What happens if endometriosis is not treated?

Endometriosis tissue can respond to hormonal changes and cause repeated inflammation in the pelvis. Over time, inflammation may lead to adhesions, which are bands of scar tissue that make nearby organs stick together. This can contribute to persistent or worsening painful periods, ovulation pain, pain during sex, bowel or bladder discomfort, and tiredness related to ongoing pain.

Endometriosis is also associated with difficulty conceiving. Adhesions or changes around the ovaries and fallopian tubes can interfere with the movement of an egg. A symptom does not identify the cause by itself, so a pelvic pain assessment remains useful even when symptoms vary from month to month.

Arrange a gynaecology review if pain affects work, sleep, movement, sex or plans for pregnancy. Keep a short record of cycle timing, pain location, bleeding, bowel or bladder symptoms, medicines used and their effect. Treatment may include anti-inflammatory therapy for period pain, hormone-based treatment, or surgery in selected situations. Discuss plans for pregnancy before choosing treatment, because some options prevent ovulation while they are being used.

Seek urgent medical help for sudden severe pelvic pain, fainting, marked weakness, repeated vomiting, fever, or heavy bleeding with dizziness. These symptoms can have causes other than endometriosis and need prompt assessment. Book a timely appointment for new pain, pain that is steadily worsening, bleeding between periods, blood in urine or stool, or difficulty becoming pregnant.

Ask what could explain your pain, whether imaging or examination is appropriate, how treatment may affect fertility, and what symptoms should prompt urgent review. Also ask how progress will be monitored if you choose observation.