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Intro to endometriosis: Symptoms, causes & lifestyle tips

what is Endometriosis written on a notepad
Endometriosis... what actually is it? And what are the symptoms of it? Find out all you need to know about the condition and how to manage it, in this guide.
Let’s talk about endometriosis: read on for more info about symptoms, causes & lifestyle tips

If you’ve heard of endometriosis, you might know that it can result in painful periods, bloating and pelvic pain, but did you know that it can be far more serious than just a bad period? 

So if you’re keen to learn a bit more about endometriosis, the second most common gynaecological condition in the UK,1 you’re in the right place.

Holland & Barrett’s women’s wellness business, Parla, has launched a ground-breaking e-learning programme, to demystify endometriosis and teach people how to manage symptoms of the condition in a healthy and holistic way.

Parla are working with Carla Cressy, founder of The Endometriosis Foundation, to encourage people to share their #endostories and raise awareness of this misunderstood condition. If you want to find out more about Parla or read about Carla's story, click here.

We’ll guide you through everything you need to know to get to grips with endometriosis, below.

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What is endometriosis?

What is endometriosis?

If you’ve only just heard of endometriosis, you’re probably wondering what it is. Well, endometriosis is a common condition that is said to affect 1 in 10 women, non-binary people and trans men in the UK.2 It can affect a wide range of age groups, starting from the teenage years right through to postmenopause.3

Endometriosis causes tissue that’s similar to the lining of your womb to start to grow in other places, like the ovaries and fallopian tubes.This tissue acts like the lining of the uterus during menstruation, meaning that it becomes inflamed and tries to shed.

But, unlike during your period (when this shedding comes out in the form of blood), it instead causes scar tissue. These can then lead to adhesions that cause pain in the pelvis, bladder, bowels, ovaries and uterus.4

What are the symptoms of endometriosis?

Taking an average of 8 years for a firm diagnosis, it’s safe to say that getting one isn’t a straightforward process.5 One of the reasons for this is that a lot of the main endometriosis symptoms fall into other categories too, such as primary dysmenorrhea, pelvic inflammatory disease, IBS and period pain.

Endometriosis symptoms to look out for:

  • Pelvic pain 
  • Discomfort in your lower tummy or back – usually worse during your period 
  • Period pain that stops you from doing your normal activities 
  • Discomfort during ovulation 
  • Spotting between periods 
  • Loss of old or dark blood before period 
  • Discomfort during or after sex 
  • Discomfort when weeing or pooing during your period 
  • Feeling sick 
  • Recurrent constipation 
  • Recurrent diarrhoea 
  • Blood in your wee or poo during your period 
  • Difficulty getting pregnant 
  • Heavy periods 
  • Depression 
  • Regular fatigue 
  • Back ache 
  • Leg discomfort3,6

Symptoms of endometriosis

Symptoms of endometriosis

Symptoms of endometriosis can vary by severity for each individual and may be pronounced during the menstrual cycle. Having said this, it’s important to seek medical help or speak to your GP as these symptoms can be indicators of other conditions too.

Also, it’s important for us to mention the link between endometriosis and difficulty getting pregnant. Roughly 30-50% of female infertility is associated with endometriosis, but that doesn’t mean you won’t be able to get pregnant, as many people with endometriosis go onto conceive.7

We know understanding endometriosis can be very difficult. To learn more about endo and holistic ways to manage the symptoms directly from a nutritionist and hormone health expert, join Parla’s 6 week endo-programme.

What are the stages of endometriosis?

Endometriosis is categorised into four stages by the American Reproductive Society, depending on where the endometrial tissues are, how big they are, how deep they are and how widespread they are. Having said this, the stage you are at doesn’t always match up with the severity of symptoms. Here’s what each stage means:8

Stage one

A few small lesions (or injuries), some pelvic inflammation and shallow endometrial implants - aka the tissue that grows outside of the womb - on the ovaries.


Stage two

Still mild, with more lesions and implants on just one or both ovaries as well as the pelvis.


Stage three

Moderate level, multiple deeper implants on both the ovaries and the pelvis. Presence of small cysts on either one or both ovaries. Filmy adhesions present.


