Endometriosis Symptoms And Treatments: A Beginner's Guide

In this article, we’ll take a closer look at endometriosis, a common yet often misunderstood condition that affects many women across the UK. We’ll explain what endometriosis is, how frequently it occurs and the different types that can develop. As well as this, we will also look at the possible causes, key symptoms to look out for and the impact the condition can have on daily life. We’ll also discuss the various treatment options available, as well as the support networks that can help people living with endometriosis.

Key Takeaways

Here are the five biggest takeaways from this article about endometriosis:

• Endometriosis affects 1 in 10 people assigned female at birth in the UK, impacting approximately 1.5 million people.

• There are three main types of endometriosis. These are superficial endometriosis, ovarian endometriosis and deep endometriosis.

• Endometriosis symptoms will vary from person to person, with the most common being chronic pain in the pelvis, back or legs, painful or heavy periods, pain during or after sex and abnormal bleeding.

• There is currently no cure; however, treatment options like the combination pill and over-the-counter pain relief may help with symptoms.

• Organisations like Endometriosis UK and The Samaritans offer support to those suffering from the condition.

What is endometriosis?

Endometriosis is a long-term medical condition where tissue similar to the lining of the womb grows outside the uterus. This tissue can develop on the ovaries, fallopian tubes, the outer surface of the uterus and other areas in the region. In some cases, it can even spread beyond the pelvis.

This misplaced tissue responds to hormonal changes during the menstrual cycle, thickening and breaking down each month. However, unlike menstrual blood, this tissue has no way to leave the body, leading to inflammation, pain, scarring and sometimes the formation of cysts.

Endometriosis causes a range of symptoms, including chronic pain, heavy or irregular periods, pain during intercourse and fertility issues. Unfortunately, there is no known cure for endometriosis; however, various treatments can help manage symptoms and improve quality of life.

How common is endometriosis in the UK?

Endometriosis is a common condition in the UK, affecting around 1 in 10 people assigned female at birth. This is approximately 1.5 million people, a similar number to those living with diabetes. Globally, an estimated 10% of women (around 176 million people) are affected.

It is also one of the leading causes of infertility, with 30–50% of women experiencing fertility issues having endometriosis. Despite being the second most common gynaecological condition in the UK, diagnosis can take an average of 8 years and 10 months from the first GP visit. The economic impact is also significant, with the condition costing the UK £8.2 billion per year in treatment, lost work and healthcare expenses [1].

What are the different types of endometriosis?

Endometriosis can be classified into three main types based on the location of the endometrial tissue. These are superficial, ovarian and deep endometriosis. Each type affects different areas of the body and can cause different symptoms and complications.

• Superficial Endometriosis – Also known as peritoneal endometriosis, this is the most common form. It occurs when endometrial-like tissue grows on the thin membrane lining the pelvic cavity.

• Ovarian Endometriosis – Also called endometrioma or chocolate cysts, this type affects the ovaries. Cysts are filled with dark, old blood and can cause pain, affect fertility and sometimes lead to complications such as ovarian cyst rupture.

• Deep Endometriosis – Also known as deeply infiltrating endometriosis (DIE), this severe form occurs when endometrial-like tissue grows deeper in organs such as the bladder and bowel. This type can cause significant pain, digestive issues, and complications that may require surgical intervention.

Here is a handy table that outlines the three main types of endometriosis:

What can cause endometriosis?

The exact cause of endometriosis is unknown, but researchers believe it is likely due to a combination of genetic, immune system and hormonal factors. Several theories have been proposed to explain how the condition develops, including [2]:

Retrograde Menstruation

One of the most widely accepted theories suggests that menstrual blood containing endometrial cells flows backwards through the fallopian tubes into the pelvic cavity instead of leaving the body. These displaced cells can then implant and grow outside the uterus.

Genetic Predisposition

Endometriosis tends to run in families, which may suggest a genetic link. If a close relative has the condition, there may be an increased risk of developing it.

Spreading Through the Bloodstream or Lymphatic System

Some experts suggest that endometrial-like cells travel through the blood or lymphatic system, similar to how cancer cells spread, allowing the tissue to grow in other parts of the body.

Immune System Dysfunction 

A weakened or malfunctioning immune system may be unable to recognise and destroy endometrial-like tissue growing outside the uterus.

