Endometriosis: When to Seek Help and What to Expect from Treatment

If pelvic pain, painful periods, or pain with sex are disrupting your life, you’re not alone - and you don’t have to put up with it. Endometriosis is a common, chronic condition that can affect every aspect of wellbeing, from work and study to relationships, sleep, fertility and mental health. The good news: there are proven medical and surgical treatments, and with a tailored plan you can reclaim comfort, confidence, and control.

What is Endometriosis?

Endometriosis occurs when tissue similar to the lining of the uterus grows outside the uterus - often on the ovaries, pelvic ligaments, bowel or bladder - triggering inflammation, scarring and pain. While the exact cause isn’t fully understood, it’s a chronic inflammatory gynaecological condition that can be effectively managed with the right care.

Common Symptoms (and Why They Matter)

You might recognise one or more of these symptoms:

• Severe period pain (dysmenorrhoea) or pelvic pain throughout the cycle

• Pain with sex (dyspareunia) - during or after intercourse

• Heavy or irregular bleeding

• Bowel or bladder symptoms (e.g., pain with bowel movements, constipation, diarrhoea, urinary pain)

• Fatigue, back pain, sleep difficulty, headaches

• Fertility challenges

These symptoms vary widely - from minimal discomfort to debilitating pain - and a normal pelvic exam or ultrasound does not rule out endometriosis, which is why a careful, evidence‑based assessment is essential.

If pain interferes with your life, seek care. Early assessment and treatment can reduce the impact on quality of life and future health.

How We Diagnose Endometriosis

At your first consultation, Dr Walker will take a comprehensive history and perform a gentle pelvic examination where appropriate. Depending on your symptoms, the diagnostic plan may include:

• Transvaginal ultrasound (first‑line imaging). If not appropriate, a trans‑abdominal ultrasound may be used.

• Specialist pelvic ultrasound or MRI when deep endometriosis is suspected or standard imaging is inconclusive.

• Diagnostic laparoscopy (keyhole surgery) may be considered if symptoms persist after a trial of medical treatment - even when ultrasound or MRI are normal.

Dr Walker emphasises shared decision‑making and trauma‑informed care throughout the process.

Treatment Options: Tailored to You

Evidence‑based care often combines medical therapy, lifestyle support, allied health, and - where appropriate - minimally invasive surgery.

Medical (Non‑Surgical) Management

• Hormonal therapies (e.g., combined oral contraceptives, progestins) are first‑line to reduce pain and suppress endometriosis activity.

• Pain relief may include short courses of NSAIDs (e.g., ibuprofen) and paracetamol.

• Adjunct therapies such as physiotherapy (for pelvic floor muscle pain and spasm) and psychological support can improve outcomes when combined with medical treatment.

Surgical Management

When symptoms persist or imaging suggests disease requiring operative management, laparoscopic (keyhole) surgery can remove or excise endometriosis lesions and free adhesions to reduce pain and improve function. Choice of surgery is personalised and balances symptom control, fertility goals, and recovery time.

Surgery is not a cure, but for many people it’s a vital part of a comprehensive plan alongside medical therapy and rehabilitative support.

Meet Dr Scott Walker: Gynaecologist & Pelvic Pain Advocate

Dr Scott Walker is an experienced Gynaecologist - and former physiotherapist - who provides holistic, patient‑centred care for pelvic pain conditions, including endometriosis and adenomyosis.

• Advanced laparoscopic & hysteroscopic surgeon: meticulous, safety‑first approach to excision of endometriosis, removal of adhesions, and minimally invasive procedures such as total laparoscopic hysterectomy, ovarian cyst surgery, salpingectomy, fibroid and polyp removal, uterine septum correction, and endometrial ablation for heavy periods.

• Comprehensive pelvic pain care: integrates evidence‑based medical therapies with multidisciplinary support (pelvic floor physiotherapy, pain management strategies).

• Certified Colposcopist & Vulval Disorders Lead: expertise in managing abnormal cervical screening results and conditions such as vulvodynia, pelvic floor muscle spasm, painful sex, lichen sclerosus, and vulval/vaginal cellular abnormalities.

• Approachable and advocacy‑focused: ensures patients feel heard, respected, and empowered during every step of care.

What to Expect at Your First Appointment

1. Listening first: We start by understanding your symptoms, history, goals (e.g., pain relief, fertility, returning to sport or study).

2. Gentle examination & targeted tests: Only what’s necessary, explained clearly.

3. A clear plan: You’ll leave with an individualised management plan - this may begin with hormonal therapy, short‑term analgesia, allied‑health referrals, and a timeline to review benefits. If symptoms persist, we’ll discuss the role of specialist imaging or laparoscopy.

Fertility and Endometriosis

Endometriosis can be associated with fertility challenges. Management focuses on pain control while optimising reproductive goals - which may include medical therapy, surgical excision in selected cases, and coordination with fertility specialists when appropriate. Decisions are made collaboratively, guided by the latest evidence and your priorities. 

Our Care Philosophy

• Evidence‑based: We follow the Australian Living Evidence Guideline for Endometriosis - kept up to date and endorsed for primary and specialist care - so your plan reflects the best current recommendations. [

• Holistic: Pain is multidimensional; we incorporate pelvic floor physio, lifestyle strategies, and psychological support alongside medical or surgical care.

• Shared decisions: We prioritise your preferences, explain options clearly, and review progress together.

Ready to Take the Next Step?

If you suspect endometriosis - or you’ve been living with pelvic pain and would like a second opinion - book a consultation with Dr Scott Walker. We’ll work with you to build a plan that’s safe, precise, and personal, aiming for a faster return to normal life.

Please bring any previous imaging, laparoscopy reports, and a list of current medications.

Helpful, Trusted Resources

• RANZCOG: Endometriosis patient information (PDF) — clear overview of symptoms, diagnosis and management. [ranzcog.edu.au]

• RANZCOG: Australian Living Evidence Guideline—Quick Reference for Primary Care (PDF) — what to expect in assessment and first‑line treatments. [ranzcog.edu.au]

• RANZCOG: Endometriosis clinical practice guideline (overview) — how specialists apply current evidence. [ranzcog.edu.au]

Disclaimer

This article provides general information and does not replace medical advice. Please seek personalised guidance from a qualified healthcare professional. (Guidelines are regularly updated; our practice keeps recommendations current.) [ranzcog.edu.au]