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Endometriosis

On this page you can find the following information: 

  • About Endometriosis 
  • Types of Endometriosis 
  • Symptoms 
  • Treatments  
  • University Support  

Fact check: 

The information provided on this website has been written to the best of our knowledge using trusted resources. The University of Manchester recognises that it is important to share accurate, up-to to-date information about these conditions and treatments. Therefore, if you are an expert in this area and notice any inaccuracies, please contact brooke.foulger@manchester.ac.uk so that we can update this webpage. 

About Endometriosis

The lining of your womb (uterus) is called your endometrium. Endometriosis occurs when cells similar to the ones in the lining of the womb are found elsewhere in the body. These cells can grow and change in response to hormones in the menstrual cycle. This can cause inflammation, pain and scar tissue across the whole body.  

Endometriosis affects 1 in 10 women and 1 in 4 trans men.1 Nonbinary people assigned female at birth can also be affected by endometriosis. 

3,120 1 10 Women Stock Vectors and Vector Art | Shutterstock

It can take up to an average of 8 years and 10 months from the first GP visit to reaching a diagnosis in the UK.  

This NHS video explains what endometriosis is, what the common symptoms are and what treatment options are available. 

More information about endometriosis 

Information (Endometriosis UK): General information about endometriosis. Endometriosis UK also have a free confidential helpline on 0808 808 2227.   

Information packs (Endometriosis UK): Free publications, factsheets and leaflets to help those with endometriosis, their families, and people who want to learn more about the condition. 

Endometriosis Foundation; General information and support/resources for endometriosis. 

A-Z of medical terms: This resource from the Royal College of Obstetricians & Gynaecologists explains some of the medical words and phrases used when discussing conditions like endometriosis. 

Types of Endometriosis

Endometriosis can appear in different forms depending on where the tissue grows, how much is present, and how deeply it penetrates. It’s also possible to have more than one type at the same time. 

  1. Peritoneal (superficial) endometriosis

This is the most common type. It appears on the pelvic peritoneum - a thin layer that lines the inside of the pelvis and covers pelvic organs. 

  1. Ovarian endometriosis (endometrioma)

This type involves cysts on the ovaries, often called "chocolate cysts" due to their dark, fluid-filled appearance. 

  1. Deep infiltrating endometriosis (DIE)

This form grows deeper into tissues, such as the bladder, bowel, or the recto-vaginal septum (the tissue between the vagina and rectum). It tends to cause more severe symptoms. 

  1. Extra-pelvic endometriosis

Less commonly, endometriosis can be found outside the pelvic area, such as in the chest, lungs, or surgical scars (like caesarean section scars). 

Symptoms

Symptoms can vary in intensity in those with endometriosis. The amount of endometriosis does not always correspond to the amount of pain and discomfort that people experience. Not everyone with endometriosis experiences symptoms.  

There is no 'one size fits all' approach to symptoms. Each person will have their own experience. It is important to note not just what the symptoms are, but also how they impact your life day-to-day. 

The most common symptoms may include:  

  • Pelvic pain 
  • Painful periods that interfere with everyday life 
  • Heavy menstrual bleeding 
  • Pain during or after sex 
  • Painful bowel movements 
  • Pain when urinating 
  • Difficulty getting pregnant – up to 70% of those with endometriosis will be able to get pregnant without medical assistance 
  • Fatigue with one or more of the above symptoms 

Other symptoms may also include: 

  • Pain starting before periods 
  • Ovulation pain 
  • Pain on internal examination (such as cervical screening ) 
  • Prolonged bleeding  
  • Bleeding after sex 
  • Frequent urinary tract infections 
  • Feeling faint or fainting during a period 

Symptoms of bladder endometriosis

  • Needing to pee more often 
  • Pain when peeing 
  • Having an urgent need to pee 
  • Having trouble emptying your bladder when peeing 
  • Blood in your pee 
  • Kidney pain (in rare cases) 

Symptoms of bowel endometriosis

  • Bloating or gas in your tummy 
  • Pain in your lower back 
  • Pain during sex 
  • Rectal bleeding while menstruating 
  • Extreme pain when having a bowel movement 
  • Digestive pain or symptoms like irritable bowel syndrome (IBS) - nausea, diarrhoea, constipation  

Symptoms of thoracic (chest) endometriosis

  • Shortness of breath 
  • Chest pain specifically during a period. 
  • Shoulder-tip pain 

More information about symptoms

 

What should you do if you suspect you have endometriosis? 

Talk to your GP  

A GP cannot diagnose endometriosis for certain, but they can offer you appropriate treatment to help with symptoms.  

