# Endometriosis: your pain is real > Why “bad periods” are not always just bad periods. Category: Conditions · 6 min read · Written by the Splash team · Sources checked October 2026 URL: https://splash.care/learn/conditions/endometriosis ## Quick answer Endometriosis is a long-term condition where tissue similar to the womb lining grows elsewhere, usually in the pelvis. Common symptoms are period pain that stops you doing normal things, pain during or after sex, pain when peeing or pooing during a period, and difficulty getting pregnant. It can take years to diagnose, so tracking symptoms helps. - Endometriosis affects about 1 in 10 and is often diagnosed late (about 9 years on average in the UK). - Life-disrupting pain is not “just periods”. - A normal scan does not rule it out; NICE offers an ultrasound to everyone with suspected endometriosis. - Painkillers, hormonal treatments, surgery and pain support can help a lot. [Endometriosis](https://splash.care/learn/glossary/endometriosis) is when tissue similar to the womb lining ([Endometrium](https://splash.care/learn/glossary/endometrium)) grows outside the womb, often on the ovaries, fallopian tubes or around the pelvis. Each cycle it reacts to [hormones](https://splash.care/learn/cycle-basics/hormones-explained), which can cause inflammation, pain and scarring. It can affect anyone who has or had a womb. **1 in 10** reproductive-age women worldwide, around 190 million people, live with endometriosis (WHO) **9 years 4 months** is the average time from first seeing a doctor about symptoms to getting a firm diagnosis in the UK, says Endometriosis UK ## What are the symptoms of endometriosis? NICE says to suspect endometriosis in anyone, including young people aged 17 and under, with one or more of these: - [Period pain](https://splash.care/learn/period-care/cramp-relief) that stops you doing normal things - Long-lasting pelvic pain - Pain during or after sex - Pain when pooing or peeing, especially on your period, or blood in your pee during your period - [Heavy periods](https://splash.care/learn/period-care/heavy-periods), [bloating](https://splash.care/learn/body-literacy/bloating), nausea and tiredness - Difficulty getting [pregnant](https://splash.care/learn/fertility-ttc/early-pregnancy-signs), alongside the above - Feeling low or anxious from living with pain Some people have no symptoms at all, and the amount of endometriosis does not always match how much it hurts. A first-degree relative with endometriosis makes it more likely. **Myth:** Period pain bad enough to miss school or work is normal. **Fact:** Pain that disrupts your life is a reason to see a doctor, not something to just put up with. ## How is endometriosis diagnosed? A GP will ask about your symptoms and family history and should offer an examination. Since the 2024 update, NICE says everyone with suspected endometriosis should be offered a transvaginal ultrasound (or a tummy scan if that is not suitable), even if the examination is normal, and referral can happen alongside starting treatment, rather than after waiting. A normal exam or scan does not rule endometriosis out. A scan or MRI is better at finding deeper disease, and [Laparoscopy](https://splash.care/learn/glossary#laparoscopy) (keyhole surgery) can confirm endometriosis and treat it at the same time. NICE says to consider it even if scans are normal, but you do not have to have it before starting treatment. **Quick quiz:** Does a normal scan rule out endometriosis? 1. Yes, always 2. No, referral may still be needed 3. Only if you are under 30 Answer: No, referral may still be needed. NICE says not to rule out endometriosis because an examination or ultrasound is normal. Referral may still be needed. ## How is endometriosis treated? - A short trial of paracetamol or an anti-inflammatory painkiller ([NSAID](https://splash.care/learn/glossary/nsaid)) such as ibuprofen, alone or together - Hormonal treatments such as the combined pill or a [progestogen](https://splash.care/learn/glossary/progestogen). NICE says these can reduce pain and have no permanent effect on fertility. You will not be given them if you are trying to get pregnant right now. - For pain that continues after treatment, specialist options include newer hormone-blocking tablets ([GnRH](https://splash.care/learn/glossary/gnrh) antagonists with add-back hormones) - Surgery to remove patches or cysts of endometriosis, usually by keyhole - Pain support, pelvic physio, fertility advice and mental health support Treatment is based on your symptoms, wishes and priorities rather than on a “stage”. The NHS says endometriosis can come back after surgery, and can sometimes cause scar tissue (adhesions). NICE says the evidence does not support traditional Chinese medicine or herbal supplements for endometriosis. > **Splash says:** log pain level, location and what you tried every period. Splash’s Doctor report puts it all on one page, which makes “how bad is it?” much easier to answer. ### When to see a doctor See a GP if period pain stops you doing everyday things, painkillers do not help, you have pain during sex or when pooing, or you have blood in your pee or poo. NICE says to refer you to a gynaecology service if first treatment does not work, you cannot tolerate it, symptoms affect daily life or they come back. If you feel dismissed, you can ask for your concerns to be recorded, a second opinion or a referral to a gynaecologist. Call 111 or 999 for sudden severe pain. Rarely, endometriosis outside the pelvis can cause chest pain, breathlessness or coughing up blood with periods; see a doctor urgently. ## Questions people ask ### How do I know if period pain is endometriosis? Period pain that painkillers do not help, that stops you going to work or school, or that comes with pain during sex or bowel movements is worth discussing with a GP. Only a doctor can diagnose endometriosis. ### What should I track before seeing a doctor about endometriosis? Note pain levels and where you feel pain each day, when your period starts and ends, pain during sex, bowel or bladder symptoms, and what painkillers you tried. A few cycles of notes make a strong case. ## Sources 1. [NHS: Endometriosis](https://www.nhs.uk/conditions/endometriosis/) 2. [NICE guideline NG73: Endometriosis diagnosis and management](https://www.nice.org.uk/guidance/ng73) 3. [WHO: Endometriosis fact sheet](https://www.who.int/news-room/fact-sheets/detail/endometriosis) 4. [Endometriosis UK: Diagnosis and treatment](https://www.endometriosis-uk.org/diagnosis-and-treatment) 5. [Endometriosis UK: What is endometriosis?](https://www.endometriosis-uk.org/what-is-endometriosis) This is general information, not medical advice. Splash can’t diagnose. If you’re worried, talk to a GP, pharmacist or sexual health clinic. In an emergency call 999 (UK) or 911 (US).