- Disabling period pain is not normal — it deserves investigation.
- A symptom diary shortens the diagnostic journey.
- Normal ultrasound does not exclude endometriosis.
What normal period pain looks like
Mild cramping on the first day or two of your period, responsive to paracetamol or ibuprofen, is common and physiological. It is caused by prostaglandins contracting the uterine muscle to shed the lining.
Red-flag symptoms of endometriosis
Symptoms that warrant assessment include: pain severe enough to take days off work or school; pain that starts before your period and lingers after; pain with sex (dyspareunia), particularly deep pain; painful bowel movements or urination during your period; heavy bleeding with clots; and difficulty conceiving after 12 months of trying.
- Pain that requires strong painkillers or bed rest.
- Pain during or after sex.
- Painful bowel movements or urination with your period.
- Cyclical bloating, fatigue and low mood.
- Trouble conceiving after a year.
What to do next
Track your symptoms for two full cycles using a simple diary or app. When you see your GP, ask for a pelvic ultrasound and, if pain is significant, a referral to a gynaecologist. In the UK, average time from symptom onset to diagnosis is still 7–8 years — the fastest way to shorten that is to arrive at your appointment with a clear symptom record.
Frequently asked questions
Can teenagers have endometriosis?
Yes. Severe period pain in a teenager is not 'normal' and should be investigated.
Does a normal ultrasound rule it out?
No. Superficial and early endometriosis is often invisible on ultrasound; MRI or laparoscopy may still be needed.
Does the pill cure endometriosis?
It can control symptoms, but it does not eliminate the disease. When symptoms return off treatment, the endometriosis is still there.
Could a doctor-led plan help you?
A 30-minute video consultation with Dr Berra Önsoy — reviewing your symptoms and imaging and giving you a clear personalised plan for endometriosis surgery.
Request a video consultation