Endometriosis

What is endometriosis?

Endometriosis is a condition where tissue similar to the inner lining of the womb (endometrium) is found elsewhere, usually in the pelvis around the womb, ovaries and fallopian tubes. It is a very common condition, affecting around 1 in 10 women. You are more likely to develop endometriosis if your mother or sister has had it. Endometriosis usually affects women during their reproductive years. It can be a long-term condition that can have a significant impact on your general physical health, emotional wellbeing and daily routine.

Key points
• Endometriosis occurs when tissue similar to the inner lining of the womb (endometrium) is
found elsewhere, usually in the pelvis around the womb, ovaries and fallopian tubes.
• Endometriosis can sometimes be a difficult condition to diagnose. It is a chronic condition that
can affect your physical, sexual, psychological and social wellbeing.
• Common symptoms include pelvic pain and painful, sometimes irregular or heavy periods. It
can cause pain during or after sex and can lead to fertility problems.
• Treatment options include pain-relieving medications, hormones and/or surgery.

What are the symptoms?

Common symptoms include pelvic pain and painful, sometimes irregular or heavy periods. It can cause pain during or after sex and can lead to fertility problems. You may also have pain related to your bowels, bladder, lower back or the tops of your legs, and experience long-term fatigue. Some women with endometriosis do not have any symptoms.

Endometriosis can cause pain that occurs in a regular pattern, becoming worse before and during your period. Some women experience pain all the time but for others it may come and go. The pain may get better during pregnancy and sometimes it may disappear without any treatment. For more information, see the RCOG patient information Chronic (long-term) pelvic pain: (www.rcog.org.uk/en/patients/patient-leaflets/long-term-pelvic-pain)

What causes endometriosis?
The exact cause of endometriosis is not known but it is hormone dependent. This means that, just like the endometrium which responds to hormonal changes resulting in a period, the endometrial-like tissue located outside the womb also bleeds. This bleeding can cause pain, inflammation and scarring, and can possibly damage your pelvic organs.
Endometriosis may be found:

• on the ovaries, where it can form cysts (often referred to as endometriomas or ‘chocolate cysts’)
• in the peritoneum (the lining of the pelvis and abdomen)
• in or on the fallopian tubes
• on, behind or around the womb
• in the area between the vagina and the rectum.

Endometriosis can also occur within the muscle wall of the womb (adenomyosis) and occasionally on the bowel and/or bladder. It may sometimes be found in other parts of the body, but this is rare.

How is it diagnosed?
Endometriosis can be a difficult condition to diagnose. This is because:

• the symptoms of endometriosis vary so much
• the symptoms are common and can be similar to pain caused by other conditions such as irritable bowel syndrome (IBS) or pelvic inflammatory disease (PID); for further information, see the RCOG patient information Acute pelvic inflammatory disease: tests and treatment (www.rcog.org.uk/en/patients/patient-leaflets/acute-pelvic-inflammatory-disease-pid-tests-and-treatment)

• different women have different symptoms
• some women have no symptoms.

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To find out more about Endometriosis and what will happen if you see a healthcare professional you can download the patient information sheet here: www.rcog.org.uk/en/patients/patient-leaflets/endometriosis/