Endometriosis has these key symptoms:

  • Pelvic and/or abdominal pain (and ovulation pain is common)
  • Pain with sex
  • Extremely painful periods
  • Pain with pooing
  • Problems with fertility, making it harder to fall pregnant.

However, research shows there is no link between the severity of these symptoms and the severity of your endometriosis. In other words, you can have severe endometriosis with lower symptoms. You can also have mild endo with severe symptoms.

Endometriosis is really quite common:

  • 21% of women having investigation for fertility problems have it
  • 16% of women with chronic abdominal pain have it.

Endometriosis also overlaps with these conditions, which often cause similar symptoms:

Causes of endometriosis are unknown. Like many complex conditions, it’s likely to be caused by a number of factors. Interestingly, early research shows that women with deep infiltrating endo have higher levels of oestrogen-like toxins in their fat.

Endometriosis can only officially be diagnosed via laparoscopy (a type of surgery involving a camera in the abdomen).

Diagnosis usually turns into treatment. That is, if they find endometriosis during the laparoscopy, they usually surgically remove as much as they can see. Unfortunately, the pain often persists after surgery. We don’t fully understand why, but there are probably several reasons.

Why is the pain sometimes still there after surgery?

Endometriosis involves inflammation

Endometriosis is an inflammatory condition. The inflammation continues after surgery as it’s part of the condition. (But – amazingly – some research does show that inflammatory chemicals drop after surgery). Even if pain initially improves after surgery, the process continues. Inflammation causes further adhesions. This explains the return of pain that many women get after a period of time.

Surgery unavoidably causes scar tissue (adhesions)

Scar tissue, or adhesions, is part and parcel of any surgery. Sometimes surgery is needed to remove major adhesions caused by endometriosis. But all surgery causes scarring. The scarring may need to be treated to improve pain.

There are muscular problems as well

Surgery doesn’t make muscular problems go away. Research shows that women with endometriosis have tight, sore pelvic floor muscles. These tight muscles are still there after surgery. And in fact, pelvic floor muscle tension can increase after surgery. It’s important to see a pelvic floor physiotherapist for this.

The nervous system gets over-sensitive

This is called central sensitisation, and it is common in other chronic pelvic pain conditions too like interstitial cystitis. In central sensitisation, pain and function can be improved by a type of brain retraining. My e-book Outsmart Your Pain takes you through a 12-week program of retraining your brain in chronic pelvic pain.

All that said, some women do get improvement after surgery – and I’ve seen it be life-changing at times.

Until recently, we have had no organisation in Australia to specifically support women with ongoing pelvic pain. Now, however, we have the Pelvic Pain Foundation of Australia, where you can get information and search for a health professional near you with a special interest in pelvic pain, including endometriosis.

How can we help you?

At Equilibria our focus is on alleviating the bothersome symptoms of endometriosis. But we don’t stop there. We also look at what’s going on under the surface to cause all of your symptoms. This condition is a prime example of where the combination of our approaches is ideal: physical therapies, nutritional therapies, brain retraining, reduction of oestrogen-like toxic exposure, and herbal medicine.



Mon 9am - 5pm
Tues 9am - 5pm
Wed Closed
Thurs 9am - 5pm
Fri 9am - 5pm

The A to Z of Your Pelvis

Learn all there is to know about pelvic symptoms and conditions