This is the condition where I am most likely to send someone back to their GP with a script for what to say. Endometriosis is diagnosed late because severe period pain is normalised, and the single most useful thing I do for some people is tell them that what they are describing is not normal and should be investigated.
What makes me suspect it: pain that starts a day or two before bleeding rather than with it, pain that simple analgesia does not control, pain with sex — particularly deep pain rather than at entry — pain with bowel movements or urination during a period, cyclical bowel symptoms, and heavy bleeding. Also a family history, and a history of being told repeatedly that it is just bad periods.
What I ask you to ask for: an appointment specifically about pelvic pain, mentioning endometriosis; a pelvic ultrasound, with the understanding that a normal scan does not exclude it; and referral to a gynaecologist with an interest in endometriosis rather than a general one. Australian guidance now supports earlier referral, so this is not an unusual request.
What I then work on is narrower: pain management between cycles, the pelvic floor guarding that develops after years of pain, sleep, and the digestive side. Where the pelvic floor is the main driver I refer to a pelvic health physiotherapist, because that is their work and not mine. The clinic is in Lane Cove, opposite the library, and I write to your GP and to your specialist.
