Understanding Endometriosis: Symptoms, Causes, and Treatment
One in ten women in the UK who are of reproductive age suffer with endometriosis, a chronic, excruciating illness. While quite common, it is still woefully underdiagnosed with a lot of women waiting for years for a correct diagnosis.
The condition happens when tissue that behaves like the lining of the womb grows outside the womb, causing inflammation, scarring and severe pain. Symptoms can include severe menstrual cramps and difficulty getting pregnant and can take a toll on a woman’s quality of life.
In this blog we’re going to look at what endometriosis is, what are the causes of endometriosis, what are the symptoms of endometriosis, and what treatment options are there. Whether you are looking for solutions for yourself or someone you care about, it’s essential to get to know this diagnosis as a means to understand how to manage it.
What is Endometriosis?
Endometriosis is a condition in which tissue similar to the lining of the womb starts to grow in other places, such as:
- The ovaries
- The fallopian tubes
- The lining of the pelvis
- The lower abdomen
It is a long-term condition that can have a significant impact on your life, but there are treatments that can help.
During each menstrual cycle, this displaced tissue grows, degrades, and bleeds like regular endometrial tissue. But because it has nowhere to go out of the body, it causes inflammation, scar tissue (adhesions) and very strong pain. These can result in blocked fallopian tubes and problems getting pregnant.
Causes and Risk Factors
The origin of endometriosis is unknown, though currently several theories can explain the cause:
1. Retrograde Menstruation
- When endometrial cells adhere to pelvic organs, some menstrual blood is forced backward into the pelvis.
- But not all women who have retrograde menstruation develop endometriosis.
2. Hormonal Influence
- Oestrogen stimulation of endometrial-like tissue growth is protected by progesterone.
- Its proliferation may be predisposed by hormone imbalances.
3. Genetic Factors
- People are 7–10% more likely to have acquired endometriosis if they have a first-degree relative who has it.
4. Immune System Dysfunction
- Weakened immune responses can cause displaced endometrial cells to escape normal clearance.
5. Surgical Scars
- Endometrium tissue can attach to surgery scars (like the one from a caesarean section).
Symptoms of Endometriosis
Endometriosis can cause a variety of symptoms, but some of the more prevalent ones are as follows:
✔ Severe menstrual pain that starts before the period and lasts longer than usual.
✔ Chronic pain in the pelvis – Not only during the periods, you have pain even at other times of the month.
✔ Pain during sex or after sex – Intense internal pain.
✔ Heavy periods, or irregular periods – Lots of bleeding or very long periods.
✔ Infertility – Caused by blocked tubes or inflammation.
Less Common Symptoms:
- Discomfort when passing stools or urine
- Blood in your stool or urine (especially if your bowel or bladder are affected by endometriosis)
- Fatigue and bloating (often misdiagnosed as IBS)
- Rarely, endometrial tissue can cause cyclical chest discomfort by moving to the diaphragm or lungs.
Diagnosis
Endometriosis is difficult to diagnose because symptoms can mimic other disorders. The process may include:
Clinical History and Physical Examination
- A doctor evaluates symptoms and looks for pelvic tenderness.
Imaging Tests
- Cysts are discoverable with the use of ultrasound (transvaginal or abdominal).
- MRI yields detailed images, although tiny patches may be overlooked.
Laparoscopy (Gold Standard)
- A form of minimally invasive surgery in which a camera is inserted through the pelvis to view the endometriosis and take tissue samples.
Impact on Quality of Life
Endometriosis is much more than physical — it impacts emotional and social well-being:
- Physical: Chronic pain can result in tiredness and be a limitation in movement.
- Emotional: Anxiety, depression, and frustration are common emotions among women, especially those challenged by infertility.
- Social: Too common are missed work, cancelled plans, and stressed relationships.
Messages of support from healthcare professionals, counselling and peer support groups can also make a big difference.
Treatment Options
Pain Management
- Over-the-counter analgesics (paracetamol)
- Non-steroidal anti-inflammatory drugs (ibuprofen, naproxen)
Hormonal Therapies
These override oestrogen and inhibit endometrial growth:
- Combined hormonal contraception (pill, patch, or ring)
- Progesterone-only treatments (in pills, injections, or IUDs)
- Gonadotropin-releasing hormone (GnRH) agonists (effect is temporary menopause-like state)
Surgical Treatments
- Laparoscopic excision – Resection of endometrial deposits and adhesions.
- Excision – For larger or particularly painful endometriomas.
- Hysterectomy: This is an option of the last resort and should only be performed when all other treatment options have been tried and failed, or when one no longer wishes to conceive.
Fertility and Endometriosis
Endometriosis that can lead to infertility include:
- Blocked fallopian tubes
- Inflammatory effects on eggs and sperm
- Hormonal disruptions
Fertility Treatment Options:
- Removal of tissue from the pelvis to enhance the ability to conceive via laparoscopic surgery.
- In vitro fertilisation (IVF) if you are having trouble getting pregnant.
The sooner intervention occurs, the better the outcome — so consulting a specialist is essential.
Living with Endometriosis
There is no cure, but there are lifestyle changes to manage its symptoms:
- Getting exercise regularly (decreases inflammation)
- Anti-inflammatory diet (high omega-3s, leafy green vegetables)
- Relaxation (yoga, meditation)
Emotional relief can also be found in support groups and counselling.
Conclusion
Endometriosis is a complex disease, but with early diagnosis and the proper treatment, women can live full lives. If you think you might have endometriosis, don’t let your symptoms go unaddressed — go to an expert for evaluation.
At Chase Lodge Hospital, our dedicated gynaecology experts provide complete care from diagnosis through to advanced treatment. Schedule your appointment now and let us help you on the path to wellness.
You don’t have to face this alone — help and support are available.
