Endometriosis

What is endometriosis?

Endometriosis is a long-term gynaecological condition that can cause chronic pelvic pain, painful periods, and other symptoms that may affect daily life. It occurs when tissue similar to the lining of the womb grows outside the uterus. Endometriosis affects around 1 in 10 women and girls of reproductive age, but it can affect women in any stage of life. 

When left untreated or poorly managed, endometriosis can have a significant impact on physical wellbeing, mental health, and fertility. Although there is currently no cure, early diagnosis and specialist led treatment can help control your symptoms, reduce pain, and improve your quality of life.

As part of our private, world-leading gynaecology services, our women’s health specialists offer expert diagnosis, personalised treatment plans, and ongoing support for women living with endometriosis.  You can access dedicated endometriosis care at Guy’s Hospital and St Thomas’ Hospital. 

How endometriosis affects the body

Usually, endometrial tissue is only found in the lining of the uterus (also called the womb or endometrium). However, in endometriosis, endometrial tissue grows outside the uterus in other body areas and organs.  

Endometrial tissue will typically grow on or around the reproductive organs, including the: 

• fallopian tubes 
• ligaments around the uterus 
• pelvic cavity lining 
• ovaries 
• outside surface of the uterus 
• space between the uterus and the rectum or bladder 

Less often, endometrial tissue will grow in other areas and organs in the body, such as the: 

• bladder 
• cervix 
• intestines 
• rectum 
• stomach (abdomen) 
• vagina or vulva 

During your menstrual cycle, endometrial tissue thickens before breaking down and bleeding during menstruation (your period). The tissue grown outside the uterus cannot leave the body, becoming trapped.  

This process can inflame the surrounding tissues and lead to cysts (endometriomas) and scar tissue that can cause tissues and organs to stick together. The symptoms can include severe pain, and it can be harder to get pregnant naturally.

If you have endometriosis and would like to talk through your symptoms or explore treatment options, our specialists are here to support you. Complete the form on this page to arrange an appointment and speak with one of our experienced consultants.

What are the symptoms of endometriosis? 

Endometriosis symptoms differ for each person – some people will notice symptoms, while others won’t. As a result, endometriosis is challenging to diagnose in some cases. 

The symptoms of endometriosis are usually most severe during your period. You may notice: 

• severe period cramps that stop you from going about your normal day – learn more about period problems and the treatments we offer here
• very heavy periods where you must change your pad or tampon regularly, or you may even bleed through to your clothes 
• pain when you wee or poo 

You may also have symptoms at other times during your cycle, including: 

• bleeding or spotting between periods 
• bloating or nausea 
• difficulty getting pregnant (infertility)
• extreme tiredness (fatigue) 
• low mood or anxiety 
• pain during or after sex 
• pain in your lower tummy and back (pelvic area) 

Endometriosis can impact your life and be distressing. If you are experiencing any of these symptoms, our expert gynaecologists can help diagnose and treat your conditions. 

Endometriosis and fertility 

Endometriosis can make it harder to get pregnant, but its effect on women’s fertility varies – find out about the symptoms and treatments available for female infertility here. Some will need medical treatment to help them conceive and others won’t.

Endometriosis causes scarring within the pelvis and can therefore block the egg’s natural journey from the ovary into the uterus, affecting fertility. 

If you have endometriosis and are thinking of starting a family, our fertility specialists can tailor a personalised treatment plan to give you the best chance of becoming pregnant. 

Endometriosis and maternity 

Many women with endometriosis who become pregnant often find relief from their symptoms as their periods stop during pregnancy.  

However, pregnancy does not cure endometriosis. Your periods will start again and your symptoms will return after delivering your baby and once you have stopped breastfeeding. Discover more about endometriosis and pregnancy in our latest news article.

Our maternity team will work with you to create a postnatal endometriosis management plan. It can help you manage your symptoms as much as possible and may include hormonal contraceptives that control endometriosis symptoms effectively. 

What causes endometriosis? 

No one knows the cause of endometriosis, but medical research and studies have led to several theories: 

• during your period, endometrial tissue may flow back through your fallopian tubes and into your ovaries and tummy, rather than through the vagina and out of the body, leading to it implanting and getting trapped in your pelvis 
• cells from the endometrium may travel through your blood or lymphatic vessels to other locations in your body, where they begin to grow 
• cells outside your uterus may change into endometrial cells and start to grow 
• the condition may be inherited genetically 

If you experience symptoms of endometriosis and think you have the condition, our women’s health specialists can help. Contact our customer services team to book an appointment with one of our consultants. 

Diagnosing endometriosis 

Endometriosis can be challenging to diagnose as the symptoms are similar to other conditions like adenomyosis, fibroids (find out more about fibroids here), pelvic inflammatory disease (PID) and irritable bowel syndrome (IBS). Therefore, tests are often needed to confirm whether you have endometriosis. 

Our world-class consultants offer an in-depth consultation. They will perform a physical examination, ask questions about your medical history and symptoms.

Based on their findings, your consultant may arrange an ultrasound of your uterus and ovaries to check for signs of endometriosis. They will also look for ovarian cysts and fibroids which can cause similar symptoms to endometriosis. 

You may need further investigative procedures like a laparoscopy (keyhole surgery). This surgical procedure involves inserting a camera into your tummy through a small cut to take a detailed look inside your body, identify signs of endometriosis, and treat it. 

Treating endometriosis 

We can treat endometriosis non-surgically and surgically. Your consultant will always explore the least invasive options first. 

Treatments for endometriosis include: 

• medications, such as painkillers like paracetamol and ibuprofen 
• using contraceptive and hormone medications to extend the time between periods, to allow your body to heal in the areas affected by endometrial growth and reduce pain 
• laparoscopic (keyhole) surgery to remove the endometrial tissue or ovarian cysts caused by endometriosis 
• a hysterectomy to remove all or part of your womb, or an oophorectomy to remove your ovaries 
• surgery to remove part of your bladder or bowel if they have been affected  

Support is also available to help you manage other effects of endometriosis, such as: 

• advice on managing long-term pain and fatigue 
• a referral to a fertility specialist for help getting pregnant 
• mental health support for low mood or anxiety 

Your gynaecologists will discuss all options depending on your symptoms, the severity of your condition and your lifestyle to find the treatments and support that suit you. 

If you are concerned about endometriosis and would like to talk through your symptoms or next steps, complete the form on this page to speak with one of our women’s health specialists.