In short: Endometriosis is a long-term condition where tissue similar to the womb lining grows outside the womb, causing pain, inflammation and sometimes fertility problems. It affects around 1 in 10 women of reproductive age in the UK and is often diagnosed late. NICE recommends an ultrasound scan when it is suspected, with treatment and specialist referral able to start alongside tests. Treatment includes pain relief, hormonal medicines and surgery, chosen according to your symptoms and plans for pregnancy.

This guide, written by a Ready Health prescribing pharmacist, explains endometriosis symptoms, how it is diagnosed under current NICE guidance, and the treatment options available in the UK.

What is endometriosis?

In endometriosis, tissue similar to the lining of the womb grows in places such as the ovaries, fallopian tubes, the lining of the pelvis, the bowel or the bladder. Like the womb lining, this tissue responds to monthly hormone changes, which can lead to inflammation, scar tissue (adhesions) and pain. Occasionally it is found outside the pelvis. The exact cause is not known, and it is not an infection or a cancer.

What are the symptoms of endometriosis?

period pain that affects daily activities
pelvic pain at other times in the cycle
deep pain during or after sex
pain when opening the bowels or passing urine, especially during a period
blood in urine or stools during a period (less common)
tiredness
difficulty getting pregnant

Symptoms can begin in the teenage years. The severity of symptoms does not always match the amount of endometriosis found, so some people with mild disease have severe pain and vice versa.

How is endometriosis diagnosed?

Diagnosis can take a long time because symptoms are often mistaken for normal period pain or bowel problems such as irritable bowel syndrome. Under the NICE endometriosis guideline (NG73, updated in 2024):

a clinician should take a detailed history and offer an abdominal and, if appropriate, pelvic examination
a transvaginal ultrasound should be offered if endometriosis is suspected, even if the examination is normal (another type of scan can be used if a transvaginal scan is not acceptable)
a normal examination or scan does not rule out endometriosis, and referral should still be considered if symptoms continue
initial treatment, scans and referral can happen at the same time
laparoscopy (keyhole surgery) can confirm the diagnosis, and sometimes treat it in the same procedure

Keeping a pain and symptom diary over a few cycles can help your clinician.

What are the treatment options for endometriosis?

Treatment	How it helps	Points to know
Pain relief (anti-inflammatories such as ibuprofen, and paracetamol)	Reduces period pain and inflammation	Often tried first, for a short trial; not suitable for everyone
Combined hormonal contraception or progestogens (tablets, injection, implant or hormonal coil)	Reduce or stop periods, easing pain	First-line hormonal options in NICE guidance
GnRH agonists or antagonists	Lower oestrogen levels to settle endometriosis	Usually started by a specialist; given with add-back hormones to protect bones where needed. NICE (TA1057, 2025) recommends a combined daily tablet option for some people already treated
Surgery	Removes or destroys endometriosis tissue or cysts	Planned by a gynaecologist; more complex disease is managed at specialist endometriosis centres
Hysterectomy	May be considered in some cases	Not a guaranteed cure, and only after full discussion

Hormonal treatments are contraceptive, so they are not used while trying to conceive. A prescriber will decide which options are suitable for you.

Does endometriosis affect fertility?

Endometriosis can make it harder to get pregnant, but many women with endometriosis conceive naturally. If you are trying for a baby, tell your clinician, as this affects which treatments are recommended. Surgery or assisted conception may be discussed with a specialist.

How can I manage endometriosis day to day?

take pain relief early in a period, as advised by a pharmacist or prescriber
heat pads and gentle exercise may help
pelvic physiotherapy and pain management services can help with long-term pain
psychological support matters, as living with chronic pain can affect mood and relationships
support organisations such as Endometriosis UK offer information and peer support

Frequently asked questions

Can endometriosis be cured?

There is currently no cure, but treatment can control symptoms well for many people. Symptoms often improve after menopause.

Is endometriosis the same as adenomyosis?

No. In adenomyosis, womb lining tissue grows into the muscle wall of the womb. The two conditions can occur together and have similar symptoms.

Does pregnancy cure endometriosis?

No. Symptoms may ease during pregnancy, but they often return afterwards. Pregnancy is not recommended as a treatment.

Can teenagers have endometriosis?

Yes. Severe period pain in teenagers should be taken seriously and assessed.

Key takeaways

Endometriosis is common and often diagnosed late.
NICE recommends an ultrasound when it is suspected, but a normal result does not rule it out.
Treatment can start while tests and referral are in progress.
Options include pain relief, hormonal medicines and surgery, guided by your symptoms and pregnancy plans.
Specialist care is recommended for complex or deep endometriosis.

Sources and further reading

Last reviewed: October 2026 by Shamir Patel, Independent Prescribing Pharmacist, Ready Health. This article is general information and does not replace advice from your own clinician.

If you think you could have endometriosis, you can book a women's health consultation at Ready Health in Standish, Wigan. We will listen to your symptoms, discuss investigations and help you plan next steps, including referral where needed.