Endometriosis is a condition where the cells of the lining of the womb (endometrium) are found elsewhere in the body, usually in the pelvis.  Adenomyosis is a condition where the endometrium is found in the muscle layer of the womb.  Endometriosis and adenomyosis can affect women at any age from puberty to menopause. Endometriosis is a common condition, affecting up to 10 in 100 women. You are more likely to develop endometriosis if your mother or sister has had it

Causes of endometriosis:

The exact cause of endometriosis is not known.

Symptoms of endometriosis:

Your symptoms depend on where your endometriosis is, and some may have no symptoms at all.

Common symptoms are:

 Painful periods. Pelvic pain and cramping may start before a menstrual period and last for several days.   Pain may also be in the lower abdomen or vary, depending on the location of endometriosis. 

 Pain with sex. Pain during or after sex is common with endometriosis.

 Pain with bowel movements or urination. You’re most likely to have these symptoms before or during a menstrual period.

 Excessive bleeding. Sometimes, you may have heavy menstrual periods or bleeding between periods.

Subfertility. For some people, endometriosis is first found during tests for subfertility.  

Other symptoms: You may have fatigue, diarrhoea, constipation, bloating or nausea. These symptoms are more common before or during menstrual periods.

Investigations depending on symptoms:

 A detailed transvaginal ultrasound scan – this may show whether there are any cysts on your ovaries that are associated with endometriosis or may show evidence of endometriosis in pelvis.  It can also detect adenomyosis.  

 MRI scan – this can be useful to identify endometriosis involvement of your bowel or bladder or pelvic wall and to identify possible adenomyosis.

 Laparoscopy (keyhole surgery) can be used to diagnose and to treat endometriosis. You may be offered this surgery if initial treatment to help your symptoms is not effective.