Posted: Wednesday, 19 March 2025
Endometriosis: Causes, Symptoms and Treatment
By Claudia Jackson
March 2025 is endometriosis awareness month and at Morehealth, we’re joining the global campaign to raise awareness of this common, but often poorly understood condition.
Endometriosis fast facts
- Endometriosis affects around 10% of women and girls of reproductive age globally.
- Endometriosis is the second most common gynaecological condition in the UK.
- Women with endometriosis are more likely to experience depression and anxiety and have a higher risk of developing heart disease.
- Endometriosis is frequently misdiagnosed or diagnosed late. On average it takes 8 years and 10 months from the first GP visit to getting a diagnosis.
What is endometriosis?
Endometriosis is a condition where tissue similar to your uterus lining (endometrium) grows outside your uterus (womb). It commonly affects your reproductive organs including your ovaries, fallopian tubes and the lining of your pelvis, but can also affect your bladder and bowel. Rarely, endometriosis can develop in areas outside your pelvis, such as your chest.
The build up of this abnormal tissue can lead to inflammation, scarring and painful cysts. Scar tissue can also build up between your reproductive organs causing your organs to “stick together” and resulting in pain and fertility problems.
Endometriosis can affect anyone assigned female at birth and of reproductive age (from when your periods start to when they stop).
What are the symptoms of endometriosis?
Endometriosis symptoms vary from person to person and can range from mild or non-existent to severe and debilitating. The symptoms of endometriosis can resemble those of other conditions such as Irritable Bowel Syndrome (IBS), Pelvic Inflammatory Disease or fibroids which may lead to the condition being misdiagnosed or remaining undiagnosed for months or even years.
The most common symptom of endometriosis is pain in the lower abdomen (pelvis). This pain may be worse during your period, during or after sex or when passing urine or opening your bowels.
Other symptoms of endometriosis may include:
- Heavy periods
- Bleeding between periods
- Fatigue
- Nausea (feeling sick)
- Abdominal bloating
- Depression or anxiety
- Pain or bleeding in other parts of your body, such as your chest, which may be accompanied by symptoms such as shortness of breath and coughing up blood
- Difficulty getting pregnant or infertility
What causes endometriosis?
It isn’t fully understood what causes endometriosis, but possible causes include:
- Genetic factors: Endometriosis may run in families.
- Retrograde menstruation: This is where menstrual blood flows back through the fallopian tubes and into the pelvic cavity rather than out of the body.
- Environmental factors: Exposure to toxins in the environment is a possible cause of endometriosis.
- Problems with your immune system: A weakened immune system is common in people with endometriosis, but it is unclear whether this is a cause of the condition or occurs as a result of endometriosis.
- Hormones: The female hormone oestrogen may promote endometriosis, and the condition may be due to an imbalance in your body's hormonal system.
- Surgery: Endometrial tissue may be moved accidentally during pelvic surgery such as a Caesarean (C-section) or hysterectomy.
- Lymphatic or circulatory spread: Endometriosis tissue may spread around the body in the blood or lymphatic system.
- Metaplasia: A process where a body cell changes into a different type of cell, usually due to inflammation.
How is endometriosis diagnosed?
Your GP or specialist will start by asking you about your symptoms, including what your symptoms are, how severe they are, when or if they get worse or better and how long you have been experiencing them.
They will perform a physical examination, including an internal (vaginal) examination and an examination of your abdomen.
If your doctor suspects endometriosis, they may refer you for further tests including:
- Ultrasound scan: Uses high-frequency sound waves to create images of your pelvis and reproductive organs.
- Magnetic Resonance Imaging (MRI): A non-invasive procedure to examine your pelvic organs for signs of endometriosis.
- Laparoscopy: A procedure where a thin tube with a light and a camera is inserted through a small incision (cut) in your abdomen to look for areas of endometriosis. Your surgeon may also take a biopsy or remove any areas of endometriosis during the procedure.
How is endometriosis treated?
There is currently no cure for endometriosis, and treatment focuses on managing and relieving symptoms such as pain. Depending on your symptoms and how your endometriosis affects you, your doctor may refer you to another specialist for support with issues like depression or infertility.
