Endometriosis is a chronic inflammatory condition in which tissue similar to the lining of the uterus grows in places where it shouldn’t. It can appear on the ovaries, bowel, bladder, pelvic wall - even the diaphragm in some cases. It’s far more than a “bad period.” Estimates vary, but endometriosis is commonly cited as affecting somewhere between 1 in 7 and 1 in 9 people with periods, and it can cause severe pelvic pain, heavy bleeding, fatigue, digestive issues and fertility challenges. It’s a whole-body condition that deserves whole-body care.

Quick version: endometriosis is a chronic condition where tissue similar to the lining of your uterus grows where it shouldn't, often causing pain, heavy periods and fatigue. Estimates vary, but it is often cited as affecting somewhere between 1 in 7 and 1 in 9 women and people who menstruate. It is common, it is real, and it is not something you should have to just push through.

What are the symptoms of endometriosis?

Endo doesn’t look the same for everyone. Symptoms can be loud, subtle, cyclical or constant, which is why so many people go years without answers. The most common signs include chronic pelvic pain, heavy or long periods, pain during or after sex, bloating, fatigue, digestive upset, pain when passing urine or stool and difficulty conceiving. Endo also often travels alongside adenomyosis, a related condition worth knowing about if your pain and bleeding feel bigger than a normal period. If you are not sure whether what you are feeling is normal, this is worth a read.

If you regularly miss work, cancel plans or reshape your life around pain, that’s not “just periods.” That’s a cue to get support. Start by tracking your symptoms for at least two cycles.

What causes endometriosis, and how is it diagnosed?

There's no known single cause or way to prevent endometriosis. There is a genetic link: you're roughly 7 to 8 times more likely to develop it if a family member has it. Diagnosis usually starts with a pelvic examination, ultrasound or MRI, though laparoscopy remains the gold-standard test for a confirmed diagnosis, even though it's invasive. Average time to diagnosis is commonly cited at around 6.5 years from first symptoms - we'd flag that figure is worth double-checking against the latest research before relying on it, as diagnosis timelines are an active area of study.

What are the treatment options for endometriosis?

There's no one-size-fits-all approach, and most people land on a combination that works for them. Western medicine options include pain medication, hormonal therapy (such as the oral contraceptive pill or LARCs), and laparoscopic surgery to remove lesions, alongside support from pain specialists or endocrinologists. See our full treatment breakdown here. Allied and complementary options include naturopathic care (working on inflammation and hormone balance through diet, lifestyle and herbal medicine), acupuncture and Chinese medicine, massage, pelvic physiotherapy, dietetics and psychological support. Alongside medical care, many people find real day-to-day comfort in heat, gentle movement, pelvic physio, and looking after sleep and stress. Heat is one of the simplest comforts on a bad day, which is exactly why we made the rae Heat Device. None of this replaces specialist care, it sits alongside it. The right combination depends on your symptoms, your body and your care team.

Does endometriosis affect fertility?

It can, but endo does not automatically mean you can't get pregnant, and that myth causes a lot of unnecessary fear. Many people with endometriosis conceive, some with support like fertility treatment. If having children is something you might want, now or down the track, it is worth raising early with your specialist, so you have information and options rather than pressure.

Who should be on your endometriosis care team?

Endo care works best when you’re supported from multiple angles. You don’t need to do everything at once, but you deserve a team that takes your pain seriously and treats your health holistically. Your core players include:

• GP: Your first stop for referrals, medication and ongoing management. Ask: “Can I be referred to an endometriosis specialist?”
• Gynaecologist: Can diagnose endo (via laparoscopy) and build a management plan. Ask: “Do you specialise in endometriosis?”
• Pelvic Physiotherapist: Supports pelvic floor tightness, muscle spasms and pain flares. Ask: “How can physio help with the pain I’m experiencing?”
• Nutritionist/Naturopath: Works on gut health, inflammation and hormonal balance. Ask: “What shifts could support my symptoms?”
• Psychologist: Pain, fatigue, and medical trauma take a toll. Mental health support matters. Ask: “Do you work with chronic illness clients?”

How do you prepare for an endometriosis appointment?

Appointments can feel intimidating - especially if you’ve been dismissed before. Preparation helps shift the dynamic. The more clearly you can describe what’s happening in your body, the easier it is for your clinician to advocate for you.

How do you explain endo pain to a doctor?

Go beyond numbers on a pain scale. Explain the effect:

• “I miss one to two workdays every cycle.”
• “Painkillers only work for an hour.”
• “I can’t sleep through the night on my heavy days.”

What should you ask your doctor about endometriosis?

• How can we confirm whether this is endometriosis?
• Do I need imaging or surgery to get clarity?
• What treatment options make sense for my symptoms?
• What should I know about hormonal treatments?
• Should I be referred to an endometriosis specialist surgeon?
• What lifestyle changes could support my symptoms?
• How often should I follow up with you?
• Can you refer me to a pelvic physio or psychologist?
• What should I track between now and my next appointment?
• Who do I contact if my symptoms worsen?
  

Quick answers

Q: Is it endometriosis or just a bad period?
A: If pain regularly stops your day, comes with heavy bleeding, pain during sex or pain when you wee or poo, that is worth investigating. Normal period pain generally eases with rest and basic pain relief. Endo pain tends not to.

Q: How common is endometriosis?
A: Estimates vary by source and population studied, but it is commonly cited as affecting somewhere between 1 in 7 and 1 in 9 women and people who menstruate. Australian research (AIHW) puts it at around 1 in 7 by age 44-49.

Q: How is endometriosis diagnosed?
A: Often a mix of symptom history, a pelvic exam and imaging, with a laparoscopy the definitive test. Scans can look normal even when endo is present, so keep advocating if your symptoms say otherwise.

Q: Does endometriosis affect fertility?
A: It can, but many people with endo conceive, some with support. If children are on your radar, raise it early with your specialist.

Q: Is there a cure for endometriosis?
A: Not yet. But treatments and daily support can genuinely reduce symptoms for many people. Endo care is about management, not one single fix.

Q: What helps endometriosis pain at home?
A: Heat, gentle movement, rest, pelvic physio and tracking your triggers can all help take the edge off. Severe, new or worsening pain is always worth a medical review.