What is Endometriosis? Understanding the Hidden Women's Health Epidemic
Endometriosis affects an estimated 1 in 10 women of reproductive age¹, making it as common as diabetes, yet it remains one of the most under-recognised conditions in women’s health. Recent data releases, including the ONS 2024 endometriosis dataset, reinforce that diagnosed cases represent only a fraction of those affected, highlighting how significantly the condition is under-detected².
Endometriosis occurs when tissue similar to the lining of the uterus grows outside the womb, often on the ovaries, fallopian tubes, bladder, or bowel. This tissue responds to hormonal changes in the same way as the uterine lining, leading to inflammation, scarring, and chronic pain.
Despite its prevalence, this disease is often described as a “hidden epidemic.” Many individuals experience years of debilitating endometriosis symptoms before receiving a diagnosis, with an average delay of 7 to 8 years³. This delay is due to underdiagnosis, stigma surrounding menstrual pain, and a lack of awareness across healthcare settings. The result is a condition that affects millions, yet it often slips under the radar in healthcare, leaving many feeling unseen and unsupported.
What Does Endometriosis Feel Like? Recognising the Symptoms
For many people, endometriosis is far more than “bad period pain.” It’s a persistent, often invisible condition that affects daily life, relationships, and overall wellbeing.
The most common symptom is severe period pain. This is pain that goes well beyond normal cramps and can interrupt work, school, or routine activities. Many also experience chronic pelvic pain that continues throughout the month, ranging from a constant ache to sudden, intense flares.
Endometriosis can cause pain during or after sex, as well as pain when urinating or during bowel movements, especially during menstruation. Heavy or prolonged periods are also typical, often involving large clots or frequent bleeding through clothing.
Beyond pain, many people live with profound fatigue, driven by chronic inflammation, disrupted sleep, and the physical toll of ongoing symptoms. For some, endometriosis also contributes to fertility challenges, adding emotional strain to an already difficult experience.
Common Endometriosis Symptoms: When to Seek Help
Endometriosis can show up in many different ways, and no two people experience it exactly the same. Some may have only a few symptoms, while others face many, and these can become more severe over time if left untreated. If any of these endometriosis symptoms are affecting your daily life, it’s a good idea to speak with a healthcare professional. Getting assessed early can help you manage symptoms and stop them from worsening.
Primary Symptoms
- Severe period pain that goes beyond typical menstrual cramps
- Chronic pelvic pain that continues throughout the month
- Pain during or after sex
- Pain when urinating or during bowel movements, especially during menstruation
- Heavy or prolonged periods, sometimes with large clots
Associated Symptoms
Endometriosis can also cause additional symptoms linked to inflammation and the organs affected:
- Bloating or abdominal swelling (“endo belly”)
- Nausea or digestive discomfort
- Constipation, diarrhoea, or bowel changes
- Painful bladder symptoms or urinary urgency
- Fatigue that feels persistent and disproportionate
- Fertility challenges for some individuals
Why Endometriosis Often Goes Undiagnosed
Endometriosis is frequently missed or misdiagnosed, with many people waiting 7 to 8 years for a confirmed diagnosis³. There are several factors that contribute to this delay.
Severe period pain is often normalised, leading many to believe their endometriosis symptoms are “just part of being a woman.” At the same time, limited awareness among GPs means symptoms may be overlooked or attributed to more common conditions.
Endometriosis mimics other illnesses, including IBS, pelvic inflammatory disease (PID) and urinary or bowel disorders. Because these conditions are easier to diagnose, many patients are treated for them first.
Diagnosis is further complicated by the fact that the only definitive test is laparoscopy, a surgical procedure that often requires specialist referral and long waiting times4. For many, this means years of unmanaged endometriosis pain before reaching the right specialist.
If you’ve ever felt dismissed or misdiagnosed, your experience is valid and unfortunately common.
At Ramsay, we understand the complexity of endometriosis and are committed to providing timely assessment, specialist support, and care that listens to your experience.
How Endometriosis is Diagnosed and Treated
Diagnosing endometriosis can take time because symptoms vary widely and often overlap with other conditions. Once a diagnosis is made, treatment is tailored to each person’s symptoms, goals, and stage of life, as the condition affects everyone differently. A personalised care plan is essential, and working with a specialist team helps ensure you receive the right combination of medical, surgical, and supportive treatments for your needs.
