How common is painful periods in endometriosis?

Endometriosis involves tissue similar to the uterine lining growing outside the uterus. Inflammation and scarring around nearby pelvic structures can contribute to period pain. Some people also experience pain with sex, bowel movements, urination, or ovulation, while the amount of pain does not reliably show how much endometriosis is present.

Many other problems can cause painful periods, including adenomyosis, fibroids, pelvic infection, and primary menstrual cramps. Painful periods alone cannot diagnose endometriosis. A clinician may ask about the timing of pain, bowel or bladder symptoms, bleeding, fertility concerns, and previous treatments.

Use a diary to note pain location, timing, bowel and bladder symptoms, bleeding, missed activities, and medicines tried. Heat, gentle activity, rest, and appropriate pain relief may ease symptoms for some people. A pharmacist or clinician can help you choose safely, especially if you are pregnant, trying to conceive, or managing another illness.

Arrange a gynaecology review when pain is persistent, worsening, or affecting relationships, work, sleep, or study. Treatment may involve pain medicines, hormonal treatment, pelvic support, or surgery in selected circumstances.

Get prompt medical help for sudden severe pelvic pain, fainting, fever, heavy bleeding with weakness, or possible pregnancy. Seek assessment for recurring pain with bowel or bladder changes, pain during sex, or symptoms that remain difficult despite your usual measures.

What features make endometriosis more or less likely in my situation? Would imaging or referral help? Which options could protect fertility, and how will we review treatment if the pain continues?