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Endometriosis

Endometriosis is tissue like the womb lining growing outside the womb. It often causes painful periods and can make it harder to conceive, but both the pain and the fertility can be helped.

With Datuk Dr. Navdeep Singh Pannu, FRCOG, at Alpha IVF & Women's Specialists, Kota Damansara

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How common
About 1 in 10 women of reproductive age
Main symptom
Painful periods, often worse over time
Fertility
30–50% of women with it may find it harder to conceive
Diagnosis
Symptoms, scan and sometimes laparoscopy

What it is

In endometriosis, tissue similar to the lining of the womb grows on the ovaries, fallopian tubes and other parts of the pelvis. It responds to monthly hormones, which causes inflammation, scarring and pain. On the ovaries it can form cysts, sometimes called chocolate cysts.

Period pain is often dismissed as normal, so many women wait years for a diagnosis. Endometriosis can affect fertility by distorting the tubes and ovaries, reducing the egg reserve and making the pelvis a less friendly place for eggs, sperm and embryos.

Who it can help

  • Painful periods that stop you from working or studying
  • Pain during or after sex
  • Pelvic pain between periods
  • Ovarian cysts on a scan
  • Difficulty getting pregnant
  • Previous surgery for endometriosis

How it works

  1. Assessment

    Your symptoms and history, an examination and a pelvic ultrasound, plus an AMH test to check the egg reserve.

  2. Pain relief and hormones

    Painkillers and hormone treatments can calm the disease and the pain when you are not trying to conceive.

  3. Keyhole surgery if needed

    Laparoscopy can confirm the diagnosis and remove endometriosis, adhesions or cysts, while protecting the ovaries.

  4. Fertility treatment

    Depending on the severity, your age and the egg reserve: trying naturally after surgery, IUI, or IVF.

  5. Ongoing care

    Endometriosis can come back, so follow-up continues after treatment.

Good to know

Side effects and risks

  • Surgery on ovarian cysts can lower the egg reserve, so it is planned carefully and only when it will help
  • Hormone treatments prevent pregnancy while you take them
  • Endometriosis can return after surgery

Pain is not normal

Period pain bad enough to disrupt your life deserves to be checked. Earlier diagnosis gives more options.

Protecting fertility

If surgery on the ovaries is needed, egg freezing beforehand may be worth discussing. See egg freezing.

Many women conceive

Having endometriosis does not mean you cannot get pregnant; many women conceive naturally or with treatment.

Questions people ask

Can endometriosis be cured?

Not completely, but it can be managed well with medicines, surgery or both.

Do I need surgery to get pregnant?

Not always. It depends on your symptoms, the size of any cysts, your age and egg reserve. Sometimes going straight to IVF is better.

Does pregnancy cure endometriosis?

Symptoms often ease during pregnancy, but they can return afterwards.

Is it the same as adenomyosis?

They are related. In adenomyosis the lining-like tissue grows into the muscle of the womb. It can cause heavy, painful periods too.

Further reading

This page is general information and does not take your personal circumstances into account. Please speak to your doctor for advice that is right for you. Disclaimers