Endometriosis - What will happen?

If you don't get treatment

If you don't get treatment, your endometriosis could:[3] [4]

• Get gradually worse, then get better when you go through the menopause. This happens to about half the women with the disease
• Disappear on its own over the next year or so. This happens to about a third of women with mild endometriosis
• Stay about the same, then get better when you go through the menopause.

Endometriosis isn't cancer. But women who've had endometriosis for many years have a higher risk of ovarian cancer than women who don't have endometriosis. It's hard to say how high the risk is as there is no good research to tell us.[5] [6]

If your main problem is pain

Treatment should help, whatever kind of pain you have. Most women who have treatments such as contraceptive pills, medroxyprogesterone and surgery to remove endometriosis get good relief from pain.

Unfortunately, the pain often comes back sooner or later. Between 3 and 7 out of 10 women who have treatment get pain back within five years.[7] Doctors call this a relapse. We don't know how to predict who will get a relapse, and who won't. But if your pain comes back, you can have more treatment.[8]

Patches of endometriosis bleed when you have your period. So treatments that make you stop ovulating can make your endometriosis better. Contraceptive pills can help in this way. They also make your periods lighter, shorter, and less frequent. And most women with endometriosis have less pain during pregnancy (when they don't have periods). But the pain often comes back again a few months after the birth.

Some women have surgery to remove their womb or ovaries. This often makes the pain go away and stay away. But this kind of surgery is a last resort. It brings on the menopause and you won't be able to have children after the operation. Women who choose this treatment are usually older, don't want any more children and have had painful endometriosis for a long time.[1]

Endometriosis gets better on its own once you reach the menopause. This is because your body produces less oestrogen, the hormone that makes endometriosis grow. And you stop having periods, so the endometriosis shrinks.

If your main problem is not being able to get pregnant

It's less clear how well treatment works for women who have problems getting pregnant. It may depend on how bad the endometriosis is and also what treatment you have. One study showed that nearly 1 in 3 women with endometriosis were able to get pregnant after having surgery.[9]

Many women with endometriosis have children without having had any treatment. We don't know how many because many cases of endometriosis are undetected. But in the study mentioned above, nearly 1 in 5 women who had been diagnosed with endometriosis went on to get pregnant without any treatment.[9]

To find out more, see Treatments for women with endometriosis in our section on fertility problems.