ENDOMETRIOSIS: PERIOD PAIN IS NOT ALWAYS NORMAL 2 KEY EVIDENCE-BASED MESSAGES 1. Recognize the clinical symptoms early. - Severe dysmenorrhea affecting daily activities. - Chronic pelvic pain and deep dyspareunia. - Infertility or difficulty conceiving. - Dyschezia, dysuria or cyclical bowel and urinary symptoms. - Endometriosis can be present even when pelvic examination or ultrasound is normal. 2. Individualize diagnosis and treatment. - Transvaginal ultrasound is an important first-line imaging investigation for suspected endometriosis. - A normal ultrasound does not exclude superficial peritoneal endometriosis. - Hormonal treatment, including progestogens, can help control pain in appropriate patients. - Laparoscopic surgery should be individualized, particularly when infertility, endometriomas or deep endometriosis are present. - Consider ovarian reserve and fertility goals before ovarian endometrioma surgery. KEY TAKE-HOME MESSAGE Severe period pain is not something women should simply tolerate. Early recognition, appropriate imaging and individualized treatment can improve quality of life and fertility planning. Evidence sources - ACOG — 2026 Clinical Practice Guideline: Diagnosis of Endometriosis. - NICE — Endometriosis: Diagnosis and Management. - ESHRE — Endometriosis Guideline. #SUNLEAFWOMENSCARE #ENDOMETRIOSIS #ENDOMETRIOSISAWareness #SEVEREPERIODPAIN #DYSMENORRHEA #PELVICPAIN #INFERTILITYAWARENESS #LAPAROSCOPICSURGERY #WOMENSHEALTH #GYNECOLOGY #SURAT #SART HANA #VARACHHA