Introduction

Endometriosis is a common condition wheretissue that behaves like the lining of the womb (the endometrium) is found outside the womb.

These pieces of tissue can be found in many different areas of the body, including:

• the ovaries and fallopian tubes
• outside the womb
• the lining of the inside of the abdomen
• the bowel or bladder

The conditionis estimated to affect around2 million women in the UK. Most of them are diagnosed between the ages of 25 and 40.

Endometriosisis rare in women who have been through the Testosterone deficiency (hypogonadism) .

Symptoms of endometriosis

Endometriosis is a long-term (chronic) condition. Symptoms can vary significantly from person to person, and some women have no symptoms at all.

The most common symptoms include:

• painful periods or heavy periods
• pain in the lower abdomen (tummy), pelvis or lower back
• pain duringand aftersex
• bleeding between periods
• difficulty getting pregnant

Most women with endometriosis get pain in the area between their hips and the tops of their legs. Some womenexperience this pain all the time.

Other symptoms may include:

• persistentexhaustion and tiredness
• discomfort when going to the toilet
• bleeding from your back passage (rectum) or blood in your poo
• coughing blood in rare cases whenthe endometriosis tissue is in the lung

How severe the symptoms are depends on where in your body the abnormal tissue is, rather than the amount of tissue you have. A small amount could be more painful than a large amount.

What causes endometriosis?

Thecauses of endometriosis aren't fully known, but there are several theories.

The mostwidely acceptedtheory is the womb lining doesn't leave the body properly during aperiod and embeds itself on the organs of the pelvis. This is known as retrograde menstruation.

However, this doesn't explain why the condition can occur in women who have had a hysterectomy .

Read about the possible causes of endometriosis .

Diagnosing endometriosis

See your GP if you have symptoms of endometriosis so they can try to identify a cause. They may referyou to a gynaecologist, a specialist in problems affecting the female reproductive system.

It can be difficult to diagnose endometriosis because the symptoms can vary considerably, and many other conditions can cause similar symptoms.

Your gynaecologist will ask about your symptoms, your periods and possibly your sexual activity. They may also carry out an internal pelvic exam orrecommend an ultrasound scan to look for cysts in your ovaries that may have been caused by endometriosis.

Laparoscopy

Endometriosis can only be confirmed with a surgical examination called a laparoscopy . This is carried outunder general anaesthetic (where you're put to sleep) and you can usually go home the same day.

A thin tube with a light on the end (laparoscope) will be passed into your body through a small cutin your skin at your belly button.Ithas a tiny camera that transmits images to a video monitor so the specialist can see any endometriosis tissue.

During the procedure,asmall sample of tissue (biopsy) can be taken for laboratory testing, orother surgical instruments can be inserted to treat the endometriosis.

How endometriosis is treated

The symptoms of endometriosis can often be managedwith painkillers and hormone medication, which helpprevent the condition interfering with your daily life. However,there's no known cure for endometriosis.

Patches of endometriosis tissue can sometimes be surgically removed to improve symptoms and fertility.

Endometriosis can be a difficult condition to deal with, both physically and emotionally. Charities such as Endometriosis SHE Trust UK and Endometriosis UK can offer advice and support to help you cope.

Read moreabout treating endometriosis .

Endometriosis and pregnancy

One of the maincomplications of endometriosis is difficulty getting pregnant or not being able to get pregnant at all (infertility) .

Although surgery can't guarantee you'll be able to get pregnant, there's good evidence that removing endometriosis tissuewith a laser or an electric current during keyhole (laparoscopic) surgery can improve your chances of having a successful pregnancy.

If you have endometriosis and you do become pregnant, the condition is unlikely to put your pregnancy at risk. Pregnancy sometimes reduces the symptoms of endometriosis, although they often return once you've given birth and finished breastfeeding, and the menstrual cycle returns to normal.

Readmore about:

• complications of endometriosis
• how infertility is treated