out other causes, assessing related health areas, and helping monitor treatment. It is not a test for endometriosis itself.
Ruling out other causes. Conditions that can look similar:
- Thyroid tests - TSH, Free T4, and thyroid antibodies.
- Prolactin and reproductive hormones - FSH, LH, estradiol, and progesterone.
Assessing related health areas. Things commonly affected alongside endometriosis:
- Ferritin - your iron stores are often low with heavy bleeding.
- Vitamin D - part of a general nutritional picture.
- Vitamin B12 and folate - further nutritional markers your doctor may add.
- AMH - a marker of ovarian reserve, relevant if you are considering pregnancy.
Evaluating an ovarian cyst. Used when imaging has found a cyst that needs assessment:
- CA-125 - a marker your doctor considers alongside your scan findings when assessing an ovarian cyst. It is not used to diagnose endometriosis, and it can be raised for many reasons, including endometriosis itself and even a normal period.
Following your treatment. An inflammation marker (high-sensitivity CRP) and your hormone levels can be tracked over time, where your doctor finds it helpful.
Which tests are right for you? Your healthcare provider can order what suits your symptoms and situation.
Earlier Evaluation Can Lead to Earlier Answers
If you have persistent pelvic pain, painful menstrual periods, difficulty becoming pregnant, or symptoms that interfere with your daily life, talk with your healthcare provider about whether a comprehensive evaluation is appropriate. MDL's endocrinology testing provides valuable clinical information that complements imaging studies and other diagnostic tools to support informed decision-making.
Fertility And Reproductive Health
Endometriosis can make it more difficult for some women to become pregnant, although many women with endometriosis conceive naturally.
The condition may affect fertility by altering pelvic anatomy, contributing to inflammation, or affecting egg quality or implantation. If pregnancy has not occurred after an appropriate period of trying, your healthcare provider may recommend additional fertility evaluation.
Early diagnosis allows women to discuss family planning goals and explore treatment options before symptoms progress.
Treatment and Support
Endometriosis cannot currently be cured, but it can be managed, and many women find real relief. Options include.
- Pain-relieving medications
- Hormonal therapies such as the contraceptive pill or progestogens
- Lifestyle strategies to help manage symptoms
- Laparoscopic surgery to remove endometriosis tissue when appropriate
- Fertility treatments for women trying to conceive
Living with a long-term pain condition takes a toll, and support for your emotional well-being is a legitimate part of care, not an extra. If pain is affecting your mood, your relationships, or your daily life, tell your healthcare provider. Many women also find that connecting with others who have endometriosis makes a real difference.
Endometriosis Myth Vs. Fact
Understanding the Facts
Myth
Painful periods are always normal.
Fact
While mild menstrual discomfort is common, severe pain that interferes with school, work, daily activities, or relationships should be evaluated by a healthcare provider. Endometriosis is one possible cause.
Myth
Endometriosis only affects fertility.
Fact
Although fertility can be affected, endometriosis may also contribute to chronic pelvic pain, bowel and bladder symptoms, fatigue, and reduced quality of life.
Myth
Pregnancy cures endometriosis.
Fact
Pregnancy may temporarily improve symptoms for some women because hormone levels change during pregnancy. However, it is not considered a cure, and symptoms may return after pregnancy.
Myth
A hysterectomy always cures endometriosis.
Fact
A hysterectomy may be an appropriate treatment for some women, but it does not guarantee that endometriosis-related pain will resolve. Treatment decisions depend on the location and extent of disease, symptoms, age, and reproductive goals.
Myth
There is a blood test that diagnoses endometriosis.
Fact
There is currently no single laboratory test that confirms endometriosis. Diagnosis is based on a combination of symptoms, medical history, examination findings, imaging when appropriate, and, in some cases, laparoscopic surgery.
Related Hormone Conditions:
Frequently Asked Questions About Endometriosis
Can you have endometriosis with normal imaging?
Yes. Imaging studies can identify some forms of endometriosis, but smaller or superficial lesions may not be visible. Your healthcare provider considers your symptoms, examination findings, imaging results, and overall clinical picture when determining the next steps.
Does endometriosis always cause infertility?
No. Many women with endometriosis become pregnant naturally. However, the condition can make conception more difficult for some women, particularly if it affects the ovaries or causes pelvic adhesions.
Why can it take years to diagnose endometriosis?
Symptoms often overlap with other conditions, and the severity of symptoms does not always reflect the extent of disease. Because there is no single diagnostic blood test, diagnosis may require a combination of clinical evaluation, imaging, and sometimes laparoscopy.
Can endometriosis return after treatment?
Yes. Although treatments can effectively manage symptoms, endometriosis may recur in some women. Ongoing follow-up helps guide long-term management.
What role does laboratory testing play?
Laboratory testing helps healthcare providers evaluate hormone health, investigate other possible causes of symptoms, and support a comprehensive evaluation. It is one part of the overall diagnostic process but does not diagnose endometriosis on its own.
When should I talk to my healthcare provider about endometriosis?
You should discuss your symptoms if you experience severe menstrual pain, chronic pelvic pain, pain during intercourse, heavy menstrual bleeding, infertility, or symptoms that interfere with work, school, or your daily activities. Early evaluation may help shorten the time to diagnosis and treatment.