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.

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Written by Shen Li Wen
Obstetrics and Gynecology
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How to treat endometriosis in the pelvic cavity?

When women suffer from pelvic endometriosis and the symptoms are not too severe—for instance, if the pain is relatively mild—they can be clinically observed during menstruation. If dysmenorrhea occurs, oral administration of non-steroidal anti-inflammatory drugs such as indomethacin can help alleviate the symptoms. However, some women may experience more severe symptoms and may require pseudopregnancy treatment with drugs, such as oral contraceptives or progestin-based medications. Another approach involves using GnRH analogues, a method known as 'medical oophorectomy.' If symptoms are severe and treatments are ineffective, surgical intervention might be considered. Surgical options include electrocoagulation of endometriotic lesions in the pelvis, sharp or blunt dissection of adhesions, which can also improve the pelvic environment and potentially enhance fertility in women. (Note: Medication should be taken under the guidance of a doctor.)

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Written by Li Shun Hua
Obstetrics and Gynecology
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Endometriosis characteristics

The main characteristic of endometriosis is painful menstruation, and in severe cases, it can lead to heavy periods and prolonged menstrual cycles. If endometriosis leads to the formation of ovarian chocolate cysts, the rupture of these cysts can cause severe abdominal pain. Moreover, endometriosis can easily lead to pelvic adhesions, which are a common cause of infertility. If the condition is severe, abdominal pain may also occur after the menstrual period has ended. In the case of adenomyosis, the symptoms include an enlarged uterine body, heavy periods, and prolonged menstrual cycles. If the condition is severe, then surgical treatment may be necessary.

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Written by Zhang Lu
Obstetrics
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Does endometriosis affect pregnancy?

Endometriosis is a common gynecological condition, which involves the implantation of endometrial tissue outside the uterine cavity. Endometriosis is a common cause of infertility: Firstly, when endometriosis occurs, it often affects the function of the ovaries. For example, ovarian chocolate cysts can affect the release of endocrine hormones in the ovaries, as well as cause ovarian ovulation disorders or premature ovarian failure. Secondly, endometriosis can cause inflammation in the pelvic cavity and adhesions within the pelvis. This will impact the function of the fallopian tubes, causing ovulation disorders in the tubes, as well as disorders in the transport function of the tubes. This can prevent fertilization, or after the sperm and egg have combined, the fallopian tubes may not be able to transport the fertilized egg to the uterine cavity, thus increasing the risk of ectopic pregnancy.

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Written by Xu Xiao Ming
Obstetrics and Gynecology
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What tests are done for endometriosis?

For patients with endometriosis, it is recommended that you undergo a gynecological ultrasound examination to observe the condition of the ectopic endometrial tissue in the pelvic cavity, whether it is present on the uterus or ovaries, and whether it has grown on the abdominal wall. Therefore, it is advised to have a gynecological ultrasound examination and a gynecological exam. Patients with endometriosis can also have a blood test for tumor markers. If you wish to undergo additional tests, you can also have a cervical cancer screening, which is also possible. The main recommendations are the first three: the gynecological exam, gynecological ultrasound, and tumor marker tests. These examinations are advisable. If the endometriosis is very severe and the pain is quite intense, treatment may be necessary.

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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.