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An introduction to endometriosis: symptoms, causes, and tips
Discover everything you need to know about endometriosis, including its symptoms, causes and some of the best ways to manage it effectively.
Summary
1What is endometriosis?
Endometriosis is a condition that causes endometrial tissue, similar to the lining of your womb, to grow in other places...
2What causes endometriosis?
No specific cause of endometriosis is known. However, some evidence suggests that endometriosis is linked to genetics and having...
3What are the signs of endometriosis?
The symptoms of endometriosis can vary in severity for each person.4,6 However, people experiencing endometriosis-related pain or back pain often...
Endometriosis is the second most common gynaecological condition in the UK and is said to affect one in ten people who menstruate throughout the country.1,2
While it can be diagnosed at any point across your lifespan, it is thought that two-thirds of all people with endometriosis typically start experiencing symptoms before the age of 20.3
Although you might associate endometriosis with symptoms like painful periods, bloating, and pelvic pain, there’s a lot more to the condition than meets the eye.4
Keep reading to find out everything you need to know about endometriosis, including its key symptoms, causes and how to manage the condition effectively.
What is endometriosis?
Endometriosis is a condition that causes endometrial tissue, similar to the lining of your womb, to grow in other places, such as the ovaries and fallopian tubes.4
This tissue can affect surrounding tissue in the pelvic region, leading to the formation of scar tissue (adhesions, lesions) within the pelvis and, in rarer cases, other parts of the body.5
While the cause of pain in endometriosis is still relatively poorly understood, surgical removal of these lesions can help alleviate pain.5
However, some differences exist between the severity of pain experienced and the number of lesions, so endometriosis is often described as multi-faceted in nature.6
What causes endometriosis?
No specific cause of endometriosis is known. However, some evidence suggests that endometriosis is linked to genetics and having a family history of the condition.4,7
In fact, research suggests that people who have a first-degree relative with the condition are at a higher risk of developing the condition.7
Other theories have been suggested, though none of them fully explain why endometriosis happens. These suggest endometriosis is caused by:4
- endometrium cells spreading through the body in the bloodstream or lymphatic system, a series of tubes and glands that form part of the immune system
- a problem with the immune system – the body's natural defence against illness and infection
It's likely the condition is caused by a combination of different factors.4
What are the signs of endometriosis?
The symptoms of endometriosis can vary in severity for each person.4,6 However, people experiencing endometriosis-related pain or back pain often describe it as intense, gnawing, throbbing, sharp, and stabbing.8
Endometriosis symptoms include:4
- pain in your lower tummy or back – usually worse during your period
- severe pain caused by endometriosis and periods
- pain during or after sex
- pain when peeing or pooing during your period
- blood in your pee or poo during your period
- feeling sick
- feeling bloated
- constipation & diarrhoea
- heavy periods
It’s important to also highlight the link between endometriosis and fertility problems. While this isn’t fully understood, these fertility issues are thought to be brought on due to damage to the fallopian tubes or ovaries.4,9
However, having endometriosis doesn’t automatically mean you’ll struggle with fertility. Lots of people with endometriosis don’t have fertility issues and some of those who do, go on to get pregnant without treatment.9
Getting an endometriosis diagnosis
Diagnosing endometriosis is complex as the symptoms mimic other conditions, such as period pain, pelvic inflammatory disease, and irritable bowel syndrome (IBS). There are also no specific biomarkers (natural body indicators) that can be used to reveal the condition.6
This means that the only way endometriosis can be formally diagnosed is through a type of keyhole surgery, known as a laparoscopy, to confirm the presence of endometriotic lesions.4
As a result, there tends to be a significant gap between the onset of pain and diagnosis – an average of eight years in the UK.6
Top tips for endometriosis relief
Living with endometriosis can be incredibly debilitating. Thankfully, however, there are several ways you can manage your symptoms.
Find out a bit more about each of these things and why they’re important if you have endometriosis below.
Practise good nutrition
There are multiple ways that good nutrition can help you to live with endometriosis.
Firstly, a 2020 review of multiple different studies has shown that fatty acids, antioxidants, and a combination of vitamins and minerals might have a positive effect on endometriosis-associated symptoms.10
However, the study concluded that further studies were needed to clarify which types of food in particular are best for endometriosis. So, try to consistently eat three balanced meals a day, each with a good source of protein, fibre, greens, and healthy fats.11
Prioritise anti-inflammatory foods
Research has also suggested that anti-inflammatory foods can help to reduce pain in people living with endometriosis.12
Try to incorporate more anti-inflammatory foods as part of your endometriosis diet to help reduce inflammation. This should include a mix of foods, including tomatoes, olive oil, green leafy vegetables, nuts, fatty fish, and fruits.13,14
Support your gut
Research shows that 70–80% of immune cells are found in the gut.12 So, it’s a good idea to keep your gut microbiome (the mix of bacteria, viruses, and fungi in your gut) happy.15
To do this effectively, try to add fermented foods like kimchi and kefir into your diet to encourage a diverse gut microbiome.16,17
Try gentle exercise
While it might be the last thing you want to do when struggling with painful symptoms, gentle forms of exercise have actually been proven to help.18,19,20
Tension in the muscles is a normal bodily response to pain, so slowly stretching your body or using a foam roller to massage them can help alleviate muscle fatigue.18
Research has also shown that regular exercise promotes pain relief. However, there’s little understanding regarding the intensity, duration, frequency, or type of exercise needed for this effect, particularly in people suffering with endometriosis.19
Improve your sleep
It’s no secret that sleep can have a huge effect on our health. In fact, studies have shown that even short instances of sleep deprivation can increase inflammation in the body.21,22
The occurrence of these increased inflammatory markers has been suggested to cause increased symptoms of pain among those with endometriosis.23 So, it’s important to build a quality sleep routine.
