First periods & adolescence
Symptoms can begin in adolescence. Persistent or disabling period pain should be discussed with a clinician, especially when usual pain management is not helping.
Hormone health · Every stage of life
Endometriosis
Understanding pelvic pain, across every chapter of life.
A free educational guide from the Dr. Tammy Resource Library.
Explore the guide01 · Understanding the condition
What’s going on?
Endometriosis is a chronic condition in which tissue similar to the lining of the uterus grows outside the uterus. It can cause inflammation and pain, but some people have few symptoms. Pain severity does not necessarily show how extensive the condition is.
Pain that interrupts school, work, sleep, or relationships deserves attention—not dismissal as ‘just a bad period’.
Symptoms worth discussing
- Period pain that interferes with everyday life
- Pelvic pain between periods
- Pain during or after sex
- Pain with bowel movements or urination, sometimes worse around periods
Symptoms can overlap with other conditions. This list is not a diagnostic test, and not everyone has every symptom.
02 · The lifelong picture
From first periods to menopause
Reproductive years
Pain can vary with the cycle or become ongoing. Endometriosis may affect fertility, but pregnancy is possible. Evaluation and treatment should take your pregnancy goals into account.
Perimenopause
Changing cycles can make patterns harder to recognize. New or worsening pain still needs evaluation; do not assume every change is caused by the menopause transition.
After menopause
Symptoms often improve as hormone levels fall, but menopause is not a guaranteed cure. Persistent or new pelvic symptoms need assessment. Discuss a history of endometriosis when considering menopause hormone therapy.
03 · A conversation about care
Finding the cause. Considering the options.
Your clinician may review your pain and cycle history, offer an examination with your consent, and consider ultrasound or other imaging. A normal scan does not rule out all endometriosis. In some cases, laparoscopy is discussed to look for and treat lesions; the evaluation plan is individualized.
Managing pain
Pain medicines and supportive care may be discussed. Pelvic floor therapy may help associated muscle pain, but does not remove endometriosis lesions.
Hormonal treatment
Hormonal medicines may reduce cycle-related symptoms. Choice depends on health history, side effects, and whether pregnancy is desired.
Specialist or surgical care
Surgery may be appropriate for selected symptoms or fertility concerns. Discuss benefits, risks, recurrence, and fertility before deciding.
These are topics to discuss, not a personal treatment plan. Medicines and procedures have different risks and may not be appropriate for everyone.
When not to wait
Seek emergency care for sudden severe pelvic or abdominal pain, fainting, or very heavy bleeding with dizziness, chest pain, or shortness of breath. Severe pain with possible pregnancy, fever, or vomiting needs urgent assessment. Do not use this guide to rule out an emergency.
Any vaginal bleeding after menopause—including spotting or a single episode—needs prompt medical evaluation.
NHS · Bleeding after menopause04 · Make the conversation count
Your appointment notes
Questions to bring
- 1.Could my symptoms be endometriosis, or another pelvic, bowel, or bladder condition?
- 2.What can a scan tell us—and what might it miss?
- 3.How do treatment options fit my symptoms and pregnancy plans?
Notes stay on this page only; they are not sent or saved.
05 · A little more clarity
Common questions
Sources & further reading
Educational summary prepared October 2026 from the patient resources below. This new guide has not been individually reviewed by Dr. Tammy.