Endometriosis: Symptoms, Diagnosis and Treatment Options

Endometriosis is a common condition where tissue made of cells similar to the lining of the womb grows elsewhere in the pelvis. Around 1 in 10 women are affected.

You May Have Endometriosis if:

• You have severe pelvic pain, especially during the first two days of your period.
• You have pain during sex.
• You have heavy bleeding that soaks through clothing.
• You have bowel symptoms that are painful during your period.
• You have had trouble getting pregnant.
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Symptoms vary widely. Some women have severe pain, while others experience milder or intermittent symptoms. Symptoms can start in the teenage years. Endometriosis often improves as a woman becomes menopausal. However, HRT may keep symptoms active, as hormones can influence endometriosis growth.

One important thing to note: painful periods that stop women living normal lives are not something to “just put up with”. Many women report seeing clinicians and being told “it’s normal” or “it’s part of menstruation”. On average, it takes around 10 years for women with endometriosis to receive a diagnosis. This needs to change.

If you’d like support with symptoms such as pelvic pain, heavy bleeding, or period-related bowel symptoms, you can find more information and appointment options via our Women’s Health service page.

Why Diagnosis Can Be Delayed

Women who see their GP are often referred for an ultrasound or basic blood tests as an initial screen. However, these tests may not detect endometriosis. So, even if results come back “normal”, endometriosis may still be a possibility.

A good GP will listen and can often start treatment when endometriosis is suspected. This aligns with national guidance, which advises that treatment can be offered at the first appointment - not only after a confirmed diagnosis.

If you’re ready to speak to a clinician, you can book online here.

Treatment Options

Treatment generally falls into:

• Anti-inflammatory medication (by mouth or rectally), and/or
• Hormonal treatment, to reduce monthly thickening and inflammation.

An MRI may identify endometriosis if it is advanced, but it can also miss it.

Confirming a Diagnosis

The “gold standard” way to diagnose endometriosis is a laparoscopy (a short keyhole procedure). This allows a specialist to look inside the abdomen and identify endometriosis deposits. NHS access can take time, and surgery may not feel like the right next step for everyone - but it can also allow treatment at the same time as diagnosis.

Surgical treatment involves removing endometriosis deposits, which can lead to a significant improvement in symptoms for some people.

There is also a private saliva test called the ZIWIG Endotest, which is less invasive than surgery. It currently costs around £1,000 and is reported to be around 95% accurate. If endometriosis is found, treatment may still include medication and/or surgery, depending on symptoms and response.

What Matters Most if You Think You May Have Endometriosis

• Your symptoms are valid - you don’t have to “push through” severe period pain.
• Treatment is often “trial and adjust”; we work together to find what suits you.
• Follow-up is important so you can review what’s helping and what isn’t.
• Emotional wellbeing matters too - chronic pain can be exhausting and frustrating.

For a checked symptom list and further information, Endometriosis UK is a helpful resource: https://www.endometriosis-uk.org

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