Endometriosis

Endometriosis happens when the type of tissue that normally grows inside the womb also grows outside on other organs in the body. It is most common in women in their 30s and 40s with symptoms usually improving during and after the menopause. In most cases, endometriosis affects the:

It can also affect the:

In very rare cases, it can also affect other parts of the body including the lungs, skin and brain.

What are the symptoms?

These include:

  • Very painful periods, often becoming worse as time goes on
  • Lower back and pelvic pain
  • Pain during/after sex
  • Stomach pain, including pain when having bowel movements or urinating during periods. You may also have diarrhoea, bloating, constipation, or nausea during periods
  • Spotting/bleeding between periods
  • Fatigue
  • Fertility problems

How is it diagnosed?

Endometriosis is diagnosed in a number of ways:

  • A pelvic examination: this is when the doctor will feel for larger affected areas, including cysts
  • Ultrasound: this can show if the endometriosis has affected your ovaries, causing cysts
  • Laparoscopy: this is the most effective way to check the extent of endometriosis inside your abdomen. It involves having a light anaesthetic and then a thin tube with a camera is inserted through a tiny hole in your abdomen to examine the area

How is it treated?

Although it is not yet possible to cure the condition, medication that contains hormones can be used to control endometriosis and sometimes you may be offered surgery to remove some of the tissue to improve your fertility.

  • Painkillers: in some cases, over-the-counter pain relief can help or, in some cases, stronger prescription painkillers
  • Hormone medication: this can include the contraceptive pill and other hormonal medication
  • Surgery: laparoscopy and laparotomy (types of keyhole surgery). The most commonly used type of surgery is laparoscopy which is usually combined with laser surgery to target and precisely remove the small growths in the pelvis or abdomen. Laparotomy involves making a larger cut in the abdomen and is used if the endometriosis is very extensive and involves very large cysts being removed

Endometriosis and infertility

Endometriosis can cause infertility, especially if it damages the ovaries or fallopian tubes, preventing fertilisation. It can be treated with medication or by keyhole surgery to remove damaged areas. Alternatively you may be offered treatment with IVF. Endometriosis is unlikely to cause problems once you are pregnant, and being pregnant can sometimes reduce your symptoms (although they may come back once your periods return). If your main symptoms are hirsutism, alopecia and/or acne then you will be given a course of medication which works by suppressing the levels of male hormone in your blood. This could be as simple as taking the oral contraceptive pill each month or involve other hormonal drugs (such as cyproterone acetate).

For more information you can download our patient information leaflet about endometriosis.