🔴 Men's Health

Endometriosis — Living With It

When period pain is more than "normal" — and what to do about it.

Endometriosis is a condition where tissue similar to the uterine lining grows outside the uterus. It affects 1 in 10 women worldwide — and is one of the most under-diagnosed conditions, with an average diagnostic delay of 7–10 years. Severe period pain is not normal and should always be investigated.

Signs and Symptoms

✓ Severe, debilitating period pain (dysmenorrhoea)

✓ Chronic pelvic pain — not just during periods

✓ Pain during or after sex

✓ Pain with bowel movements or urination during periods

✓ Heavy or irregular periods

✓ Spotting between periods

✓ Fatigue — often severe

✓ Difficulty conceiving

✓ Bloating ("endo belly") — cyclic abdominal swelling

✓ Lower back or leg pain during periods

Risk Factors

Family history of endometriosis
Short menstrual cycles (less than 27 days)
Heavy, prolonged periods
Delayed first pregnancy or no pregnancy
Immune system factors — still being researched

When to Seek Help

SoonPeriod pain severe enough to miss school, work, or regular activities — this is not normal and warrants investigation.

SoonPain during sex, pain with bowel movements, or pelvic pain outside of periods.

SoonDifficulty conceiving combined with any of the above symptoms — endometriosis is identified in up to 50% of women investigated for infertility.

Tests & Diagnosis

🧪 Pelvic Ultrasound

Can identify ovarian endometriomas (chocolate cysts). Cannot rule out superficial endometriosis — a normal scan does not mean no endometriosis.

🧪 MRI (Pelvis)

Better than ultrasound for mapping deep infiltrating endometriosis, especially involving bowel and bladder.

🧪 Laparoscopy

The definitive diagnostic procedure — keyhole surgery that allows direct visualisation and biopsy. Diagnosis cannot be confirmed without this.

🧪 CA-125 Blood Test

May be elevated in endometriosis but is neither sensitive nor specific enough to diagnose or rule it out. More useful for monitoring known disease.

Treatment Options

Pain Management

NSAIDs (ibuprofen, naproxen) taken before pain onset significantly reduce prostaglandin-driven period pain. Regular dosing during the first 2–3 days of the period is more effective than waiting until pain is severe.

Hormonal Suppression

Combined pill, progestogen-only pill, hormonal IUS (Mirena), or GnRH analogues suppress menstruation and reduce endometriosis growth. These are long-term management strategies, not cures.

Surgery (Laparoscopic Excision)

The most effective treatment for endometriosis — removal of endometrial implants. Associated with significant pain reduction and improved fertility.

Fertility Planning

Endometriosis can affect fertility. Early fertility assessment and specialist referral is important for women who want to conceive.

Multidisciplinary Support

Pain management specialists, physiotherapy (pelvic floor), psychological support, and dietitian input all contribute to living well with endometriosis.

Frequently Asked Questions

Why does it take so long to diagnose endometriosis?

Period pain is normalised in Nigerian and global culture. Women are frequently told "it's just periods" or "you'll feel better after having a baby." GPs may not consider endometriosis when pain is the only complaint.

Will having a baby cure endometriosis?

No. Pregnancy temporarily suppresses endometriosis. Symptoms typically return after delivery and breastfeeding. Pregnancy should be chosen when you want a child — not as a medical treatment.

Is endometriosis related to infertility?

Yes. Moderate-to-severe endometriosis affects fertility through multiple mechanisms. Early referral to a fertility specialist is important.

Can diet help endometriosis?

An anti-inflammatory diet (omega-3 rich foods, reducing red meat and processed foods) may reduce inflammation and symptoms for some women. It complements but does not replace medical treatment.

Is endometriosis cancer?

No. Endometriosis is benign. It is not cancer and does not become cancer.