Environmental Causes

Exposure to toxins or chemicals may contribute to hormonal imbalances that increase the risk of developing endometriosis.

Metaplasia 

This theory suggests that certain cells in the body can transform into endometrial-like cells, particularly during development or in response to injury or inflammation.

What are the symptoms of endometriosis?

The symptoms of endometriosis can vary widely from person to person. Some people experience severe pain and other complications, while others may have no noticeable symptoms at all. The most common signs to look out for include:

• Pain – This can occur in the lower abdomen, pelvis, lower back, or even the legs. The pain may be constant or linked to the menstrual cycle.

• Painful Periods – Many people with endometriosis experience severe menstrual pain, which can interfere with daily activities. Periods may also be heavy or prolonged.

• Pain During or After Sex – Pain during or after intercourse is a common symptom and can be linked to deep endometriosis.

• Abnormal Bleeding – This includes bleeding between periods, blood in the urine, or blood in the stool.

• Fertility Issues – Endometriosis is one of the leading causes of infertility, making it difficult for some individuals to conceive.

• Fatigue – Many people with endometriosis experience exhaustion and low energy levels, which can significantly affect daily life.

• Bowel Problems – Symptoms may include pain or bleeding during bowel movements and, in severe cases, bowel blockage.

• Urinary Issues – Some people experience pain or discomfort when urinating.

• Other Symptoms – Endometriosis can also cause bloating, low mood, anxiety and general discomfort.

If you experience any of these symptoms, seeking medical advice can help with the diagnosis and management of endometriosis.

Here is a table outlining the different types of endometriosis symptoms and how they affect you:

How can you treat and manage it?

Endometriosis treatment and management focus on targeting symptoms and improving quality of life. There is no definitive cure for endometriosis; however, a number of various options can help manage the condition. Treatment options include:

Medication as First-Line Treatment

Doctors typically start with hormonal treatments, such as the combined oral contraceptive pill (Microgynon or Rigevidon) to regulate hormone levels, suppress ovulation and reduce pain.

Pain Relief

Over-the-counter painkillers, such as ibuprofen and paracetamol, can help alleviate discomfort. Stronger prescription pain relief may be recommended in more severe cases.

Laparoscopic Surgery

If medication isn’t effective, keyhole surgery may be performed to remove or destroy endometriosis tissue. This procedure can provide symptom relief, but endometriosis may return over time.

GnRH Agonists

In some cases, GnRH agonists may be prescribed for a short period to temporarily suppress ovulation and reduce inflammation before surgery.

Specialist Referral

If symptoms are severe or standard treatments don’t work, a referral to a specialist endometriosis clinic may be necessary for further assessment and tailored treatment.

Lifestyle Management

Alongside medical treatment, certain lifestyle changes may help manage symptoms:

• Regular exercise can reduce inflammation and improve overall well-being.

• A healthy diet may support hormone balance and reduce bloating.

• Stress management techniques such as yoga or mindfulness may help with symptom control.

What support is available to endometriosis patients?

A diagnosis of endometriosis can be overwhelming, but there are support networks available to help you manage the condition and connect with others who understand your experience.

Endometriosis UK Support Network

Endometriosis UK provides a range of support services to help those affected by the condition [3], including:

• A helpline offering advice and reassurance.

• Local support groups where you can connect with others facing similar challenges.

• An online community for sharing experiences and advice.

• A web chat service for real-time support.

• A nurse-led support line to provide medical guidance.

Emotional Support

If you are struggling with the emotional impact of endometriosis, The Samaritans offer 24-hour confidential support for anyone in distress.

Final Thoughts

Endometriosis is a common condition that affects millions of people worldwide, including 1 in 10 women in the UK. Despite its prevalence, diagnosis can take several years, and there is currently no cure. Understanding the symptoms, types, causes and treatment options can empower those affected to get medical support and manage the condition effectively.

From hormonal treatments and pain relief to laparoscopic surgery and lifestyle changes, there are various ways to help reduce symptoms and improve quality of life. Support networks such as Endometriosis UK and The Samaritans also provide essential guidance and emotional support for people living with the condition.

Sources

[1] Endometriosis Facts and Figures | Endometriosis UK

[2] Endometriosis - NHS

[3] Get support | Endometriosis UK