Endometriosis is a chronic condition that can impact a woman’s daily life in a profound way. It occurs when tissue similar to the lining of the uterus grows in places outside the womb where it does not belong, and cannot leave the body. It affects the menstrual health of an estimated 190 million women of reproductive age worldwide, and yet it remains widely misunderstood and frequently underdiagnosed.
The last Saturday in March each year is Endometriosis Awareness Day, which aims to raise public awareness about this condition, which too often slips under the radar due to the lack of clear patterns in the symptoms and causes. Often, women hear that it’s just a matter of “period pain,” a natural feature of the body’s hormonal cycle. Our aim is to help women identify the condition more clearly early and begin treatment plans that could greatly improve the quality of their menstrual health. If you or someone you care about has recently heard about endometriosis, this article is here to help you make better sense of this often debilitating condition.
What is endometriosis?
The uterus is lined with a layer of tissue called the endometrium. Each month, during a normal menstrual cycle, this lining thickens in preparation for a possible pregnancy. When pregnancy does not occur, the lining breaks down and is shed during menstruation.
In endometriosis, some tissues outside of the womb behave similarly to the endometrium but are growing in the wrong place. It is most commonly found around the ovaries, fallopian tubes, and the pelvic lining. In some cases, it appears on the bladder or bowel, or, more rarely, in areas outside the pelvis entirely, such as the chest.
Because this tissue has nowhere to go when it breaks down, it causes inflammation, pain, and sometimes scarring. Over time, that scarring can affect nearby organs and, in some women, their fertility.
Endometriosis is not an infection. It is not caused by anything a person did or did not do. And it is not something that resolves on its own. Understanding this is often the first step toward getting the right support.
Who does endometriosis affect?
Endometriosis is most commonly diagnosed in women who menstruate, from the time periods begin in puberty through to menopause. It can affect anyone with a uterus, regardless of age, background, or reproductive history.
One of the most frustrating aspects of this condition is how long it takes to identify. On average, there is a significant delay between when symptoms first appear and when a diagnosis is confirmed. This happens partly because the symptoms of endometriosis overlap with many other conditions, including uterine fibroids, irritable bowel syndrome, and pelvic inflammatory disease.
The condition also does not always look the same from person to person. Some women experience severe, debilitating pain. Others have relatively mild symptoms. A small number of women discover they have endometriosis only when investigating difficulties with fertility.
Symptoms to recognize 
The most widely reported symptom of endometriosis is pain, pain that goes beyond normal period discomfort and often interferes with daily life, work, and relationships. Symptoms include:
- Severe pain during menstruation that limits normal activities.
- Heavy menstrual bleeding, sometimes requiring frequent pad or tampon changes within an hour or two.
- Chronic pelvic pain that persists outside of the menstrual cycle.
- Pain during or after sex.
- Pain when using the bathroom, particularly during a period.
- Bloating, nausea, and extreme fatigue.
- In rare cases, pain or bleeding in the chest, which may cause shortness of breath.
Difficulty conceiving is also associated with endometriosis, particularly in more advanced cases where scarring has affected the fallopian tubes or ovaries. Low mood and anxiety are common too, and they are a valid part of the condition’s impact, not a separate problem to manage in isolation.
It is worth noting that the intensity of symptoms does not always reflect the extent of the condition. Someone with widespread endometriosis may have milder symptoms than someone with a smaller amount of affected tissue. A doctor can help interpret what these symptoms mean for each individual situation.
How endometriosis is diagnosed
There is no simple blood test that confirms endometriosis. A doctor will typically begin with a conversation about symptoms and family history, followed by a physical examination. They may also arrange an ultrasound or an MRI scan to look for signs of the condition.
The definitive way to confirm endometriosis is through a laparoscopy, a minor surgical procedure in which a small camera is passed through a tiny incision in the abdomen. This allows a specialist to see and assess the extent of any endometrial tissue growing outside the uterus. In some cases, it is possible to remove endometriosis lesions during the same procedure.
