Endometriosis: getting a diagnosis and the right care

Painful periods that stop you living your life are not normal. Here's how endometriosis is diagnosed and who can help.

Endometriosis is a condition where tissue similar to the lining of the uterus grows outside the uterus, often in the pelvis. It can cause inflammation, pain and scarring. It is common, but it often takes a long time to be diagnosed, partly because period pain is sometimes dismissed as normal.

Common symptoms

• Period pain that stops you going to school, work or doing usual activities
• Pelvic pain at other times of the month
• Pain during or after sex
• Pain with bowel motions or passing urine, especially during your period
• Heavy or irregular bleeding
• Bloating and tiredness
• Difficulty getting pregnant

Symptoms vary a lot. Some people with severe pain have small amounts of endometriosis, and some with a lot of endometriosis have few symptoms.

Starting with your GP

Your GP will ask about your symptoms and may do an examination and arrange tests, such as a pelvic ultrasound. A specialised ultrasound or MRI can sometimes show endometriosis, but a normal scan doesn't rule it out. Keeping a symptom diary across a few cycles can help.

Your GP may suggest first treatments such as pain relief and hormonal options. They can also connect you with others who help with pelvic pain.

When to see a gynaecologist

Your GP may refer you to Obstetrics & gynaecology if pain isn't controlled, the diagnosis is unclear, scans show endometriosis, or you're having trouble getting pregnant. Some gynaecologists have a special interest in endometriosis and pelvic pain.

The gynaecologist may suggest more imaging, adjust medical treatment, or talk about laparoscopy. This is keyhole surgery that can diagnose endometriosis and often remove it at the same time. Ask about the benefits, risks and recovery, and what other options exist.

A team approach often works best. This may include Physiotherapy with a pelvic health physiotherapist, Psychology for pain coping and mood, Dietetics if bowel symptoms are a problem, and a fertility specialist if needed.

You need a GP referral to claim a Medicare rebate for a gynaecologist. Fees vary, so ask before you book. Spec Book shows which gynaecologists have the soonest appointments, and your GP can send the referral with the booking.

When to get urgent help

Go to an emergency department or call 000 for sudden severe pelvic or tummy pain, pain with fever, fainting, or heavy bleeding that soaks a pad every hour. If you could be pregnant and have pain or bleeding, seek urgent care.

General information only, not medical advice. Everyone's situation is different, so check with your GP or the provider. In an emergency call 000.