Endometriosis medication
The first line of treatment for endometriosis is usually medication. There are two main types of medication used to treat endometriosis:
Endometriosis surgery
If medication hasn’t helped relieve your symptoms, or your endometriosis is severe or affecting your fertility, your doctor may recommend surgery. The most common type of endometriosis surgery is laparoscopic (keyhole) surgery. This is a minimally invasive procedure where the surgery is performed through small incisions in your abdomen using a light, a camera and special instruments. For more severe or complex endometriosis, your doctor may recommend open surgery (laparotomy).
Endometriosis surgery may be used to:
- Remove areas of endometriosis or ovarian cysts (fluid-filled sacs on your ovaries) caused by endometriosis.
- Remove part of your bladder or bowel, if they are affected by your endometriosis.
- Remove your womb (hysterectomy) or ovaries (oophorectomy).
Endometriosis alternative treatments
In addition to conventional medicine, there are a range of alternative treatments available that may reduce your risk of developing endometriosis or help relieve your symptoms.
Alternative endometriosis treatments include dietary changes, exercise, supplements, herbs and acupuncture. It’s important to remember that just because a treatment is “natural,” it doesn’t mean it’s safe and effective. Many alternative treatments for endometriosis lack scientific evidence and some may even be harmful or interact with other medications you are taking. Always talk to your doctor before starting any alternative treatment for endometriosis.
Chinese medicine for endometriosis
Some studies have found that traditional Chinese herbal medicine may reduce the inflammation and pain associated with endometriosis.
Studies on the ancient Chinese practice of acupuncture found that it can help reduce the severity and duration of endometriosis-related pain and improve your well-being and quality of life.
Diet and endometriosis
There is a possible link between diet and endometriosis, though more research is needed.
- Dietary fats: Intake of a common saturated fatty acid called palmitic acid and trans fats increase your circulating oestrogen concentrations which may raise your risk of endometriosis. Conversely, omega-3 fatty acids may protect against endometriosis.
- Dietary fibre: A high-fibre diet may help reduce circulating oestrogen and lower your risk of endometriosis.
- Meat consumption: A diet high in red meat and poultry has been linked to an increased risk of endometriosis. Following a plant-based or vegan diet for endometriosis may be beneficial, but more research is needed.
- Dairy products: Contain the female hormone oestradiol and palmitic acid, which have been associated with an increased risk of endometriosis.
Exercise and endometriosis
Regular exercise (around four hours per week) is recommended for people with endometriosis. Physical activity may help ease endometriosis symptoms by regulating your body’s hormone levels and reducing body fat. Exercise also releases endorphins, the body’s natural painkillers, reduces stress and increases wellbeing.
The best exercise for endometriosis includes:
- Aerobic exercise: Exercise that increases your heart rate and oxygen consumption such as running, walking, swimming and cycling.
- Yoga: A 2017 study found that hatha yoga reduced pelvic pain in people with endometriosis.
- Pelvic floor exercises
Dietary supplements for endometriosis
Research into supplements to relieve symptoms of endometriosis is still in the early stages and remains inconclusive. A 2022 review concluded that some supplements including vitamin D, zinc, magnesium, omega 3, vitamin C, and vitamin E may be beneficial as a complementary treatment for endometriosis.
Is endometriosis covered by Private Medical Insurance?
Most PMI does not cover chronic (long-term) conditions such as endometriosis, however some aspects of your treatment may be covered.
- Most policies cover diagnosis and initial treatment to stabilise your condition (providing it is not listed as an excluded condition in your policy).
- Initial treatment may include surgery to diagnose and remove areas of endometriosis and possibly a hysterectomy and/or oophorectomy.
- Ongoing monitoring or treatment such as pain management or hormone therapy is not usually covered under PMI.
- Flare-ups of your condition are usually covered.
- If a new treatment aiming to cure a chronic condition becomes available, most insurers will cover it, however, treatment may be removed if it becomes clear that it is not working.
- Treatment for fertility problems, that can occur as a result of endometriosis are not covered by PMI.
For further information, advice and support on living with endometriosis contact Endometriosis UK, a registered charity that offers support groups, a helpline, a webchat and an online community.
References and Further Reading
Endometriosis World Health Organisation
Endometriosis NHS
Endometriosis Yale Medicine
12 Natural Endometriosis Treatments Very Well Health