Endometriosis and back pain: a frequently missed cause of cyclical pelvic and lower back pain
Cyclical back or pelvic pain that worsens around your period?
The myBackPain assessment screens for the cyclical back pain pattern associated with endometriosis — a diagnosis with an average 7–8 year delay that deserves to be found sooner. Results in minutes.
What is endometriosis?
Endometriosis is a condition in which tissue similar to the lining of the womb grows outside the uterus — most commonly on the ovaries, fallopian tubes, the tissue lining the pelvis, and occasionally on the bowel, bladder, and rarely beyond the pelvis. This tissue responds to the menstrual cycle, thickening and breaking down with each period, but has nowhere to go, causing inflammation, scarring, and pain.
Endometriosis affects approximately 1 in 10 women of reproductive age. The average time from first symptoms to diagnosis is 7–8 years — a reflection of how commonly it is dismissed, misdiagnosed, or attributed to other causes including back pain.
Lower back or pelvic pain that is worse around your period • Painful periods (dysmenorrhoea) alongside back pain • Pain during or after sex • Difficulty conceiving • Cyclical bowel or bladder symptoms alongside pelvic pain • Back pain that has been investigated without a clear mechanical cause.
How endometriosis causes back pain
Diagnosis and treatment
Endometriosis is notoriously difficult to diagnose from symptoms and examination alone. Transvaginal ultrasound and MRI can identify ovarian cysts (endometriomas) and deep infiltrating disease. Definitive diagnosis requires laparoscopy — surgical inspection of the pelvis. This is why diagnosis is often delayed: the definitive test is invasive, and many clinicians wait too long before referring for it.
Treatment depends on severity and the woman’s priorities. Hormonal suppression (the combined pill, progesterone, GnRH analogues) reduces endometriosis activity and symptom severity. Surgical removal of deposits significantly reduces pain in many cases. Pain management and physiotherapy address the musculoskeletal and sensitisation components.
The assessment screens for the cyclical pain pattern that should prompt consideration of endometriosis — back pain that reliably worsens around the period, associated pelvic symptoms, and a female patient whose back pain has not responded to standard mechanical management. If this pattern fits, the report will direct you toward GP assessment for investigation.
Cyclical back or pelvic pain that hasn’t been explained?
The myBackPain assessment screens for the endometriosis pattern — and directs you toward the right investigation pathway if the features fit.