What is endometriosis?

Endometriosis is a condition in which the tissue (endometrium) normally lining the womb (or uterus) grows on different organs outside the uterus.

Endometriosis is believed to affect up to 15 percent of all women and after fibroids, is the most common gynaecological problem.  The National Endometriosis Society estimates that between 1.5 and 2 million women in Britain have endometriosis.

Like normal endometrium, the endometriosis tissue undergoes monthly changes according to the hormonal cycle and typically causes painful periods (dysmenorrhoea) although some women will experience no symptoms at all.

The commonest areas to be affected are:

  • the ovaries where cysts might appear
  • the area behind the womb and in front of the rectum (large bowel). This space is called the Pouch of Douglas and endometriosis here often causes deep pain and painful intercourse.
  • less common sites include the bowel itself, the bladder and sites outside the pelvic cavity.

What causes endometriosis?

This is still uncertain, but one theory suggests that during a period, light ‘backward’ bleeding carries tissue from the uterus to the pelvic area via the Fallopian tubes.

It may also be associated with lowered immunity and there is research looking into it being a genetic condition.

Another theory is that endometriosis is sensitive to oestrogen.  Therefore, women who have had more cycles, without a break for pregnancy, will have had more exposure to the female hormones.  The incidence of endometriosis-linked infertility may be increasing due to the fact that many women are putting of having children until later in life.

What does endometriosis look like?

It appears as small blackish-blue nodules on the external lining of the ovaries or elsewhere in the pelvis. In some cases it may lead to the formation of cysts filled with altered blood, known as ‘chocolate cysts’.

What are the symptoms of endometriosis?

  • Endometriosis might cause discomfort or mild to very severe pain during a period (dysmenorrhoea), with many sufferers experiencing chronic and debilitating pain during their period.
  • Sexual intercourse can be painful, and women with chocolate cysts may have a feeling of fullness in the lower parts of their stomach.
  • Heavy or irregular periods.
  • Back pain during menstruation.
  • General gastrointestinal discomfort including bloating, diarrohea and pain when you ‘poo’.

Does endometriosis affect a woman’s chances of becoming pregnant?

In severe cases, formation of connecting tissues around endometriosis near the Fallopian tubes or ovaries may reduce fertility.

How is endometriosis diagnosed?

Although the doctor may suspect endometriosis and start treatment on the basis of symptoms alone, usually the diagnosis is made through direct inspection of the pelvis. This is most commonly via laparoscopy performed by a gynaecologist.
Adenomyosis, in which endometriotic tissue is formed within the muscle of the womb wall, is usually difficult if not impossible to diagnose without performing a hysterectomy because it cannot be seen.

How is endometriosis treated?

Depending on the severity of symptoms, a GP or consultant may recommend non-steroidal anti-inflammatory drugs (NSAIDs) or painkillers.  However in more severe cases patients may be offered the contraceptive Pill.  Unfortunately symptoms usually recur when medication is stopped.  Surgical treatment is then often appropriate and can include keyhole surgery (laparoscopic surgery) to remove or destroy endometriosis or open surgery to remove ovarian cysts.

What can I do to help myself?

Endometriosis can be triggered by a number of factors including hormone imbalances, stress and nutritional deficiencies so addressing these issues may help alleviate symptoms.

  • Eating a diet of complex carbs (ie avoiding processed foods high in sugar) to help balance hormones
  • Make sure you have adequate amounts of omega 3 fatty acids in your diet
  • adequate amounts of vitamins and minerals including B vitamins, Vitamin E, Magnesium and Vitamin C


For more information about how to eat a healthy diet, contact Pippa Mitchell, our Nutritional Therapist on 01483 527 945