Understanding Endometriosis: Causes, Symptoms & Management

Endometriosis occurs when tissue similar to the uterine lining implants on pelvic organs—ovaries, fallopian tubes, peritoneum—responding to hormonal cycles and causing bleeding outside the uterus.

Lesions trigger chronic inflammation, scarring (adhesions), and can form painful cysts (endometriomas) on the ovaries.

• • Severe menstrual cramps (dysmenorrhea) that worsen over time
• • Pain during intercourse (dyspareunia)
• • Chronic pelvic or lower back pain
• • Bloating, diarrhea or constipation around periods
• • Heavy menstrual bleeding or spotting
• • Fertility difficulties or recurrent miscarriages

Diagnosis begins with detailed symptom history and pelvic exam, followed by imaging such as transvaginal ultrasound or MRI to detect cysts and adhesions.

Definitive diagnosis requires laparoscopic surgery with biopsy of lesions.

Delay in diagnosis is common; tracking cycle‑related pain and symptoms aids early referral.

• • Stage I (Minimal): Few superficial lesions
• • Stage II (Mild): More lesions, superficial implants
• • Stage III (Moderate): Deep implants, small adhesions, endometriomas
• • Stage IV (Severe): Extensive deep implants, large endometriomas, dense adhesions

Laparoscopic excision or ablation of lesions can reduce pain and improve fertility; choice depends on lesion extent and patient goals.

Hysterectomy with oophorectomy reserved for severe, refractory disease in women who have completed childbearing.

Consult multidisciplinary team—gynecologic surgeon, pain specialist, fertility expert—for personalized plan.

• • Heat therapy (heating pad, warm baths) to relieve cramps
• • Gentle stretching, yoga and pelvic floor exercises
• • TENS unit use for localized pain control
• • Mind‑body practices: mindfulness, biofeedback, acupuncture

Endometriosis can impair ovarian reserve and tubal function; early fertility evaluation recommended for those desiring pregnancy.

Assisted reproductive technologies—ovulation induction, IUI, IVF—improve chances when medical/surgical therapy alone insufficient.

Fertility‑preserving surgery may restore anatomy and delay assisted reproduction.

• • Chronic pain and fertility struggles increase risk of anxiety and depression; counseling or support groups are critical.
• • Peer networks and endometriosis foundations offer resources, mentorship, and advocacy.
• • Involve community health workers (CHWs) for education, lifestyle coaching, and referral navigation.

• • Anti‑inflammatory diet rich in omega‑3s, antioxidants, and low in red meat and processed sugars.
• • Regular moderate exercise to improve circulation and reduce pain sensitivity.
• • Adequate sleep and stress management to modulate inflammatory response.

• • SHELY Endometriosis Hub: symptom trackers, expert articles, coping tools.
• • Local and online endometriosis support organizations and forums.
• • Recommended reading: “The Doctor Will See You Now” by Dr. Tamer Seckin; WHO guidelines on chronic pelvic pain.

Endometriosis is a lifelong condition requiring tailored, multidisciplinary care. With informed medical treatment, self‑care strategies, and robust support networks, women can manage symptoms, preserve fertility, and lead fulfilling lives.

• • Track your symptoms and pain patterns for three cycles to share with your provider.
• • Schedule imaging or specialist referral if you suspect endometriosis.
• • Implement one self‑care pain management technique this week.
• • Join a peer support group to connect with others who understand.