It is not OK or normal to have severe period pain. Also, if the pain is so severe that you are missing school, work and other activities, you should get help.
If you think you have endometriosis, see your doctor who can refer you to a specialist gynaecologist. It is important not to delay seeing your doctor, as early diagnosis and treatment may reduce the severity of the disease. It is also important to know that many women often do not get a correct diagnosis for seven to ten years, because the symptoms can vary between women and can change over time. Diagnosis can also be delayed by period pain often being seen as normal by both the community and health professionals.
How is endometriosis diagnosed?
At present, laparoscopy is the only way to diagnose endometriosis correctly. This is an operation, under an anaesthetic, in which a thin telescopic tube with a light (a laparoscope) is inserted into the abdomen through a cut in the belly button, allowing the gynaecologist to see if there is any endometrial tissue within the pelvis. Some or all of the visible tissue is removed so it can be examined under a microscope to confirm a diagnosis of endometriosis.
Stages or grades of endometriosis
The American Fertility Society has created a staging (or grading) system for endometriosis. This system allows surgeons to record the location, extent and depth of endometriosis implants, the severity and presence of adhesions, and also ovarian endometriomas seen during surgery. Endometriosis may be classified as mild or minimal, moderate or severe and can also be listed as a grade or stage I through to IV.
The staging system is useful, but has its limitations, as the level of endometriosis present does not correlate to the severity of symptoms a woman may experience. A woman with stage I endometriosis could be in just as much pain, or more, as a woman with stage IV endometriosis.
|Stages of endometriosis||What this means|
|Stage I – mild or minimal||There are small endometrial patches/plaques, inflammation and mild adhesions|
|Stage II – mild||
As above but also there are:
|Stage III – moderate||As above, but also with adhesions involving the ovaries|
|Stage IV– severe||
As above, but also there are:
Information your doctor will need
If you think you have endometriosis, keeping a diary of your symptoms is a good way to help your doctor or gynaecologist find out what is wrong. Your doctor may ask questions as part of the diagnosis, so having all of the information ready will help.
Revised American Society of Reproductive Medicine Classification of endometriosis: 1996 Fertil Steril. 1997;67: 817-21
Last updated 08 November 2018 — Last reviewed 06 October 2016
This web page is designed to be informative and educational. It is not intended to provide specific medical advice or replace advice from your health practitioner. The information above is based on current medical knowledge, evidence and practice as at October 2016.