Cookies on the Bupa website

We use cookies to help us understand ease of use and relevance of content. This ensures that we can give you the best experience on our website. If you continue, we'll assume that you are happy to receive cookies for this purpose. Find out more about cookies




If you have endometriosis, you’re not alone. About one in every 10 women is affected by it. The condition often affects women of a childbearing age and usually disappears after the menopause

Normally, as part of the menstrual cycle, your womb lining will thicken to receive a fertilised egg. When an egg is released and isn't fertilised (if you don’t get pregnant), the lining of your womb will break down. It will leave your body as menstrual blood (a period). This process is controlled by your body’s hormones.  

In endometriosis, you have cells that would normally line your womb (endometrial tissue) elsewhere in your body. This tissue will also thicken and break down with your menstrual cycle, but it has no way of leaving your body. This can lead to pain, swelling and scarring. If you have endometriosis on your fallopian tubes or ovaries, it can lead to fertility problems.

Endometriosis is most common on your ovaries, fallopian tubes and the tissues that hold your womb in place. You can also get it on or around other organs in your pelvis and abdomen (tummy), such as your vagina, bladder or bowel. Rarely, endometriosis can occur in other places such as your lungs or breast.

Read more Close
An image showing the location of the womb and surrounding structures


  • Symptoms Symptoms of endometriosis

    The symptoms of endometriosis can differ from woman to woman. You may have no symptoms at all. One of the most common symptoms is long-term pelvic pain lasting six months or more. This feels like period pain and may come before or during your period.

    Other symptoms you may have include:

    • pain during sex
    • changes to your periods, such as heavy bleeding
    • extreme tiredness
    • depression
    • unexplained difficulties becoming pregnant
    • blood in your urine

    These symptoms may be caused by things other than endometriosis. If you have any of these symptoms, see your GP.

    Less commonly, endometriosis on your bowel can cause pain when you have a bowel movement. You may also have blood in your faeces during your period. If you have endometriosis on your bladder, it can cause pain when you pass urine.

    Symptoms of endometriosis usually get better or disappear after the menopause.

    Bupa On Demand

    Want to talk to a Bupa consultant? We’ll aim to get you seen the next day. Prices from £250.

  • Diagnosis Diagnosis of endometriosis

    Your GP will ask you about your symptoms. They may ask to carry out a vaginal or rectal examination. A vaginal examination involves your GP inserting gloved, lubricated fingers into your vagina to gently feel for any abnormalities in your uterus (womb). At the same time, he or she will use their other hand to lightly press on your abdomen (tummy). A rectal examination involves your GP inserting a gloved, lubricated finger into your anus. This may feel uncomfortable but shouldn't be painful.

    You may also be asked to have an ultrasound scan. Ultrasound uses sound waves to produce an image of the inside of the body. To look for endometriosis, an ultrasound scan may be performed using a sensor placed in your vagina.

    Your GP may refer you to a gynaecologist, (a doctor that specialises in women's reproductive health) for further tests. It may take some time for you to get a diagnosis of endometriosis because the symptoms are similar to some other health conditions. The only way doctors can be sure that you have endometriosis is to check through a procedure called laparoscopy. This is carried out under general anaesthetic and involves a gynaecologist looking inside your abdomen using a narrow tube-like telescopic camera (laparoscope) that is inserted through a small cut. This is sometimes called ‘key-hole surgery’.

    Sometimes, rather than you having this procedure right away, your doctor may suggest trying treatments for endometriosis first, to see if they help.

    You may also be asked to have an MRI scan. An MRI scan uses magnets and radio waves to produce images of the inside of the body.


    Your gynaecologist may tell you the stage of your endometriosis after your laparoscopy. This is a description of how large your areas of endometriosis are, and how much they are affecting other tissues. There are four stages of endometriosis: stage one, two, three and four. Stage one is the most mild, while stage four is the most severe.

  • Treatment Treatment of endometriosis

    About one in three women get better on their own over six to 12 months. Other women may need to have treatment to reduce their symptoms. Your treatment depends on factors such as how bad your symptoms are and whether or not you want to have children.

    A number of treatments can help to manage your symptoms, but they don’t always work in the long-term. About half of women find that their symptoms come back. You may choose to have another course of medication or more surgery if this happens.