Your GP can also provide a referral to a gynaecologist to investigate symptoms further. The only definitive way to diagnose endometriosis is by a laparoscopy - an operation in which a camera (a laparoscope) is inserted into the pelvis via a small cut near the navel. 

It is important to go to any appointments with as much information as possible including your medical history, menstrual cycle, symptoms and any patterns you have noticed with your health. 

There are lots of tools to support tracking symptoms that will aid an initial GP consultation: 

Living with endometriosis can be emotionally challenging, and it's completely normal to feel overwhelmed or in need of support. The condition affects more than just the physical body—it can deeply impact your emotional wellbeing, relationships, and daily life.  

You don’t have to go through this alone. Reaching out to your partner, friends, or family can make a real difference. Sharing how you feel can help ease the emotional burden and strengthen your support network. 

There are also dedicated support groups that can offer understanding and connection with others who truly get what you're going through. Endometriosis UK signposts a range of support groups across the country—these can be a valuable source of comfort and advice. You can explore them here: Support Groups | Endometriosis UK and there’s also a UoM Endometriosis and PCOS Network Support Group available. (See details below.) 

Your GP can refer you to counselling services, where trained psychologists and counsellors can help you navigate the emotional effects of chronic pain and the frustration that often accompanies endometriosis It can offer a safe space to explore your feelings, develop coping strategies, and regain a sense of control and hope. 

The University has an Employee Assistance Programme which is a is a confidential and independent counselling and information service. Support is free and confidential.   

Treatments for endometriosis

It’s not known what causes endometriosis, and there are currently no treatments that can cure it. But treatment can help manage symptoms such as pain, and your GP should discuss treatment options with you. 

A helpful tool to help you ask questions that you might have regarding your treatment options can be found on the NHS Inform website: It's OK to Ask. 

Medicines are often the first treatment for endometriosis.  

They include: 

Pain-relieving medication

Medications can range from over-the-counter treatments (such as paracetamol and ibuprofen) to medications prescribed by your healthcare professional. 

Hormone treatments

Hormone treatments can help control your symptoms and can reduce bleeding and inflammation from your endometriosis and reduce pain by stopping your periods. 

Most hormone treatments that may be offered are contraceptive, which means they have a high likelihood (over 99% with perfect use) of preventing you from becoming pregnant while you are having treatment. 

Recent medication

Relugolix with estradiol and norethisterone acetate 

 

The first long-term daily pill to treat endometriosis was approved in March 2025 called relugolix-estradiol-norethisterone (also known as relugolix combination therapy).   It works by blocking specific hormones that contribute to endometriosis, while also providing necessary hormone replacement in a single daily tablet. 

 

Linzagolix 

 

On 1 May 2025, it was confirmed that the once-a-day pill, Linzagolix, will soon be available for NHS patients in England who have had previous treatment for endometriosis, following approval by the National Institute for Health and Care Excellence (NICE).  Linzagolix will be available specifically for patients whose previous medical or surgical treatments for endometriosis have been unsuccessful. It will be given alongside ‘add-back’ hormone therapy which involves using low-dose hormone replacement therapy (HRT) to prevent menopause-like symptoms and bone density loss. 

Find out more  

Surgery for endometriosis

If other treatments are not working, or you have lots of endometriosis, you may be offered surgery. The type of surgery you may be offered for endometriosis will depend on your individual situation. 

Most people with suspected endometriosis can be treated by laparoscopic (keyhole) surgery. Surgery for extensive or deep endometriosis can be more complex. This is usually done in specialist centres, with support from bladder and bowel specialists. 

Find out more 

University of Manchester Support

Endometriosis and PCOS Network 

The University of Manchester has a staff network to support colleagues with endometriosis and PCOS. It is also open to colleagues with other menstrual conditions such as PMDD.  

If you would like to join this network or find out more information, please contact lauren.bramley@manchester.ac.uk  or brooke.foulger@manchester.ac.uk  

Endometriosis Champions 

As part of the Endometriosis Friendly Employer Scheme, The University has three dedicated Endometriosis Champions;    

Amina Mufti : amina.mufti@manchester.ac.uk  

Emma Lewis-Kalubowila: elk@manchester.ac.uk  

Gillian Burns: gillian.burns@manchester.ac.uk  

Useful blog posts 

 

 

Sources of information for this page:  

Endometriosis UK 

Endometriosis - NHS 
Dismissed, ignored and belittled" The long road to endometriosis diagnosis in the UK 
Endometriosis Foundation   

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