Endometriosis – Symptoms, Diagnosis & Treatment

Endometriosis is a little-known condition – but the reality is that it around one in 10 women of fertile age are affected to some extent.

Learn more about it, including the symptoms to look out for.

What is endometriosis?

Endometriosis is the name given to the condition where tissue, similar to the lining of the womb, starts to grow in other parts of the body. It can appear on the ovaries, fallopian tubes, inside your tummy, in or around the bladder or bowel, or on a Caesarean scar. 

While the tissue in your womb can leave your body as a period each month, endometriosis tissue has nowhere to escape to. This can cause inflammation, pain and the growth of scar tissue. 

It's a long-term condition, thus endometriosis and its symptoms can have a big impact on the quality of a woman’s life.

What causes endometriosis?

The exact cause of endometriosis remains unknown. Endometriosis is most commonly attributed to retrograde menstruation - an abnormality where menstrual fluid flows back into the pelvic cavity rather than being expelled. 

It can also be caused by hormonal imbalance, immune system problems, surgical scars or genetics.

Is endometriosis genetic?

Genetics has been quoted as one of the causes of endometriosis. According to NHS, the condition tends to run in families and can affect people of certain ethnic groups more than others. Researchers at the University of Oxford also shared strong evidence that the shared genetic basis for endometriosis does run in families.

Who’s at risk?

Endometriosis can affect anyone born with a womb from the time they start their period. Endometriosis UK reports that as many as 1.5 million women in the UK are currently living with it.

Can you get endometriosis at any age?

Endometriosis can affect anyone born with a womb at any age. It is less common in those who have been through the menopause.

What are the main signs to look out for?

Consultant gynaecologist at Benenden Hospital Mr Rowan Connell outlines the symptoms and treatment options for this hard-to-diagnose condition.

• Pelvic pain

  Pain often starts as a dull ache in the lead-up to a period and worsens when bleeding begins. If there’s endometriosis on an ovary, you may have mid-cycle pain on one side, and perhaps down your leg, when an egg is released. You may also have pain during and after intercourse due to it pulling on internal adhesions caused by the scar tissue.

• Heavy periods

  Endometriosis can cause long and heavy periods, and sometimes bleeding between periods.

• Bowel and urinary problems

  Endometrial tissue is sometimes found on the rectum and bladder and this can cause painful bowel movements or urination, and occasionally bleeding. The inflammation can also lead to spasms in the digestive tract and diarrhoea, which may be mistaken for Irritable Bowel Syndrome.

• Tiredness and depression

  Endometriosis can cause tiredness, lethargy and low mood. This is partly due to the unpleasant symptoms but also because the inflammation prompts your immune system to work overtime.

• Problems conceiving 

  Although it doesn’t usually block the fallopian tubes, endometrial tissue around the reproductive organs can make it harder for sperm to reach the egg.

What are the symptoms of endometriosis?

There are a range of endometriosis symptoms, and they can vary widely from one person to another. Some are badly affected, while others notice very few signs. The most common symptoms are:

• Heavy or irregular periods.

• Pain during or after sex.

• Difficulty getting pregnant.

• Painful bowel movements during your period.

• Lack of energy.

You can also have intensely painful periods. Unlike normal period pain, it can take its toll on your everyday life.

But don’t forget, these symptoms could have other causes, too.

How is endometriosis diagnosed?

If you think you may have endometriosis, it’s a good idea to share your symptoms with your GP, as soon as possible. The symptoms can be similar to those of other conditions, so a diagnosis can take time.

Your GP will ask you about your experience and discuss appropriate treatment options. They might also refer you to a specialist, as the only way to get an accurate diagnosis is by a laparoscopy. This is an operation where a camera is passed through a small cut in your tummy, so the surgeon can have a look for signs of endometriosis. 

What treatments are available in the UK?

There’s no cure for endometriosis, but there are possible UK-based endometriosis treatments, which can help relieve symptoms and improve your quality of life. Your GP can talk you through the options, they can include:

• Painkillers.

• Hormone medicines.

• Surgery.

Deciding on the right treatment for you depends on a few things – your age, your main symptoms, whether you want to become pregnant and your feelings about surgery. If you’re getting near to the menopause, symptoms may get better without treatment.

Find out more

If you’re concerned about any potential symptoms, you can make an appointment to see your GP. Alternatively, if you're a Benenden Health member, you can call our helpline for medical advice from a qualified UK-based GP, 24 hours a day, 7 days a week. Learn more about our 24/7 GP Helpline service. 

Endometriosis UK also offers support, information and a community for those affected, through their website.

You can read more about endometriosis through the NHS too.

Visit our Women's Health Hub for more articles on women's health, including women hair loss, ovarian cancer, things that happen to your breasts as you age and many more.

Medically reviewed by Llinos Connolly in March 2024.