    If you need pain relief, you can try over-the-counter painkillers, such as paracetamol and ibuprofen. Always read the patient information leaflet that comes with your medicine. If you have any questions, ask your pharmacist for advice.

    Hormone treatments can help to reduce endometriosis and lessen your pain. If you’re not trying to get pregnant, your doctor may offer you the combined oral contraceptive pill or the progestogen-only pill. You’ll be offered these for a few months at first, but if they’re helpful, you’ll usually be able to carry on taking them.

    If they don’t help, you doctor may advise you to try another type of hormone treatment. These may include the following:

    • progestogens such as norethisterone
    • gonadotrophin-releasing hormone (GnRH) analogues (such as buserelin)
    • androgens such as gestrinone

    These medicines may be given to you for a few months at a time. After a break, your doctor may suggest another course of treatment or surgery if your symptoms come back.

    Each of these medicines has different side-effects. Side-effects are the unwanted but mostly temporary effects you may get after having your treatment. Your doctor can explain these to you and recommend which treatment may be most suitable to try first.

    You may also be able to have cognitive behavioural therapy (CBT) to help you to manage your pain. This can help you to understand your thoughts, feelings and actions. Through techniques you will learn, you can change the way you react to and cope with things such as pain.


    Surgery can remove areas of endometriosis. This can help to improve your fertility if your endometriosis is affecting it, and can also reduce your pain.

    If you have surgery to diagnose your endometriosis, your gynaecologist will remove the endometriosis during the procedure if possible.

    Surgery can often be done by laparoscopy. This involves a gynaecologist looking inside your abdomen (tummy) using a narrow, tube-like telescopic camera (laparoscope) inserted through a small cut. He or she can remove your endometriosis by cutting it away or destroying it with heat from an electric current, a laser, or helium gas.

    Endometriosis can come back after surgery, so you may need to have surgery again in the future.

    If you don’t want to have children in the future, you may be offered a hysterectomy. This is a larger operation to remove your womb and sometimes your ovaries. This operation can also be done by laparoscopy. Having a hysterectomy may reduce your pain and make it less likely that you’ll need to have further surgery in the future.

  • Bupa On Demand

    You can receive private treatment, scans and consultations on a pay-as-you go basis with Bupa On Demand. Find out more today.

  • Causes Causes of endometriosis

    The exact reasons why you may develop endometriosis aren't fully understood.

    Endometriosis might be caused by a combination of factors. For example, your immune system or hormones might play a role. Endometriosis may also run in families, as you’re more likely to get it if your mother or sister has it.

    There are certain factors that may make you more likely to get endometriosis. For example, you're more likely to get it if you:

    • started your periods at an early age (before the age of 11)
    • have frequent, heavy painful periods
    • haven’t had any children
  • Complications Complications of endometriosis

    Some complications of endometriosis are listed below.

    • Scar tissue can attach to organs in your pelvis and abdomen (tummy). These scars are known as adhesions and can cause pain.
    • Your fertility may be reduced. Up to four in every 10 women with endometriosis have reduced fertility.
    • Endometriosis increases your risk of getting ovarian cysts. These can rupture and cause pain and reduced fertility.
    • Endometriosis on your bowel may cause it to become blocked.
    • There’s a small amount of proof to suggest that you may have a slightly increased risk of ovarian cancer.

    Speak to your GP or doctor if you’d like more information, or if you have any questions about the complications of endometriosis.

  • FAQs FAQs

    I have endometriosis. Does this mean I'm more likely to get cancer?


    Endometriosis is a benign condition, which means it isn't a type of cancer. There’s a small amount of proof to show that women with endometriosis may have a slightly increased risk of getting ovarian cancer. However, proof is needed to be sure.


    Endometriosis may be linked with an increased risk of ovarian cancer, but more proof is needed to be certain. Researchers aren’t sure why there might be a link between the two conditions. It might be that the same things that can cause you to get endometriosis can also cause you to develop ovarian cancer.

    You’re more likely to develop ovarian cancer if you:

    • have a mother or sister with the condition
    • haven’t had any children
    • started your periods at an early age

    These same factors make you more likely to get endometriosis too.

