BLOG : A Focus On Women's Health & Endometriosis

05th, Mar 2025

Shining a light on a condition that affects millions of women worldwide, we spoke with Dr Lisa Neligan on the topic of Endometriosis. We take a closer look at what endometriosis is, its impact on women’s health, and how we can help support those already familiar with endometriosis or are just beginning to learn. Let's break the silence, spread awareness, and empower each other.

What is Endometriosis?

The endometrium is the tissue that lines the inside of the uterus (womb). Endometriosis is a condition where tissue similar to the endometrium grows outside the uterus, typically in the pelvic area or lower abdomen, and occasionally in other parts of the body.

The exact cause of endometriosis remains unknown, though various factors such as genetics, the immune system, and hormonal imbalances may play a role.

What are the symptoms of endometriosis?

Endometriosis symptoms can vary greatly. Some women have no symptoms, while others experience mild to severe discomfort. The size of the endometriosis patches doesn't always correlate with the severity of symptoms; women with large patches may have no issues, while those with few spots could experience significant pain.

Common symptoms include:

Painful periods: Also referred to as menstrual cramps, this pain often starts days before menstruation and can persist throughout the cycle. Unlike typical period pain, it tends to be more intense and lasts longer. Over time, the pain may extend to cover most or all of the month.

Pain during or after sex: This is typically felt deep inside and may linger for several hours.

Difficulty getting pregnant (reduced fertility): This may happen because endometriosis can block the egg's path from the ovary to the Fallopian tube. In some cases, the impact on fertility isn’t fully understood.

Other symptoms can include fatigue, lower abdominal pain while urinating, pain during bowel movements, lower back pain, and, on rare occasions, blood in the urine or stool.

In very rare instances, endometriosis patches may form in other parts of the body, causing unusual symptoms such as pain or bleeding coinciding with the menstrual cycle.

How common is endometriosis?

The exact prevalence of endometriosis is unclear, as many women with mild or no symptoms remain undiagnosed.

It’s estimated that approximately 10% of women of reproductive age in the UK have endometriosis. Among women facing subfertility issues, this figure rises to 30–50%, as endometriosis is a leading cause of subfertility.

After fibroids, endometriosis is the second most common gynaecological condition. It can affect women between the onset of their first period (menarche) and menopause. Factors like having a family history of endometriosis can increase your risk, while taking combined hormonal contraception may reduce it.

What causes endometriosis?

Although the exact cause isn’t known, one theory suggests that during menstruation, some endometrial cells travel backward through the Fallopian tubes into the pelvic area.

Endometriosis patches are often "sticky," causing organs to adhere to each other in what are known as adhesions. For instance, the bladder or bowel might stick to the uterus. Larger patches of endometriosis may develop into cysts that bleed during menstruation. These cysts can fill with dark blood and are commonly referred to as "chocolate cysts"

How is endometriosis diagnosed?

If you suspect you have endometriosis, the first step is to visit your GP. They will take your medical history and may conduct an examination to assess the likelihood of endometriosis.

Testing for endometriosis

Swabs: Although swabs cannot diagnose endometriosis, they can check for infections in the pelvis, which may cause similar symptoms.

Ultrasound: This involves imaging of the uterus and ovaries. A transvaginal scan provides a more detailed view by inserting the scanner probe into the vagina. If this is uncomfortable, an abdominal ultrasound can be performed, though it may not detect smaller patches of endometriosis. Large patches or endometriosis-related ovarian cysts can be identified via ultrasound.

It’s important to note that small patches of endometriosis may not appear on scans, so it’s common for individuals with the condition to receive normal scan results.