Endometriosis

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10% of female patients have endometriosis

When endometrial-like tissue grows in areas other than the uterus, it’s known as endometriosis. Unlike the uterine lining that builds up then sheds leaving the body during menstruation, endometrial lesions shed but the tissue has nowhere to go. This results in pain & inflammation and eventually scarring & adhesions.  

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85% of patients have "superficial disease"

Endometriosis subtypes include superficial disease (small, flat lesions <5mm), endometriomas (ovarian), deep-infiltrating (DIE) and extra-pelvic endometriosis. Current imaging technologies like TVUS & MRI often miss superficial disease. Becuase of this, the gold standard for diagnosis remains a laparoscopic surgery.

8.6 year diagnostic gap globally

Need for surgery to make a diagnosis helps explain a near decade-long gap between first onset of symptoms and receiving a diagnosis. A lack of TIER-1 testing to provide doctor’s with clinical decision support, plus varied symptoms that overlap with other diseases, have meant diagnosis is a long and invasive process.  

80+ symptoms

Dysmenorrhea, dyspareunia, dyschezia, dysuria are the 4 D’s, however research reports bloating as the most common symptom. IBS is commonly diagnosed. Often symptoms worsen during menstruation, but pain can also be chronic. Or non-existent, in the case of silent endometriosis.

Infertility & Miscarriage and Risks in Pregnancy

30 – 40% of women with endometriosis will experience infertility.  The disease also raises risk for some pregnancy complications. 

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Causes are still not understood

Retrograde menstruation, immune system dysfunction, environmental exposures, and genetic predisposition are a few of the proposed theories of causes of endometriosis.

7x genetic risk

Research shows patients with an affected close relative are seven times more likely to develop endometriosis.

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Diagnostic Tests for Endometriosis

Although endometriosis is not presently curable, it can be diagnosed and treated. With awareness, education and early detection efforts including TIER-1 testing, we can drop the women’s health gap. The goal of improving quality of life and long term health for women with endometriosis is achievable so these women can  lead healthy, productive, and active lives.

Gynecologists who are experienced in working with endometriosis may be able to offer a preliminary diagnosis of endometriosis based on symptoms, pain mapping exams, and/or ultrasound findings.

Superficial peritoneal endometriosis often cannot be seen on ultrasound or MRI and until now, the only way to definitively diagnose that type of endometriosis was through a laparoscopy. Electroviserography (EVG) testing, most similar to an ECG but for the gut,  can now diagnose all subtypes of endometriosis non-invasively in 30-minutes.

Advanced dynamic pelvic ultrasound (TVUS) or MRI can also detect advanced stages of endometriosis (DIE and/or endometrioma cysts in the ovaries). These TIER-2 testing tools are useful for diagnosing advanced disease, identifying advanced disease subtype and stage, and for locating lesions in preparation for surgical excision. 

Medical treatments are available, including non-hormonal and  non-prescription options.  Lifestyle changes such as diet and exercise are extremely important in reducing the impact of inflammation.

If symptoms persist and are severe, surgical treatments can be very effective and offer very good outcomes when the gynecologist is trained to provide advanced laparoscopic excision of endometriosis.

Pelvic pain and other symptoms may not completely disappear post surgery. Contributing factors may need to be addressed, such as immune system, musculoskeletal, bowel/bladder, vaginal/vulvar, psychosocial and nervous system dysregulation. 

“I was trying to get pregnant for quite a while, trying to figure out what the root issues were. I was able to get an ENDOSURE referral from my practitioner and get the test right away. It was painless, super simple and they were able to figure out that I had endometriosis, which was amazing because we were trying to figure out what was going on. I was able to get surgery and through surgery I was able to get pregnant….this test is incredible.”

Nathalie

Vancouver, BC

Endometrial-like tissue (the uterine lining that is built up and then shed with each menstrual cycle) growing in areas other than the uterus is known as endometriosis. This condition occurs in 10% or more of women of reproductive age. 
The exact causes are still not yet fully understood. Immune system, environmental exposures, and genetic predisposition are a few of the proposed theories. If you have an affected close relative, research has shown that you are seven times more likely to develop endometriosis.
Symptoms of endometriosis vary among among women, with some having no recognized outward signs or symptoms. The most common symptom is pelvic pain, which is called dysmenorrhea because it occurs during menstruation. Pain may occur at times other than the period, for example at time of ovulation, during sexual intercourse, with urination or bowel movements, and in some cases when breathing. Other symptoms of endometriosis can be diarrhea or constipation (often at the time of the menstrual period), abdominal bloating, IBS, heavy periods, fatigue, anxiety/depression, and in some cases infertility or miscarriage.
Experiencing pelvic pain does not necessarily mean you have endometriosis. In fact, some women with endometriosis do not have pelvic pain or any symptoms at all. It is important for a woman who has persistent pelvic pain to see a health care provider such as a physician or physiotherapist with specialized experience in endometriosis and pelvic pain.
A woman’s reproductive years occur between the onset of the first menstrual period (menarche) and the last menstrual period (menopause). This is when endometriosis can develop.
Predicting whether you will have infertility depends on two things: the severity of the disease and how long it has been present. A common misconception is that having a baby or reaching menopause can “cure” endometriosis. While 30 to 40% of women with endometriosis will experience infertility, 
60 to 70% of women with endometriosis are still able to achieve pregnancy. However, endometriosis is a risk for some pregnancy complications, and this should be discussed with your primary care provider.
Gynecologists who are experienced in working with endometriosis may be able to offer a preliminary diagnosis of endometriosis based on symptoms, pain mapping exams, and/or ultrasound findings. Some types of endometriosis (superficial peritoneal) cannot be seen on ultrasound or MRI and until now, the only way to definitively diagnose that type of endometriosis was through a surgical procedure called a laparoscopy. Electroviserography (EVG) testing can now diagnose superficial and deep endometriosis non-invasively. In addition, advanced dynamic pelvic ultrasound or MRI can also allow the detection and diagnosis of advanced stages of endometriosis (deep disease and/or endometrioma cysts in the ovaries). Other associated painful conditions such as adenomyosis may also be diagnosed. 
Endometriosis medical treatments are available, including non-hormonal and  non-prescription options.  Lifestyle changes such as diet and exercise are extremely important in reducing the impact of inflammation. If symptoms persist and are severe, surgical treatments can be very effective and offer very good outcomes when the gynecologist is trained to provide advanced laparoscopic excision of endometriosis.
While surgeons can remove endometriosis, pelvic pain and other symptoms may not completely disappear. There are often many contributing factors to chronic pelvic pain that need to be addressed, such immune system, musculoskeletal, bowel/bladder, vaginal/vulvar, psychosocial and nervous system factors. Including a health care team approach in managing chronic pelvic pain is necessary to address all factors involved.
Although endometriosis is not presently curable, through awareness, education and early detection efforts we can drop the health gap for early diagnosis and treatment. The goal of improved quality of life and long term health are achievable, and women with endometriosis can still lead healthy, productive, and active lives.
BC Women’s Hospital + Health Centre. Pelvic pain/endometriosis. https://www.bcwomens.ca/health-info/sexual-reproductive-health/pelvic-pain-endometriosis. Accessed December 18, 2025.