Endometriosis is a condition in which tissue similar to the lining of the uterus is found outside the uterus. Symptoms vary widely. They may include pelvic pain, painful periods, pain during sex, bowel or bladder discomfort around menstruation, heavy bleeding or difficulty becoming pregnant. Some people have few or no symptoms.
There is no single symptom that proves endometriosis. Evaluation usually begins with a detailed conversation, examination and appropriate imaging. Laparoscopy may be considered in selected situations, but the pathway should reflect the severity of symptoms, previous treatment, fertility plans and personal preferences.
Treatment can include pain relief, hormonal medicines, surgery or a combination of approaches. Surgery is not automatically the first or only choice. A thoughtful plan balances symptom control, fertility goals, previous procedures and the possible benefits and risks of each option.

