Endometriosis is a condition in which tissue similar to the lining of the uterus grows outside it — most commonly on the ovaries, the ligaments supporting the uterus, the bowel or the lining of the pelvis. It affects around one in nine Australian women and often begins in the teenage years, though diagnosis is frequently delayed.

Symptoms vary widely. Many women experience painful periods, pain with intercourse, pain with bowel movements or urination, and pelvic pain that persists between periods. Others have few symptoms but experience difficulty conceiving. The severity of symptoms does not always match the extent of disease seen at surgery.

Persistent pelvic pain can also arise from other sources — the pelvic floor muscles, the bladder, the bowel or the nervous system — and these frequently coexist with endometriosis. A careful assessment aims to identify all the contributing factors so that treatment addresses the whole picture, not just one part of it.

Management is individualised. Options include hormonal treatments to suppress the disease, pain-modifying medications, pelvic physiotherapy, and laparoscopic (keyhole) surgery to excise endometriosis where appropriate. For many women a combination of approaches, coordinated with their GP and allied health team, offers the best long-term result.