Diagnosing Endometriosis
A typical diagnostic pathway includes several steps:
- Medical history - your clinician will ask about your symptoms, menstrual cycle, pain patterns, and any impact on daily life.
- Pelvic examination - to help identify areas of tenderness, cysts, or abnormalities. However, many people with endometriosis have a normal exam.
- Ultrasound or MRI - can detect ovarian cysts (endometriomas) or signs of deep endometriosis, but it cannot rule out the condition entirely.
- Laparoscopy (gold standard) - is the only definitive way to diagnose endometriosis. It is a minimally invasive surgical procedure that allows a specialist to see and, in many cases, treat endometriosis at the same time.
Endometriosis Treatment
Treatment options include:
1. Pain Management
- NSAIDs (such as ibuprofen or naproxen) to help reduce inflammation and period pain.
- Heat therapy, gentle movement, and lifestyle adjustments may also relieve endometriosis pain.
2. Hormonal Treatments
These aim to reduce or stop ovulation, which can lessen endometriosis pain and slow its growth:
- Combined contraceptive pill - often used as a first-line option to regulate periods and reduce pain. Example: Microgynon 30 / Rigevidon
- Progestogen-only pill - helps thin the lining of your womb and can reduce bleeding and cramping. Example: Dienogest - used specifically for endometriosis management.
- Hormonal IUD - releases a small amount of progestogen directly into your womb to reduce pain and bleeding. Example: Mirena Coil.
- GnRH analogues - used when other options aren’t effective or suitable. They temporarily switch off ovarian hormone production to reduce symptoms. Example: Zoladex.
3. Surgical Options
Surgery may help relieve persistent or severe endometriosis symptoms and improve fertility for some people. Laparoscopy, a minimally invasive procedure, is the main surgical treatment.
There are two main techniques:
- Excision surgery – your surgeon cuts out endometriosis lesions completely, including deeper tissue. This approach is often preferred for long-term relief, especially when disease is deep or widespread.
- Ablation surgery – your surgeon burns or destroys the surface of endometriosis lesions using heat, laser, or electrical energy. This can be effective for small, superficial lesions, but may leave deeper disease behind.
Your specialist will discuss the most appropriate approach based on your symptoms, the extent of disease, and your fertility goals.
4. Fertility Treatments
If endometriosis affects your ability to conceive, options may include:
- Ovulation-inducing medications
- Assisted reproductive technologies, such as IVF
- Surgical treatment to improve pelvic anatomy before fertility treatment
What does the latest research show?
Research into endometriosis is moving faster than ever. Scientists are learning more about what causes the condition, why symptoms vary so much, and which treatments offer the best long-term relief. This growing understanding is helping shape better care for people living with endometriosis.
Excision vs Ablation: What the Latest Evidence Shows
When surgery is needed, recent studies show that laparoscopic excision (where endometriosis tissue is carefully cut out) offers better long-term pain relief than laser ablation (which burns the tissue away). People who have excision are less likely to see their endometriosis symptoms return, making it the preferred option for many specialists⁵.
Excision is a highly skilled procedure, which means it isn’t available everywhere. Outcomes depend heavily on the surgeon’s experience and the resources of the hospital or endometriosis centre.
New and Emerging Approaches to Endometriosis Care
Alongside surgery, researchers are developing new treatments aimed at being more targeted and easier to tolerate. These include:
- Next-generation hormonal medicines with fewer side effects
- Immune-based treatments, reflecting growing evidence that the immune system plays a role
- Non-hormonal options that reduce inflammation and nerve-related pain
There is also exciting progress in diagnostics. New imaging techniques including advanced ultrasound, MRI, PET-CT, and even a potential saliva-based test, may help shorten the long wait many people face before getting a diagnosis⁶.
Genetic and Immune System Breakthroughs
A major study from the University of Oxford has shown that endometriosis shares genetic links with several immune-related conditions, such as rheumatoid arthritis, multiple sclerosis, coeliac disease, osteoarthritis, and psoriasis7. The research found that people with endometriosis have a 30 to 80% higher risk of developing these conditions, and there may even be a causal connection with rheumatoid arthritis.
