Endometriosis
Endometriosis is a condition where tissue similar to the lining of the uterus grows outside the womb, often on the ovaries, fallopian tubes, or pelvic lining. This tissue responds to hormonal changes each month, which can cause pain, heavy periods, or fertility challenges. Symptoms vary widely, and some people have no obvious signs. While there’s no cure, treatments such as medication, hormone therapy, or surgery can help manage symptoms and improve quality of life.
Overview | Symptoms & Causes | Diagnosis | Treatment Options
Endometriosis: Introduction
The uterus is a muscular organ lined by the endometrium, a tissue that thickens and sheds during the menstrual cycle. Normally, the endometrium is confined to the inner lining of the uterus. In endometriosis, tissue similar to the endometrium grows outside the uterus, commonly on the ovaries, fallopian tubes, pelvic peritoneum, or ligaments supporting the uterus, but it can occasionally appear in other areas, such as the bladder or intestines.
This misplaced tissue responds to hormonal changes during the menstrual cycle, just like the normal endometrium. Each month, it can bleed, swell, and cause inflammation, leading over time to scar tissue, adhesions, and sometimes cysts (endometriomas).
Endometriosis is a chronic and often progressive condition that affects a significant number of people with periods. The impact varies widely: some experience severe pelvic pain, heavy or irregular periods, pain with intercourse, or difficulty conceiving, while others may have no noticeable symptoms. Early recognition and management are important to help reduce symptoms and protect fertility where desired.
Understanding Endometriosis
Endometriosis can affect people differently. Some may have mild discomfort, while others experience significant pain or disruption to daily life. Symptoms often correlate with the menstrual cycle, but severity does not always match the extent of tissue growth.
Common symptoms include:
- Pelvic pain: Often cyclical, worsening during periods, but can occur at other times.
- Painful periods (dysmenorrhea): Cramping that may be severe or debilitating.
- Pain during or after sex: Discomfort or sharp pain in the pelvic region.
- Pain with bowel movements or urination: Usually during periods.
- Heavy or irregular periods: Bleeding that is more than usual or lasts longer.
- Infertility or difficulty conceiving: Endometriosis can affect the ovaries or fallopian tubes.
- Fatigue: Often associated with chronic pain and heavy bleeding.
Because endometriosis can present in many different ways, these symptoms may overlap with other pelvic or gynecological conditions, making diagnosis complex and individualised assessment important.
Causes and Risk Factors
The exact cause of endometriosis is not fully understood, but several factors may contribute to its development. Endometriosis occurs when tissue similar to the lining of the uterus grows outside the uterus, causing inflammation, pain, and sometimes the formation of cysts or adhesions. Factors that may increase the likelihood of developing endometriosis include:
| Family history | Having a close relative with endometriosis increases your risk. |
| Menstrual factors | Early periods, short cycles, or heavy periods may be associated with higher risk. |
| Hormonal influences | Estrogen promotes the growth and persistence of endometrial tissue, which may contribute to endometriosis. |
| Age | Most commonly impacts women between the ages of 20 and 40. Many people find some relief from symptoms after menopause. |
Diagnosing Endometriosis
Diagnosing endometriosis can be challenging because its symptoms often overlap with other pelvic or gynecological conditions. A thorough assessment usually involves a combination of medical history, physical examination, and imaging tests.
A clinician will start by asking about your symptoms, including the timing and severity of pain, menstrual patterns, and any difficulties with fertility. They may perform a pelvic examination to feel for any abnormalities, such as nodules, cysts, or tenderness.
Imaging tests can help identify endometriosis-related changes:
| Ultrasound | Often the first test used. It can detect cysts known as endometriomas and other structural changes in the pelvis, although smaller or superficial lesions may not be visible. |
| MRI Scan | Provides a more detailed view of pelvic anatomy and can help locate deep or complex endometriosis lesions that are not easily seen on ultrasound. |
In some cases, the diagnosis can only be confirmed through a laparoscopy, a minimally invasive surgical procedure where a camera is used to directly view the pelvic organs and take biopsies if needed.
Because endometriosis can vary widely in severity and location, a combination of these approaches is often used to make the most accurate diagnosis and plan appropriate treatment.
Treatment Options
There is currently no cure for endometriosis, but a range of treatments can help manage symptoms, improve quality of life, and support fertility if needed. The right approach depends on your individual symptoms, age, and future fertility plans.
| Self-management | Gentle exercise, stretching, and physiotherapy can help manage pelvic pain. Heat therapy, relaxation techniques, and adequate rest can also support symptom relief. |
| Medical treatments | Pain relief medications: Over-the-counter options like paracetamol or non-steroidal anti-inflammatory drugs (NSAIDs) can help manage pain and discomfort. Hormonal treatments: Contraceptive pills, hormonal IUDs, or medications that reduce estrogen can help slow the growth of endometriosis tissue and decrease pain. |
| Procedural & surgical options | Laparoscopy: Minimally invasive surgery to remove or reduce endometriosis lesions. This can improve pain and, in some cases, fertility. Other interventions: In certain cases, procedures to remove cysts (endometriomas) or treat deep lesions may be recommended. |
A clinician will discuss the most appropriate combination of these treatments based on your circumstances. Because endometriosis varies widely in severity and location, ongoing monitoring and follow-up are often needed to adjust treatment and manage symptoms effectively.
How can Lanthorn help?
Ultrasound Uterus & Ovaries - From £300
A first-line, non-invasive test to look for ovarian endometriomas and other pelvic abnormalities. While it may not detect all endometriosis lesions, it provides a useful overview of the ovaries and surrounding structures.
Pelvic MRI Scan - £550
Offers more detailed imaging for deep or complex endometriosis, helping to map the extent of disease and guide treatment planning.
Referral to a specialist
If further assessment or treatment is needed, we can refer you to a trusted gynecologist experienced in managing endometriosis, including surgical options such as laparoscopy.
