Endometriosis
Article Writer: Aileen Kaur June 2025
Endometriosis is a complex condition associated with the cells lining the uterus growing in different areas of the body. These cells form the endometrial tissue which breaks down and leads to blood formation. Since this is occurring outside of the uterus, it cannot be removed by the body which leads to the formation of scar tissue and inflammation. This impacts 1 in 10 women in the UK; this is approximately 1.5 million individuals.
The condition can be categorised into 4 distinct types of endometriosis:
1. Peritoneal Endometriosis in the presence of endometrial tissue on the peritoneum, this is the lining of the pelvis. This is the most common form of endometriosis as 80% of the cases are found to have this type.
2. Ovarian Endometriosis is the presence of endometrial tissue on the cysts found in the ovaries.
3. Deep Endometriosis is found in the bladder and the bowel.
4. Extra Pelvic Endometriosis is found out of the pelvis in regions like the thorax cavity (the chest).
This condition induces symptoms of severe pain during menstruation and heavy bleeding. There may be chronic pelvis pain and may lead to pain during sexual activity. There could be painful bowel movements and fatigue. These symptoms however are not exclusive to endometriosis and many diseases and conditions may cause these. This unfortunately means that the diagnosis of endometriosis is time consuming as tests must be done to correctly identify endometriosis. Alongside this issue, there is a problem of stigmatism of any pain being considered normal for women. While mild discomfort in periods is normal in the form of cramps, if period pains are affecting your day-to-day life, it is essential to visit a GP.
The diagnosis of endometriosis can be a long and extensive process due to how symptoms shown by endometriosis can be similar to other common conditions. The only definitive method of diagnosis with endometriosis is having a laparoscopy. This is a minor invasive surgical procedure in which a small incision is made and a camera is used to view the organs to identify if there is any endometrial tissue present.
There is no proven cause for endometriosis. Scientists have investigated potential theories that could lead to endometriosis. It is likely that a combination of these theories cause endometriosis. Genetics is a potential factor in causing endometriosis, a study from Oxford with a collaboration of 25 research institutions studied the genetic code of those with endometriosis. This study was performed on 60,600 women and showed that ovarian endometriosis had a different genetic code than the other kinds of endometriosis which shows a clear link. Additionally, environmental factors like the presence of toxins have proven to cause endometriosis in animals, however this is not tested in humans. Finally, metaplasia is when cells outside of the uterus spontaneously morphs into endometrial cells. Unfortunately, endometriosis is under researched and there is no dedicated funding in the UK towards research which makes it more difficult to look at causes and cures and the only treatments are aimed for targeting the symptoms.
Treatments for endometriosis aim for improving the life of quality of those who have endometriosis as there is no cure for the condition. There are many forms of treatments possible for endometriosis, and the treatment is specific to the individual. Factors like age and the severity of the pain is considered when deciding a treatment. Hormonal treatments are a possible option. This is because endometrial tissue responds and grows when exposed to the hormone oestrogen. There can be medication that reduce the levels of oestrogen and slows down the growth of tissues but this is a temporary method and the effects are reversed once you stop taking the medication. There are surgical options to remove the deposits of endometrial tissue. A laparoscopy can be a method to remove deposits; this can be performed at the same time as the diagnosis. Physiotherapy can also help strengthen pelvic floor muscles to reduce pain symptoms. It is also possible to get a hysterectomy (the removal of uterus) or an oophorectomy (removal of ovaries). These are major surgeries and should only be considered once other treatments have not worked. They are irreversible procedures and will mean you are unable to reproduce once they are performed.
The complex nature of endometriosis results in it being under acknowledged and under researched. There is a huge burden of this disease as it affects quality of life and productivity. It is essential that there is further awareness for the sufferers and for the public as no pain is normal. Further dedicated research on this condition is necessary as globally 10% of women are affected. If you believe you have endometriosis, here are links to some websites with further information that may be useful.
https://www.endometriosis-uk.org/ending-endometriosis-starts-saying-it