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The ultrasound can be unremarkable and the condition still be there — and it does not start at thirty, sometimes with the very first period.
Also known as: endometriosis · endometrial-like tissue outside the uterus
Open in the tool — with search and all the links →This compilation is for information and replaces neither medical diagnosis nor treatment. If you have symptoms, see a doctor.
Tissue resembling the lining of the womb settles outside it — on the peritoneum, the ovaries, the bladder or the bowel. It follows the same hormonal rhythm, bleeds along with it, and because that blood has nowhere to go, inflammation, adhesions and pain follow. On average seven to ten years pass before the condition is given a name, for three understandable reasons. First, severe period pain is widely taken to be normal. Second, ultrasound is unremarkable in the commonest, superficial form — it shows cysts and nodules, not fine deposits on the peritoneum. Third, in many people the gut symptoms dominate: nausea, bloating, pain on opening the bowels, changing stools. Being mistaken for irritable bowel is the commonest confusion of all. It is little known that this is not a condition that starts at thirty. It occurs in adolescents too, sometimes within the first year after the first period — and it looks different then: not neatly cyclical but continuous, with a great many gut symptoms. The younger the person, the longer the diagnosis takes.
Cycle day, severity from zero to ten, what had to be cancelled, pain on opening the bowels or passing water. Two to three cycles are enough, and the sheet carries the conversation.
It finds cysts on the ovaries and deep nodules — it does not see the fine deposits on the peritoneum. A normal scan therefore rules nothing out.
A congenital narrowing that stops blood draining fully causes strong pain soon after the first period — and it is the one cause in this age group you do not want to miss, because it can be put right. Ultrasound sees it.
Anti-inflammatory painkillers early and regularly rather than late and in distress, and depending on the situation a hormonal treatment. Waiting for surgical confirmation only costs time.
It confirms the diagnosis and can treat, but it is not a starting point. In adolescents it belongs in hands that do many of them.
With heavy bleeding an empty store is the rule rather than the exception — it explains part of the exhaustion and can be put right.
If the gut symptoms have run as irritable bowel for years and get worse around the bleeding, that question deserves asking again.
Filled to hand warmth, wrapped in a cloth, applied for 20 to 30 minutes.
Calm walking, cycling or stretching, 20 to 30 minutes, also on the heavier days.
Hormonal treatments suppress the cycle and with it the monthly stimulus on the lesions. The lesions themselves remain. Surgery removes them — they can return. Both are ways to keep the pain small, not to end it.
About one in ten women of childbearing age is affected. It takes seven to ten years on average to reach the diagnosis — not because people ask too late, but because very painful periods count as normal for a long time. Knowing this makes it easier to ask sooner.
Pain that makes school or work impossible despite the usual painkillers is not sensitivity, it is a finding.
Pain spread across the whole month does not argue against it — in younger people that is precisely the norm.
Pain tied to these two acts and increasing around the bleeding is one of the most telling clues there is.
Nausea, bloating, changing stools. Many are told for years that it is irritable bowel, and the symptoms do fit — only the cause does not.
Continuous rather than cyclical pain, many gut symptoms, nausea. Anyone looking only for the classic picture will not find it here.
Continuous pain and iron deficiency together explain a tiredness that otherwise stays puzzling.
Not usable as a test: normal in mild disease, raised in many other situations. A normal value says nothing here.
With heavy, long bleeding it falls over time — that explains part of the exhaustion.
The store is usually empty long before haemoglobin moves and should be checked regularly with heavy bleeding.
Normally stays unremarkable. There is no blood value that shows or rules out this condition.
Clearly worthwhile and well studied when deficient; fewer data for the wider uses. Fat-soluble — check blood levels at high doses.
Effective when deficient; effects on sleep and stress plausible but moderate. Too much causes loose stool.
Warmth on the lower abdomen reliably relieves the cramping pain, if only for hours.
Studied in chronic pelvic pain — it does not change the lesions but the pain processing.