Stage four

Severe with lots of deep implants on the ovaries and pelvis. Large cysts on either one or both ovaries. Multiple dense adhesions.


What causes endometriosis?

While no specific cause of endometriosis is known, it is speculated that genetics may have a part to play. In fact, research suggests that people who have a first-degree relative with the condition are 5-7 times more likely to have the condition than those who don’t.9

Some other possible causes of endometriosis include immune system problems or the cells of the uterus lining spreading through the body in the bloodstream.3

Tips for living with endometriosis

Tips for living with endometriosis

We understand that living with endometriosis can be extremely difficult for some people. Living with endometriosis can be tough. Thankfully, though, there are certain ways you may be able to help improve your experience and manage your symptoms. Making lifestyle changes like exercise, good nutrition, sleeping well and supporting your gut health might be able to help.

Find out a bit more about each of these things and why they’re important if you have endometriosis, below.


There are multiple ways that the right nutrition can help you to live with endometriosis. Firstly, you could try to incorporate more anti-inflammatory foods into your diet to help reduce inflammatory markers. This includes a rainbow of foods like turmeric, ginger, garlic, oily fish, fruits, cruciferous vegetables, nuts and seeds.10

Try to consistently eat three balanced meals a day, each with a good source of protein, fibre, greens and healthy fats. A 2021 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.11 But concluded that further studies are needed to clarify which types of food in particular are best for endometriosis.

Get support

On a similar note, it’s worthwhile to focus on your gut health too. Research now shows that 70-80% of our immune cells are found in the gut, which is why it’s a good idea to keep your gut microbiome (aka the mix of bacteria, viruses and fungi in your gut) happy.12

Try to pack in plenty of fermented foods like kimchi, sauerkraut and kefir to help encourage a diverse gut microbiome.13 In addition to this, filling up with fibrous foods like vegetables, wholegrains, nuts, seeds and legumes may also help to keep your gut health in check.14



While it might seem counterintuitive when you’re having a hard time with your symptoms, gentle forms of exercise may actually help. Slowly stretching your body or using a foam roller to massage your muscles might loosen up tense muscles – which is a normal bodily response to pain.15 Just try not to do any stretches or yoga poses where you’re putting a lot of pressure on your stomach.

Research has also shown that regular exercise may reduce pain as it increases blood vessel dilation and flushes out prostaglandins (aka the hormone that can up your pain levels).16


It’s no secret that sleep can have a huge impact on our health. In fact, studies have shown that even short instances of sleep deprivation can increase markers for inflammation in the body.17 This in turn may worsen or intensify some symptoms of endometriosis, so it’s important to build a quality sleep routine.

Some of the best things you can do to improve your sleep include: 

  • Sticking to a consistent bedtime 
  • Sticking to a consistent wake time 
  • Avoiding screens at night 
  • Sleeping in a relaxing environment 
  • Winding down your body and mind an hour before sleeping

The final say

Understanding what’s happening to your body can be a minefield. So we hope you’re feeling a little more educated on the condition and armed with some ways to help manage it. Help is always available if you need it, and you deserve to get extra support to help with your symptoms.

For more advice on managing your endometriosis symptoms in a healthy and holistic way, join Parla’s 6-week support course.

Who are Parla?

Who are Parla?

Holland & Barrett’s women’s wellness business, Parla is a digital women’s health platform.

Driven by a desire to break taboos and end misinformation, Parla aims to empower women with the knowledge they need to make informed choices that will help them lead happier and healthier lives.

Find out about Parla's endometriosis programme

Parla has launched a ground-breaking new e-learning programme, to demystify endometriosis and teach users how to manage symptoms of the condition in a healthy and holistic way.

The six-week ‘Take Control of Your Endometriosis’ programme is a non-judgemental space for learners and includes in-depth e-modules, live webinars and most importantly, a well-connected and supportive community.


The Endometriosis Foundation: Founder Carla's story

The Endometriosis Foundation: Founder Carla's story

'It can be difficult to know what to do or where to turn when you’re suffering with endometriosis, as well as the many different ways we can support ourselves through lifestyle and diet to help better manage the condition.