    If you’re concerned about your risk of ovarian cancer, talk to your GP or doctor.

    I’ve heard about a procedure called LUNA – what is this?


    LUNA stands for laparoscopic uterine nerve ablation. It’s an operation that aims to reduce your pain.


    LUNA is a procedure that aims to reduce your pain by cutting or removing some of the nerves and ligaments attached to your uterus (womb).

    Researchers have been investigating how well LUNA works. They've found that LUNA isn't very successful at reducing pain linked to endometriosis. Other types of surgery may be better at easing pain caused by endometriosis. Ask your doctor if you’d like more information about your treatment options. They will happily answer any questions you may have and will be able to recommend the best type of treatment for you.

    Will a hysterectomy cure my endometriosis?


    Although there’s no cure for endometriosis, having a hysterectomy does stop endometriosis coming back in most women.


    If your endometriosis comes back after being removed through surgery, your doctor may recommend an operation to have your uterus (womb) and ovaries removed. This is called a hysterectomy with bilateral salpingo-oophorectomy.

    Your menstrual cycle is controlled by hormones in your body, much of which are released by your ovaries. These hormones trigger the thickening of your womb lining and your periods. They also trigger the same changes in areas where you have endometriosis. So, by removing the ovaries with surgery, this can stop areas of endometriosis swelling and bleeding, which can reduce your pain.

    Having your womb and ovaries removed, along with areas of endometriosis, may make your symptoms go away for good. It doesn’t always work though – some women still have symptoms of endometriosis after the operation. This might happen because areas of endometriosis are missed in the operation, and remain in your body.

    You won’t be able to have children after you've had a hysterectomy, so it’s important to discuss this with your doctor beforehand. Having your ovaries removed may also cause you to have symptoms similar to the menopause, such as hot flushes and mood changes.

    For more information about your treatment options, or if you have any questions, speak to your doctor. They will explain the options available to you, as well as their benefits and risks.

  • Resources Resources

    Further information


    • Endometriosis. NICE Clinical Knowledge Summaries., reviewed May 2014
    • Zafrakas M, Grimbizis G, Timologou A, et al. Endometriosis and ovarian cancer risk: a systematic review of epidemiological studies. Front Surg 2014;1(14). doi: 10.3389/fsurg.2014.00014
    • Endometriosis. Medscape., updated 20 January 2015
    • Strandring S. Gray’s anatomy: The anatomical basis of clinical practice, expert consult. 40th ed. London: Churchill Livingstone; 2008
    • Practice bulletin: Management of endometriosis. American College of Obstetricians and Gynaecologists., published July 2010
    • Map of Medicine. Endometriosis. International View. London: Map of Medicine; 2011 (Issue 4)
    • Laparoscopic uterine nerve ablation (LUNA) for chronic pelvic pain (interventional procedures consultation). National Institute for Health and Care Excellence (NICE), 2007.
    • Psychotherapy. Oxford handbook of psychiatry (online). Oxford Medicine Online., published March 2013 (online version)
    • Fadhlaoui A, Bouquet de la Jolinière J, Feki A. Endometriosis and infertility: how and when to treat? Front Surg 2014; 1(24). doi:10.3389/fsurg.2014.00024
    • Endometriosis. BMJ Best Practice., published 5 Nov 2014
    • Endometriosis. PatientPlus., published 31 Jan 2013
    • Gyneacological history and examination. PatientPlus., published 18 March 2011
    • Rectal examination. PatientPlus., published 24 Nov 2014
    • Information for you after your laparoscopy. Royal College of Obstetricians and Gynaecologists., accessed 30 January 2015
    • Hysterectomy. Medscape., published 22 Jan 2015
    • Laparoscopic hysterectomy. Medscape., published 18 October 2013
    • Ovarian cancer. PatientPlus., published 10 December 2013
    • Fertility: assessment and treatment for people with fertility problems. National Institute for Health and Care Excellence (NICE), 2013.
  • Has our information helped you? Tell us what you think about this page

    We’d love to know what you think about what you’ve just been reading and looking at – we’ll use it to improve our information. If you’d like to give us some feedback, our short form below will take just a few minutes to complete. And if there's a question you want to ask that hasn't been answered here, please submit it to us. Although we can't respond to specific questions directly, we’ll aim to include the answer to it when we next review this topic.

