Overview

Endometriosis is a painful disorder that affects approximately 10% of women and girls of reproductive age, although women of any age can have it. It can cause intense pelvic and period pain and some women may experience problems conceiving however, there are options available if you experience fertility issues or are pregnant and suffer from endometriosis. 

What is endometriosis?

When you have endometriosis, the tissue that usually lines the inside of your uterus grows outside of it. Called the endometrium, in endometriosis, this tissue can grow in the ovaries, the tissue that lines the pelvis, and sometimes the bowel or the bladder.

Along with your menstrual cycle, endometrial tissue thickens, before breaking down and bleeding. The outgrowing tissue has no way to leave the body and becomes trapped, this can lead to inflammation of surrounding tissues, cysts (endometriomas) and the development of scar tissue that can cause tissues and organs to stick together.

Symptoms and causes

What are the symptoms of endometriosis?

The symptoms of endometriosis are different for each person. You may experience a range or not notice any, which is why it can be difficult for GPs to diagnose. The main ones noted are:

• pelvic pain
• stomach pain
• lower back pain
• difficulty becoming pregnant
• period pain that prevents you from engaging in everyday activities
• pain when you go to the toilet during your period
• pain during or after sex
• constipation, diarrhoea or sickness during your period
• blood in your urine during your period.

Endometriosis can also make you have heavy periods, causing you to use a lot of sanitary products, or even bleed through to your clothes. Having a long term condition that impacts your everyday life can be distressing, if you are experiencing any of these symptoms our team of expert gynaecologists can help diagnose and treat your condition.

Endometriosis and fertility

Endometriosis can affect your chances of getting pregnant. This could be due to endometriosis causing inflammation in the pelvis or damaged ovaries/fallopian tubes as a result of scarring. Just because you have endometriosis, it doesn’t mean you will have problems conceiving or need fertility treatment.

If you have endometriosis and are thinking of starting a family, our fertility specialists are on hand to tailor a treatment plan specific for you.

Endometriosis and pregnancy

Some women with endometriosis can conceive naturally without any treatment and once pregnant often find relief from endometriosis symptoms due to periods stopping in pregnancy.

After delivery of your baby and once you have stopped breastfeeding, your periods will return which can bring previous symptoms back. Our maternity team will work with you to create a postnatal endometriosis management plan, this can include hormonal contraceptives that are effective in controlling symptoms of endometriosis.

Diagnosis and treatment

Diagnosing endometriosis

Our world class consultants will conduct a full clinical examination, including asking questions about your medical history and listening to you about how you’re feeling. They may also recommend an ultrasound of the ovaries to check for ovarian cysts which can cause similar symptoms.

Depending on your condition, further investigative methods may be used like a laparoscopy. This is a surgical procedure that involves inserting a small camera to look in detail for signs of endometriosis.

Endometriosis treatment

Endometriosis can be treated both non-surgically and surgically. Your consultant will always explore the least invasive options available to treat you and your condition.

There isn’t a definitive cure for endometriosis. However, there are many treatments that can control symptoms and provide a high quality of life. These include:

• medical management such as pain killers
• using contraceptive and hormone medication to extend the time between periods to allow your body to heal the affected areas
• laparoscopic surgery to remove the endometriosis tissue
• hysterectomy to remove all or part of the womb.

Depending on your current condition, lifestyle and personal choice, our gynaecologists will discuss all options to find a treatment that suits you.

Content verified by Mr Kumar Kunde, consultant gynaecologist and obstetrician.