What Is Endometriosis — and How Is It Treated?

By Dr. Maria Teresa Tam, MD, FACOG, FACS

Imagine spending years dreading your period — not because of mild discomfort, but because the pain is severe enough to keep you home from work, in bed with a heating pad, counting down the hours. Many women are told this is simply “normal”, and told that it’s normal to have “cramps”. It isn’t.

If painful periods or chronic pelvic pain have become a regular part of your life, you deserve answers — and real relief. While there are effective treatments that can significantly improve symptoms and quality of life, it is important to understand that endometriosis is a chronic condition, and there is no single, permanent cure.

What Is Endometriosis?

Endometriosis occurs when tissue similar to the lining of the uterus — the endometrium — grows outside the uterus where it doesn’t belong. This tissue can attach to the ovaries, fallopian tubes, the outer surface of the uterus, the bowel, or other pelvic structures. Just like the uterine lining, this tissue responds to your monthly hormonal cycle: it builds up, breaks down, and has nowhere to go.

The result is inflammation, scar tissue, and often significant pain.
Endometriosis affects roughly 1 in 10 women of reproductive age — that’s an estimated 200 million women worldwide. Despite how common it is, many women wait years before receiving a correct diagnosis. On average, it takes 7 to 10 years from the onset of symptoms to diagnosis, largely because the condition is dismissed, misdiagnosed as irritable bowel syndrome (IBS) or pelvic inflammatory disease (PID), or simply just overlooked.

Symptoms to Watch For

Endometriosis presents differently from person to person, which is part of why it’s so often missed. One important thing to understand is that the severity of symptoms does not always reflect the severity of the disease. Some women with minimal visible disease have debilitating pain, while others with more extensive endometriosis may have few or no symptoms at all.

Common symptoms include:

• Painful periods (dysmenorrhea) that go well beyond typical cramping — pain that disrupts your daily routine, requires strong pain medication, or has you calling out of work
• Pelvic pain outside of menstruation, including mid-cycle or persistent discomfort
• Pain during or after intercourse
• Heavy or irregular periods, including spotting between cycles
• Difficulty getting pregnant, as endometriosis is a leading cause of infertility
• Bladder or bowel symptoms, such as pain with urination or bowel movements during menstruation

It’s important to know that some women with endometriosis have no symptoms at all — the condition is discovered incidentally during a procedure for something else. If you do have symptoms, though, please don’t accept them as just “how it is.” You do not have to live in pain.

How Is Endometriosis Diagnosed?

Getting the right diagnosis starts with a conversation — one where your symptoms are taken seriously. As a pelvic pain gynecologist, I begin with a thorough history and a pelvic exam, which may reveal tenderness or nodularity that suggests endometriosis.

Ultrasound is often the next step. It can identify endometriomas (cysts on the ovaries caused by endometriosis) and provide useful information, but it cannot detect all forms of the disease, particularly superficial implants on the pelvic lining.

The gold standard for diagnosis is laparoscopy — a minimally invasive surgical procedure in which a small camera is used to look directly inside the pelvis and confirm the presence of endometriosis. In many cases, treatment can be performed at the same time.

Since endometriosis is a chronic condition that can significantly impact quality of life, early recognition and diagnosis matter. The sooner we identify it, the sooner we can begin managing symptoms, protecting fertility, and improving overall well-being.

How Is Endometriosis Treated?

The right treatment for you depends on the severity of your symptoms, whether you’re hoping to conceive, and your overall health history. There is no one-size-fits-all approach — and that’s exactly why personalized care matters.

Hormonal Therapies

Hormonal medications are often the first line of endometriosis treatment. These include combined hormonal birth control (pills, patch, or ring), progestin-only therapies, and GnRH agonists, which temporarily suppress estrogen to reduce the activity of endometrial tissue. These treatments can significantly reduce pain and slow the progression of the disease.

Pain Management

Anti-inflammatory medications (NSAIDs) can help manage pain, particularly during menstruation. These are often used alongside hormonal therapies as part of a broader symptom management plan.

Minimally Invasive Surgery

For many women, surgery can provide significant relief, especially when symptoms are severe or not well controlled with medication. As a Fellowship-trained Minimally Invasive Gynecologic Surgeon (MIGS), I specialize in laparoscopic excision of endometriosis — the precise removal of endometriosis tissue from where it does not belong, including endometriomas and deeper implants. Excision surgery is associated with meaningful improvement in pain and, in some cases, fertility.

However, endometriosis is a chronic condition, and even after surgery, it can recur over time. For that reason, surgery is best understood as one important part of a long-term management plan, not a one-time cure.

Fertility Considerations

If you’re hoping to get pregnant, treatment planning requires special consideration. Surgical removal of endometriosis can improve fertility in some cases, and we’ll work with you — and with reproductive specialists when needed — to create a plan that supports your family-building goals while addressing your symptoms.

Living with Endometriosis

Endometriosis is a chronic condition, which means it requires ongoing care and attention over time. Even after treatment, symptoms can return, and regular follow-up allows us to adjust your care plan and respond early to any changes.

Lifestyle factors can also play a supportive role. Many women find that regular exercise, an anti-inflammatory diet, and stress management help reduce symptom burden. These approaches are not a replacement for medical or surgical treatment, but they can be meaningful additions to a comprehensive care plan.

Most importantly, endometriosis is manageable. With the right diagnosis, a thoughtful treatment approach, and a care team that takes your symptoms seriously, it is absolutely possible to improve your quality of life and regain a sense of control. You do not have to push through pain or accept it as your normal.

The goal of treatment is not just temporary relief, but long-term improvement in pain, function, and quality of life.

If you’ve been living with pelvic pain, painful periods, or symptoms that sound familiar, it may be time for a closer evaluation. You deserve to be heard, taken seriously, and given real answers.

At All for Women Healthcare in Chicago’s Lakeview neighborhood, we specialize in the diagnosis and long-term management of endometriosis. Whether you’re looking for a gynecologist who will listen or a surgeon with expertise in minimally invasive endometriosis care, our goal is to partner with you in finding the right approach for your symptoms and your goals.

To schedule an appointment, call our office or visit allforwomenhealthcare.com.

Thoughtful, individualized care can make a meaningful difference... 
and you do not have to navigate this alone.

Author

Dr. Teresa Tam Teresa Tam, MD, FACOG, FACS