If symptoms are present and affecting quality of life, it is important to speak to a healthcare provider rather than assume things will improve on their own. Early diagnosis generally leads to better management outcomes.
Treatment approaches for endometriosis
There is currently no cure for endometriosis. However, there are effective treatments that reduce pain, slow the growth of endometrial tissue outside the uterus, and help preserve fertility where that is a goal. Treatment is almost always tailored to the individual, taking into account symptom severity, age, and whether pregnancy is being planned.
Hormonal therapies are among the most commonly prescribed treatments. These work by altering the hormonal environment that allows endometrial tissue to grow and shed. Elevated estrogen levels are closely linked to the progression of endometriosis, so many treatments aim to reduce estrogen exposure or interrupt the menstrual cycle altogether.
The medications most frequently used include:
- Nexplanon (etonogestrel), a small hormonal implant placed under the skin of the upper arm. It releases a steady dose of progestogen, which suppresses the menstrual cycle and reduces the stimulation of endometrial tissue.
- Mirena (levonorgestrel), a hormonal intrauterine device that releases a low dose of progestogen locally within the uterus. It is widely used to reduce heavy menstrual bleeding and pelvic pain associated with endometriosis.
- Kyleena (levonorgestrel), a smaller hormonal intrauterine device with a lower dose profile than Mirena. It offers similar benefits for menstrual health and is often considered by those who prefer a lighter hormonal option.
- Zoladex (goserelin), a GnRH agonist delivered as an injection beneath the skin, typically monthly. It works by suppressing the production of hormones that drive the menstrual cycle, temporarily reducing estrogen to levels that inhibit the growth of endometrial tissue.
- Depo-Provera (medroxyprogesterone), an injectable progestogen given every three months. It suppresses ovulation and menstruation, which can significantly reduce pain and slow the progression of endometriosis.
Painkillers, including anti-inflammatory medications, are often used alongside hormonal therapies to manage acute pain. For those with severe or widespread disease, or where fertility is affected, surgical intervention may be recommended. As with any long-term treatment, decisions about which approach to take are best made in close discussion with a gynecologist or specialist.
Living with endometriosis
Endometriosis is a long-term condition. For many women, it shapes daily life in ways that are not always visible to others, including missed days at work, disrupted relationships, and the ongoing problem of managing the pain. The emotional impact is real and deserves the same attention as the physical symptoms.
Support is available. Specialist endometriosis services, fertility referrals, mental health resources, and peer communities all have a role to play. Many women find it valuable to connect with others who have the same diagnosis, not for medical advice, but for understanding and solidarity.
How to access menstrual health support through IsraelPharm
For those who have been prescribed a hormonal medication and are managing an ongoing treatment plan, consistent access to medication matters. IsraelPharm is a licensed international pharmacy that stocks the branded medications used in endometriosis treatment, including Nexplanon, Mirena, Kyleena, Zoladex, and Depo-Provera. A valid prescription from a licensed physician is required. Using an international pharmacy for supply does not change or interfere with the prescribing physician’s oversight of treatment.
For patients in the US who have been prescribed one of the hormonal medications used in endometriosis treatment, sourcing through IsraelPharm provides access to the exact branded products their doctor has prescribed. IsraelPharm is a licensed international pharmacy operating under regulatory oversight, and it requires a valid prescription for all prescription medications, so physician oversight of treatment remains fully in place.
Patients sourcing medications through IsraelPharm benefit from reliable supply continuity, a practical consideration for treatments that follow a fixed schedule of monthly injections or ongoing dosing. Medications are delivered directly to the patient’s home, removing the need for repeat pharmacy visits and simplifying the logistics of long-term treatment management.
For anyone who has reached the stage of an active prescription and is looking for a consistent, accessible supply source, visiting the IsraelPharm website is a straightforward next step.