I set up The Endometriosis Foundation after spending countless days and nights searching for information, support, advice, guidance, and there simply wasn’t any. My ultimate goal for the charity is for it to be everything I never had.'

Real life stories

Read about Carla's experience with endometriosis

My Endometriosis story started in 2004. Despite suffering with all the common symptoms of Endometriosis, it took over a year for my mum and I to convince the GP to refer me to see a gynaecologist where I had my first trans vaginal scan. 

Feeling relieved I’d finally have answers to my painful and irregular periods, the gynaecologist told me everything was normal, that periods are supposed to be painful, and she sent me on my way. I was just fourteen at the time. Still, mum and I persisted and every time I had my period, which was every two weeks, I would find myself back visiting the GP seeking answers for my excruciating pain, crippling migraines and collapsing episodes. 

By the time I reached eighteen, I had trailed seven different hormone pills. Nothing was helping. My symptoms impacted much of my teenage years, and like most people with Endometriosis my pain and concerns were dismissed time and time again.

I moved away from home when I was twenty, and again I was continuously back and forth to my new GP. I remember a few weeks before my twenty-first birthday I discovered from turning to dr Google that my symptoms were mimicking those of cervical cancer – irregular bleeding, pain during sex, pelvic pain. For a long time, I was sure I had cervical cancer.

Endometriosis or Adenomyosis were nowhere to be seen on the internet 10 years ago.

Despite my worries and persistently asking for help, because of my age I was denied a smear test three times. It wasn’t until I started experiencing bladder and bowel symptoms where I would find myself regularly being admitted to hospital and unable to hold down a job, things started to be taken a little more seriously.

Over the three years, where I was regularly admitted to hospital, I was told my bowel was lazy, I had incurable gastroenteritis, ‘It’s just IBS’ or accused of having an eating disorder. 

I was twenty-five when I was finally diagnosed with Endometriosis, over a decade after my symptoms started. My diagnosis came around during an emergency two-part operation to save my life. I was admitted to the hospital for suspected acute appendicitis, this was just a few hours after I was discharged from the hospital with Gastroenteritis. 

Only after removing my appendix, we realised this wasn’t the cause of my pain. I spent three weeks in the hospital, septic, unwell, and when I was taken back into surgery a few days after my appendicectomy, doctors discovered stage four pelvic, bladder and bowel endometriosis, a frozen pelvis and infertility after cutting me from hip to hip and draining over two litres of blood from my pelvis. 

I was later referred to a specialist hospital to continue with my treatment and in October twenty-twenty, aged twenty-nine, I had no other choice than to undergo a total hysterectomy, bladder reconstruction surgery and a bowel resection, leaving me with an ileostomy (stoma) which I was lucky to be able to have reversed in June of last year. 

I’m now thirty-one, it’s been eight years since my diagnosis and although I was fortunate enough to be able to freeze my eggs, albeit a tough and devastating experience and unfortunately with an extremely low chance of success, the uncertainty of my future and the ability to have a biological child lingers over me every single day. 

Like most people, I had never heard of Endometriosis. If I had known then what I know now, I know my life could have been completely different. I may have had a child by now. 

I set up The Endometriosis Foundation after spending countless days and nights searching for information, support, advice, guidance, and there simply wasn’t any. My ultimate goal for the charity is for it to be everything I never had

Our official launch event on March 7th at Westminster, House of Lords will be a great opportunity to not only introduce the charity, but to also shine light on the many issues people with Endometriosis face. We will be focusing a lot this year on fertility awareness given the current diagnosis time takes on average 8 years, fertility needs to be prioritised. 

I understand not everybody may want children, but I believe everybody should have the choice.

To anyone concerned for their future fertility you must advocate for yourself. I can’t stress enough how important it is that you thoroughly understand your treatment options and are aware of any risks involved in your treatment for Endometriosis and especially the effect it may have on your fertility.

Our website has lots of helpful information and tips provided by experts and others going through similar experiences, to help guide you through your journey with Endometriosis and fertility.

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