Some of the best things you can do to improve your sleep include:24
- sticking to a consistent bedtime
- sticking to a consistent wake-up time
- avoiding screens at night
- sleeping in a relaxing environment
- winding down your body and mind an hour before sleeping
- improving sleep through diet and exercise
The final say
It can be difficult to understand what’s happening to your body when living with endometriosis. However, as this article should prove, there are several ways to help manage your symptoms effectively.
Medical treatment is also available if you need it, so make sure to consult your doctor for further advice on how to manage your symptoms.
- Endometriosis UK. Endometriosis Facts and Figures [Internet]. [Cited 2024 Feb 13]. Available from: https://www.endometriosis-uk.org/endometriosis-facts-and-figures.
- Rogers, P., et al. (2009) Priorities for Endometriosis Research. Reprod Sci. 2009;16(4):335–346. doi: 10.1177/1933719108330568.
- Smolarz, B., et al. Endometriosis: Epidemiology, Classification, Pathogenesis, Treatment and Genetics (Review of Literature). Int J Mol Sci. 2021;22(19):10554. doi: 10.3390/ijms221910554.
- NHS. Overview - Endometriosis [Internet]. NHS. [Cited 2024 Feb 13]. Available from: https://www.nhs.uk/conditions/endometriosis/.
- World Health Organization. Endometriosis [Internet]. [Cited 2024 Feb 13]. Available from: https://www.who.int/news-room/fact-sheets/detail/endometriosis.
- Maddern, J., et al. Pain in Endometriosis. Frontiers in Cellular Neuroscience. 2020 Oct 6;14. Available from: https://doi.org/10.3389/fncel.2020.590823.
- Liakopoulou, M-K., et al. Medical and Behavioral Aspects of Adolescent Endometriosis: A Review of the Literature. Children. 2022;9(3):384. Available from: https://doi.org/10.3390/children9030384.
- Markham, R., et al. A detailed profile of pain in severe endometriosis. Journal of Endometriosis and Pelvic Pain Disorders. 2019;11(9):228402651983894. doi:10.1177/2284026519838948.
- NHS. Endometriosis - Complications [Internet]. [Cited 2024 Feb 13]. Available from: https://www.nhs.uk/conditions/endometriosis/complications/.
- Huijs, E., et al. The effects of nutrients on symptoms in women with endometriosis: a systematic review. Reproductive BioMedicine Online. 2020;41(2). Available from: https://doi.org/10.1016/j.rbmo.2020.04.014.
- Barnard, N., et al. Nutrition in the prevention and treatment of endometriosis: A review. Front Nutr. 2023;10:1089891. doi: 10.3389/fnut.2023.1089891.
- Nap, A., et al. Endometriosis and the effects of dietary interventions: what are we looking for? Reproduction and Fertility. 2022;3(2):C14–22. Available from: https://doi.org/10.1530/raf-21-0110.
- Harvard Health Publishing. Foods that fight inflammation [Internet]. [Cited 2024 Feb 13]. Available from: https://www.health.harvard.edu/staying-healthy/foods-that-fight-inflammation
- Scheiber, A., et al. Anti-Inflammatory Diets.In: StatPearls [Internet]. Treasure Island (FL): StatPearls Publishing; 2024. Available from: https://www.ncbi.nlm.nih.gov/books/NBK597377/.
- Wiertsema, SP., et al. The Interplay between the Gut Microbiome and the Immune System in the Context of Infectious Diseases throughout Life and the Role of Nutrition in Optimizing Treatment Strategies. Nutrients. 2021;13(3):886. Available from: https://doi.org/10.3390/nu13030886.
- Wastyk, H., et al. Gut-microbiota-targeted diets modulate human immune status. Cell. 2021;184:4137–4153. https://doi.org/10.1016/j.cell.2021.06.019.
- Zidan, S., et al. Could psychobiotics and fermented foods improve mood in middle-aged and older women? Maturitas. 2024;181:107903. https://doi.org/10.1016/j.maturitas.2023.107903.
- Pearcey, G., et al. Foam Rolling for Delayed-Onset Muscle Soreness and Recovery of Dynamic Performance Measures. J Athl Train. 2015;50(1):5–13. doi: 10.4085/1062-6050-50.1.01.
- Lima, LV., et al. Does exercise increase or decrease pain? Central mechanisms underlying these two phenomena. The Journal of Physiology. 2017;595(13):4141–50. Available from: https://doi.org/10.1113/jp273355.
- Endometriosis UK. (2024) Pelvic Exercise Programme [Internet]. [cited 2024 Apr 29]. Available from: https://www.endometriosis-uk.org/sites/default/files/files/pelvic%20exercise%20programmes%20web.pdf.
- Mullington, JM., et al. Sleep loss and inflammation. Best Practice & Research. Clinical Endocrinology & Metabolism. 2010;24(5):775–84. Available from: https://doi.org/10.1016/j.beem.2010.08.014.
- Dzierzewski, J., et al. Sleep Inconsistency and Markers of Inflammation. Front Neurol. 2020;11:1042. doi: 10.3389/fneur.2020.01042.
- Ishikura, I., et al. The relationship between insomnia and endometriosis. J Clin Sleep Med. 2020;16(8):1387-1388. doi: 10.5664/jcsm.8464.
- NHS. How to fall asleep faster and sleep better - Every Mind Matters [Internet]. [Cited 2024 Feb 13]. Available from: https://www.nhs.uk/every-mind-matters/mental-wellbeing-tips/how-to-fall-asleep-faster-and-sleep-better/.
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