Further reading on endometriosis and menstrual health
From our library:
- Why Endometriosis Awareness Matters – Blogs
- Endometriosis medication options, IsraelPharm website
- Understanding Uterine Fibroids & Endometriosis – Blogs
From the web
- Endometriosis fact sheet, World Health Organization
- Endometriosis overview, symptoms, and treatments, NHS
- Endometriosis treatment and management, Endometriosis UK
Frequently asked questions about endometriosis and menstrual health
What is endometriosis and how does it affect menstrual health?
Endometriosis is a chronic condition in which tissue similar to the uterine lining grows outside the uterus. It directly disrupts menstrual health by causing severe period pain, heavy bleeding, and chronic pelvic discomfort. The misplaced tissue behaves like the endometrium, thickening and breaking down with each cycle, but has no way to leave the body. This leads to inflammation, internal scarring, and, in some cases, damage to nearby reproductive organs.
What are the most common symptoms of endometriosis?
The most common symptoms of endometriosis include:
- Severe pain during menstruation that disrupts daily activities.
- Heavy menstrual bleeding.
- Persistent pelvic pain between periods.
- Pain during or after sex, or when using the bathroom.
- Extreme tiredness and bloating.
- Difficulty conceiving.
Symptoms vary widely from person to person. A doctor can help assess severity and guide next steps.
How is endometriosis diagnosed?
Endometriosis is diagnosed through a combination of symptom review, physical examination, and imaging such as ultrasound or MRI. Definitive confirmation requires a laparoscopy, a minor surgical procedure in which a camera is used to examine the pelvic area. During a laparoscopy, a specialist can both identify and, in many cases, remove endometrial tissue found outside the uterus. Diagnosis often takes time, as symptoms overlap with other conditions.
What hormonal treatments are used for endometriosis?
Several hormonal medications are used to manage endometriosis symptoms. Commonly prescribed options include:
- Nexplanon, a hormonal implant that suppresses the menstrual cycle.
- Mirena and Kyleena, intrauterine devices that reduce pelvic pain and heavy bleeding.
- Zoladex, a monthly injection that reduces estrogen levels.
- Depo-Provera, a three-monthly injection that suppresses ovulation and menstruation.
The right choice depends on individual symptoms, fertility goals, and medical history. Always discuss options with a qualified healthcare provider.
Where can patients in the US source branded endometriosis medications?
Patients in the US with a valid prescription can source branded endometriosis medications including Nexplanon, Mirena, Kyleena, Zoladex, and Depo-Provera through IsraelPharm. IsraelPharm is a licensed international pharmacy that supplies the exact branded product prescribed, not substitutes. Medications are delivered directly to the patient’s home. A prescription from a licensed physician is required, and physician oversight of treatment is not affected by using an international pharmacy for supply.
Glossary
- Endometrium, the tissue that lines the inside of the uterus and thickens each month during the menstrual cycle in preparation for possible pregnancy.
- Laparoscopy, a minimally invasive surgical procedure using a small camera to examine the inside of the abdomen and pelvis, used to confirm endometriosis.
- Progestogen, a synthetic form of the hormone progesterone, used in hormonal treatments to suppress the menstrual cycle and reduce estrogen-driven tissue growth.
- GnRH agonist, a class of medication that suppresses the hormones controlling the menstrual cycle, used to reduce estrogen levels in endometriosis treatment.
- Retrograde menstruation, a process in which menstrual blood flows backward through the fallopian tubes into the pelvis, considered one possible factor in endometriosis development.
- Ovarian cyst, a fluid-filled sac on the ovary; in endometriosis, a specific type called an endometrioma can form when endometrial tissue grows on or inside the ovary.
- Adhesions, scar tissue that causes organs or tissues to stick together, a possible complication of endometriosis or endometriosis surgery.
- Fertility, the natural capacity to conceive a child; endometriosis can impair fertility when scarring or inflammation affects the reproductive organs.