These findings help explain why some people experience a mix of symptoms and why endometriosis can affect your body in ways that go beyond the reproductive system. They also open the door to new endometriosis treatments, including medicines already used for autoimmune diseases, combined treatment strategies, and more personalised care.
A New Understanding of the Disease
As highlighted in New Scientist, experts are increasingly viewing endometriosis as a whole-body, immune-linked condition, not just a gynaecological one8. This shift is helping drive:
- Immune-targeted therapies
- Repurposed autoimmune medications
- More personalised treatment plans based on genetic risk
- Earlier monitoring for people who may be at higher risk of related conditions
There is also growing recognition of the value of holistic support, including physiotherapy, exercise, diet and microbiome approaches, CBT, mindfulness, and cannabis-based therapies⁶. These can help people manage endometriosis pain day-to-day and improve quality of life.
Living with Endometriosis: Taking Control of Your Health
While there is currently no cure for endometriosis, many people find that symptoms can be managed effectively with the right combination of medical care, lifestyle strategies, and ongoing support.
Lifestyle Strategies That May Help
Diet and nutrition
Focusing on anti‑inflammatory foods such as leafy greens, berries, oily fish, nuts, and whole grains may help reduce inflammation and ease endometriosis symptoms. Limiting processed foods, caffeine, and alcohol can also support digestive comfort.
Gentle movement
Low‑impact exercise like walking, yoga, Pilates, or swimming can improve pelvic mobility, reduce tension, and support energy levels without worsening endometriosis pain.
Stress management
Techniques such as breathwork, mindfulness, meditation, or short rest breaks can help calm the nervous system and reduce symptom flares.
Heat therapy
Heat pads, warm baths, or hot water bottles can offer quick, soothing relief for pelvic or lower‑back pain.
Support networks
Connecting with others through support groups, online communities, or counselling can reduce isolation and provide practical coping strategies.
The Importance of Specialist Care
Because endometriosis affects everyone differently, the most effective approach combines lifestyle strategies with specialist medical care. A multidisciplinary team including gynaecologists, pain specialists, physiotherapists, and dietitians can help tailor a plan that supports your symptoms, fertility goals, and long‑term health.
If you’d like to understand your symptoms and explore treatment options, our specialist endometriosis teams are here to support you. Contact us
Get Expert Help: Book with an Endometriosis Specialist
If you’re struggling with endometriosis symptoms that are affecting your daily life, specialist support can make all the difference. Ramsay Health Care offers dedicated expertise in women’s health and endometriosis, giving you access to consultants who understand the condition in all its complexity.
Our specialist gynaecologists provide comprehensive assessment, advanced diagnostics, and personalised treatment plans, from medical management to expert laparoscopic surgery. With short wait times, one-to-one care, and highly experienced consultants, you can feel confident you’re getting the support, diagnosis and treatment from a team that puts patients first.
We’re here to help. Simply book an appointment today.
References
1 Endometriosis UK – Endometriosis Facts and Figures. https://www.endometriosis-uk.org/endometriosis-facts-and-figures
2 Office for National Statistics (ONS) – Endometriosis: Prevalence and Hospital Activity, 2024. https://www.ons.gov.uk
3 National Institute for Health and Care Excellence (NICE) – Endometriosis: Diagnosis and Management. https://www.nice.org.uk/guidance/ng73
4 Endometriosis UK – New Figures Show Impact of Long Gynaecology Wait Lists. https://www.endometriosis-uk.org/new-figures-show-impact-long-gynaecology-wait-list
5 Zhang X, Lu B, Huang X, Xu H. Comparison of laparoscopic excision and ablation for the treatment of endometriosis: a clinical study. American Journal of Clinical and Experimental Obstetrics & Gynecology. 2021;9(1). https://e-century.us/files/ajceog/9/1/ajceog0148677.pdf
6 Bupa Global. New leaps in endometriosis research. https://www.bupaglobal.com/en/your-wellbeing/healthy-body/new-leaps-in-endometriosis-research
7 University of Oxford. New research reveals shared genetic link between endometriosis and immune conditions. https://www.ox.ac.uk/news/2025-04-28-new-research-reveals-shared-genetic-link-between-endometriosis-and-immune-conditions
8 New Scientist. A deeper understanding of endometriosis is suggesting new treatments. https://www.newscientist.com/article/2496240-a-deeper-understanding-of-endometriosis-is-suggesting-new-treatments/