Top 5 things people get wrong about endometriosis

Endometriosis is a chronic condition where tissue similar to the lining of the uterus grows outside the uterus, causing pain, inflammation and sometimes infertility. Despite affecting an estimated 1 in 10 women and people assigned female at birth worldwide, it remains widely misunderstood. Here are the top five things people often get wrong about endometriosis—and what you need to know.

1. “It’s Just Really Bad Period Cramps”

Many people assume that excruciating menstrual cramps are normal. In reality, while mild discomfort can accompany menstruation, true endometriosis pain is often:

• Severe enough to interfere with school, work or daily activities
• Present before, during and even after your period
• Associated with pain during sex, bowel movements or urination

Why it matters:
• Normalizing extreme pain delays diagnosis by years.
• Early treatment can prevent disease progression, reduce pain and protect fertility.

If your cramps leave you bedridden or require prescription pain meds, don’t write it off as “just a period.” You might consider doing a free, online symptom check for endometriosis to get a better idea of your risk.

2. “You Can’t Get Pregnant If You Don’t Have Endometriosis”

The flip side of the fertility conversation is equally misleading. While endometriosis can contribute to infertility—up to 30–50% of people with endometriosis experience trouble conceiving—not everyone with endo is infertile.

Key points:

• Many people with mild or moderate endometriosis conceive naturally.
• Fertility treatments (medications, assisted reproductive technologies) often succeed.
• Early diagnosis and management improve the odds of a healthy pregnancy.

If you’re worried about fertility—whether you have endo or not—talk with a gynecologist or fertility specialist. Delaying that conversation can steal valuable time.

3. “Pregnancy or Menopause ‘Cures’ Endometriosis”

It’s a common belief that carrying a baby or reaching menopause makes endometriosis go away. Here’s the truth:

• Pregnancy can temporarily ease symptoms (thanks to hormone shifts and lack of periods), but pain often returns postpartum.
• Menopause lowers estrogen levels and may shrink lesions, but residual endometriosis cells can stay active—especially if you’re on hormone replacement therapy.

Bottom line: Pregnancy is not a treatment plan, and menopause isn’t a guaranteed cure. Ongoing care—medical or surgical—is often needed to manage symptoms long-term.

4. “Hysterectomy Is the Only Way to Beat It”

A hysterectomy (removing the uterus, sometimes with ovaries) is a radical step. While it can relieve symptoms for some, it’s not a one-size-fits-all solution:

• Conservative surgery (laparoscopy) to remove endometriotic lesions and scar tissue often eases pain while preserving fertility.
• Hormonal therapies (birth control pills, progestins, GnRH agonists) can control symptoms without major surgery.
• In cases of severe disease, hysterectomy may be appropriate—but only after exhausting less invasive options and when childbearing is complete.

Discuss all surgical and medical choices with a specialist who understands endometriosis—ideally a gynecologic surgeon with endo expertise.

5. “Endometriosis Only Affects the Pelvis”

Endometriosis is more than a “uterine issue.” It can involve multiple organs and systems, causing a wide array of symptoms:

• Bowel and bladder involvement: painful bowel movements, diarrhea, constipation, painful urination or blood in urine.
• Advanced disease: lesions on the diaphragm or lungs can cause chest pain and difficulty breathing.
• Immune and inflammatory effects: chronic fatigue, joint pain or even autoimmune symptoms in some cases.

Because endometriosis can masquerade as irritable bowel syndrome, interstitial cystitis or other conditions, a multidisciplinary approach (gynecology, gastroenterology, urology, pain management) often yields the best results.

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Take-Home Messages

• Don’t accept “bad cramps” as normal—seek evaluation if period pain disrupts your life.
• Endometriosis doesn’t automatically equal infertility; many people with endo do conceive.
• Pregnancy and menopause aren’t cures—endometriosis often requires ongoing management.
• Hysterectomy is not the only treatment; conservative surgery and hormones may control symptoms.
• Endometriosis can affect more than the pelvis—comprehensive care is key.

If you suspect endometriosis—or if your symptoms are severe, worsening or spreading—speak to a doctor. Early recognition and personalized treatment can improve quality of life, protect fertility and prevent complications. If you ever experience sudden, intense abdominal pain, heavy bleeding, fever or signs of infection, seek emergency medical care immediately.