Does endometriosis cause pain?

Written by Zhang Xiu Rong
Obstetrics and Gynecology
Updated on May 12, 2025
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The clinical feature of endometriosis is painful menstruation, which tends to worsen over time. If the endometrial tissue is displaced to the ovaries, it can lead to the formation of ovarian endometriomas, often called "chocolate cysts", which can cause the ovaries not to release eggs and generally affects fertility. If endometrial tissue displaces to the uterus, it can cause adenomyosis, leading to a uniformly thickened uterine muscle layer and uneven muscle wall echoes, resulting in an enlarged uterus, which also impacts fertility. Therefore, it is crucial for patients with endometriosis to seek early treatment and prepare for pregnancy as soon as possible. Endometriosis, which affects fertility, is typically characterized by painful menstruation that gradually worsens, and generally, painkillers are insufficient for treating this condition.

Other Voices

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Written by Liu Wei Jie
Obstetrics
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Can endometriosis turn into cancer?

The answer is no. First, let's explain what endometriosis is. Endometriosis is when the endometrium, or the lining of the uterus, is found outside of its normal location, including in the muscular layer of the uterus, the ovaries, the pelvic cavity, or the intestines; it can occur in any of these areas. This condition is known as endometriosis. Endometriosis within the uterus is a benign condition, but it can lead to severe painful menstruation and chocolate cysts. If the menstrual pain is very severe, there may be a possibility of needing a hysterectomy in the future. If a chocolate cyst occurs, surgery might also be necessary.

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Written by Xu Xiao Ming
Obstetrics and Gynecology
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Endometriosis

Endometriosis means that the endometrial tissue, which normally lines the uterus, grows in other locations. It can grow on the ovaries, inside the muscular layer of the uterus, or in the pelvic cavity. The ectopic endometrial tissue responds to changes in the body's estrogen levels during each menstrual cycle, creating symptoms similar to menstrual bleeding. If it grows on the ovaries, it may form a "chocolate cyst" on the ovaries that gradually enlarges with each menstrual cycle. If it grows within the muscular layer of the uterus, it can lead to adenomyosis, causing significant pain during menstruation. If it grows in the pelvic cavity, it can lead to the formation of pelvic lesions. Therefore, it is recommended that patients with such conditions seek prompt medical treatment.

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Written by Shen Li Wen
Obstetrics and Gynecology
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Endometriosis symptoms

When women suffer from endometriosis, the typical symptom is progressively worsening dysmenorrhea. What is progressively worsening dysmenorrhea? It is mainly because the ectopic endometrial tissue also becomes congested, swollen, and sheds each month during menstruation, causing the ectopic lesions to gradually enlarge, thus making the dysmenorrhea increasingly painful. Some women may have ovarian endometriomas or ectopic endometrial lesions in the posterior cul-de-sac of the vagina, which can also cause severe pain during intercourse. Ovarian endometriomas can also affect the normal ovulation of the ovaries, leading to menstrual cycle disorders, such as irregular menstruation or increased menstrual flow, among other phenomena. Endometriosis can also alter the pelvic environment, leading to difficulties in conception for women.

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Written by Li Shun Hua
Obstetrics and Gynecology
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How is endometriosis treated?

Treatment methods for endometriosis include conservative treatment and surgical treatment. If the patient's symptoms are relatively mild, the dysmenorrhea is not very severe, and there is no occurrence of excessive menstruation or prolonged menstrual period, conservative treatment can be applied. Common conservative treatment methods include oral contraceptive pills, and a levonorgestrel-releasing system can be placed inside the uterine cavity. If the patient has reproductive demands and the symptoms are more severe, or if there is a chocolate cyst on both ovaries, surgical treatment can be performed, but the recurrence rate after surgery is also relatively high. (The use of medication should be under the guidance of a doctor.)

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Written by Yue Hua
Obstetrics and Gynecology
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Can endometriosis lead to pregnancy?

Endometriosis can lead to pregnancy, but about 50% of those affected may not conceive. This is because the disease can cause abnormal anatomical structures in the female pelvic, leading to extensive adhesions around the fallopian tubes, thus affecting the movement of the tubes. This, in turn, impairs their function in transporting the fertilized egg. Therefore, for patients wishing to conceive, it is advisable to monitor follicular development with an ultrasound and have intercourse during the ovulation period, which could increase the chances of pregnancy.