    Let us know what you think using our short feedback form
    Ask us a question
  • Related information Related information

  • Author information Author information

    Reviewed by Hemali Bedi, Bupa Health Content Team, March 2015.

    Let us know what you think using our short feedback form
    Ask us a question

About our health information

At Bupa we produce a wealth of free health information for you and your family. We believe that trustworthy information is essential in helping you make better decisions about your health and care. Here are just a few of the ways in which our core editorial principles have been recognised.

  • Information Standard

    We are certified by the Information Standard. This quality mark identifies reliable, trustworthy producers and sources of health information.

    Information standard logo
  • HONcode

    This site complies with the HONcode standard for trustworthy health information:
    verify here.

    This website is certified by Health On the Net Foundation. Click to verify.

What our readers say about us

But don't just take our word for it; here's some feedback from our readers.

Simple and easy to use website - not alarming, just helpful.

It’s informative but not too detailed. I like that it’s factual and realistic about the conditions and the procedures involved. It’s also easy to navigate to areas that you specifically want without having to read all the information.

Good information, easy to find, trustworthy.

Meet the team

Nick Ridgman

Nick Ridgman
Head of Health Content

  • Dylan Merkett – Lead Editor
  • Graham Pembrey - Lead Editor
  • Natalie Heaton – Specialist Editor, User Experience
  • Pippa Coulter – Specialist Editor, Content Library
  • Alice Rossiter – Specialist Editor, Insights (on Maternity Leave)
  • Laura Blanks – Specialist Editor, Quality
  • Michelle Harrison – Specialist Editor, Insights

Our core principles

All our health content is produced in line with our core editorial principles – readable, reliable, relevant – which are represented by our diagram.

An image showing or editorial principals

                  Click to open full-size image

The ‘3Rs’ encompass everything we believe good health information should be. From tweets to in-depth reports, videos to quizzes, every piece of content we produce has these as its foundation.


In a nutshell, our information is jargon-free, concise and accessible. We know our audience and we meet their health information needs, helping them to take the next step in their health and wellbeing journey.


We use the best quality and most up-to-date evidence to produce our information. Our process is transparent and validated by experts – both our users and medical specialists.


We know that our users want the right information at the right time, in the way that suits them. So we review our content at least every three years to keep it fresh. And we’re embracing new technology and social media so they can get it whenever and wherever they choose.

Our accreditation

Here are just a few of the ways in which the quality of our information has been recognised.

  • The Information Standard certification scheme

    You will see the Information Standard quality mark on our content. This is a certification programme, supported by NHS England, that was developed to ensure that public-facing health and care information is created to a set of best practice principles.

    It uses only recognised evidence sources and presents the information in a clear and balanced way. The Information Standard quality mark is a quick and easy way for you to identify reliable and trustworthy producers and sources of information.

    Certified by the Information Standard as a quality provider of health and social care information. Bupa shall hold responsibility for the accuracy of the information they publish and neither the Scheme Operator nor the Scheme Owner shall have any responsibility whatsoever for costs, losses or direct or indirect damages or costs arising from inaccuracy of information or omissions in information published on the website on behalf of Bupa.

  • British Medical Association (BMA) patient information awards

    We have received a number of BMA awards for different assets over the years. Most recently, in 2013, we received a 'commended' award for our online shared decision making hub.

Contact us

If you have any feedback on our health information, we would love to hear from you. Please contact us via email: Or you can write to us:

Health Content Team
Battle Bridge House
300 Grays Inn Road

Find out more Close

Legal disclaimer

This information was published by Bupa's Health Content Team and is based on reputable sources of medical evidence. It has been reviewed by appropriate medical or clinical professionals. Photos are only for illustrative purposes and do not reflect every presentation of a condition.

The information contained on this page and in any third party websites referred to on this page is not intended nor implied to be a substitute for professional medical advice nor is it intended to be for medical diagnosis or treatment. Third party websites are not owned or controlled by Bupa and any individual may be able to access and post messages on them. Bupa is not responsible for the content or availability of these third party websites. We do not accept advertising on this page.

For more details on how we produce our content and its sources, visit the 'About our health information' section.

ˆ We may record or monitor our calls.