What is endometriosis: the symptoms, stages and causes

What is endometriosis?

About one in 10 women of child-bearing age lives with endometriosis. In addition to the physical symptoms, women can experience increased stress and anxiety as they try to cope with the effects of endometriosis.

Our short guide explains what it is, how to spot it and how to manage the impact that endometriosis can have on your day-to-day life and work.

Our short guide explains what it is, how to spot it and how to manage the impact that endometriosis can have on your day-to-day life and work.

What is endometriosis?

Endometriosis is a gynaecological condition that affects women between puberty and menopause. It causes womb tissue (endometrium) to grow in other areas such as the ovaries, fallopian tubes and the bowel. The tissue thickens and bleeds during your period, causing a range of symptoms from inflammation, heavy periods and pelvic pain to a swollen tummy, nausea and diarrhoea.

Endometriosis can also lead to ovarian cysts, problems with your bowel and infertility – as well as sleep problems caused by the strain of the condition on your emotional and physical health. It’s a serious condition and, if left untreated, can be severely debilitating.

Endometriosis: the causes, symptoms and treatment

Consultant Gynaecologist, Miss Ana Zakaryan, talks about endometriosis; what causes it, what symptoms you might experience and how our self-pay gynaecology treatments can help you get back to being you.

What causes endometriosis pain?

Endometriosis is more common now than before, and more is being discovered about its causes. This could be because of increased awareness and recognition both by healthcare professionals and by patients.

Pregnancy and breast feeding can cause regression of the disease. Delaying pregnancies and having fewer children may play a role in disease progression.

Endometriosis can also be genetic, as it often runs in families. It can also be caused by:

  • Hormones: oestrogen appears to affect endometriosis (research is ongoing)
  • Immune system issues: a faulty immune system may fail to spot and destroy the tissue
  • Surgery: C-sections and a hysterectomy can cause endometriosis to be found in scars

There isn’t much you can do to stop endometriosis, but you can help avoid hormonal endometriosis by lowering your level of oestrogen. Oestrogen helps your womb lining to thicken and may increase with the use of contraceptive pills, excess body fat, or alcohol/caffeine intake.

What are the signs of endometriosis?

Here are some of the common signs and symptoms of endometriosis:

  • Irregular, painful or heavy periods
  • Pain while having sex, or after having sex
  • Fertility problems (difficulties getting pregnant)
  • Pain or bleeding while going to the toilet
  • Fatigue, tiredness and/or depression

If you have any of these symptoms, they may not necessarily be signs of endometriosis and could be caused by other conditions.

What are the stages of endometriosis?

Endometriosis has varying degrees of severity and can get worse over time. However, it’s possible to have ‘mild’ endometriosis with a lot of pain, or barely notice ‘severe’ endometriosis.

The stages of endometriosis are based on its location, extent, depth and severity:

  1. Minimal: small lesions/shallow implants on ovary, inflammation in pelvic cavity
  2. Mild: shallow implants on ovary and pelvic lining, alongside light lesions
  3. Moderate: deep implants on ovary and pelvic lining, more lesions present
  4. Severe: deep implants on ovaries and pelvic lining, lesions have spread

It’s better to be diagnosed in the earlier stages of endometriosis, as treatment is easier.

How can I get an endometriosis diagnosis?

Referral to an endometriosis specialist is recommended if you experience symptoms such as breakthrough period pain despite being on hormonal treatment or if you develop dyspareunia (pain during sex), dyschezia (pain on opening your bowels during your period) or bleeding from the back passage.

Diagnosis is confirmed by a gynaecological laparoscopy where the Consultant passes a thin telescope through a small cut in the tummy to see if there are any patches of endometriosis tissue in your body.

Ultrasound scans are not always good enough to see endometriosis, unless the ovaries have endometriotic cysts. An MRI scan may be required if there’s indication of more severe disease.

What is endometriosis treatment?

Currently there’s no cure for endometriosis, but there are treatments which can help ease its symptoms such as painkillers, hormone medicines (such as contraception) and surgery.

Surgery in severe endometriosis can be quite complex and hence is best done by specialist surgeons. Following surgery patients need to stay on hormonal treatment to prevent recurrences unless they are trying for pregnancy.

Is endometriosis likely to affect my fertility?

Endometriosis can affect fertility and is one of the major causes of female infertility. There is good evidence that surgical excision of endometriosis in early stages improves fertility. However, in advanced cases the role of surgery in fertility is less clear.

Hysterectomy and removal of ovaries is often considered as the last resort if you’ve already completed your family.

How can I cope with endometriosis at work?

Endometriosis can manifest itself with a range of symptoms, many of which aren’t immediately obvious, so colleagues may struggle to understand what’s wrong. You may feel embarrassed about taking time off work or feel that you’re a burden on your colleagues.

Be prepared

You should be prepared in case endometriosis strikes during the working day. Keep a heated pad in your bag or desk to place on your stomach and ease cramps and have painkillers on hand.

If your endometriosis affects your energy levels, or you’re more prone to symptoms at certain times of the day, try to plan your workload. For example, if your job involves long periods of standing and this leaves you with chronic fatigue by the afternoon, could you share admin tasks with a colleague? You may want to talk to your Occupational Health department to help with planning.

Take frequent breaks

It’s important to take regular breaks at work, especially if you’re experiencing chronic pain. If you’re able to, take a walk at lunchtime or find a quiet spot to relax.

Eat well and stay hydrated

It’s always tempting when you feel unwell to reach for the sugary snacks, but – if you can – try to avoid them and replace them with healthy foods such as nuts or fruit. Some experts suggest that cutting out wheat and dairy may help improve the symptoms of endometriosis.

Don’t be afraid to ask your employer for help

It can be difficult to ask for support from your manager or colleagues. It may not be possible to take time out at work or sit down for long periods of time – especially if your job requires you to be on your feet.

Endometriosis UK has published a guide to the law and best practice for employers in supporting employees with endometriosis. This includes their duty to make reasonable adjustments, Statutory Sick Pay (if you’re not entitled to company sick pay) and flexible working.

Some employers have signed up to be Endometriosis Friendly Employers, so it’s worth asking whether your company is part of this initiative.

Speak to our experts

If you’re worried about the signs of endometriosis or if endometriosis is affecting your life or work, help is available from our expert team. We offer a range of private gynaecology treatments in a discreet environment. Contact our Private Patient team by completing our online enquiry form or by calling 01580 363158.

Published on 23 June 2022