Endometriosis is a chronic condition characterised by the growth of tissue similar to the lining of the womb (endometrial tissue) elsewhere in the body. When hormones cause the breakdown of the womb lining during your period, that endometrial tissue also breaks down - however, since it’s located elsewhere in the body, the blood cannot easily be passed. This can cause symptoms such as pain during sex, extreme fatigue, heavy periods and even infertility. 

Intense period pain can also be a symptom of endometriosis. However, like some of the other symptoms discussed, period pain is a condition that can have different causes other than endometriosis. 

If you think you might have endometriosis, you should consult your GP and inform them of your symptoms. Below, we explore the route to diagnosis, followed by the potential treatments that may be recommended to you.  

How do you diagnose endometriosis?

The symptoms of endometriosis can appear very similar to those of other conditions, such as pelvic inflammatory disease (PID) or fibroids. This can make diagnosis more complicated, as your doctor needs to rule out these other conditions to decide if you have endometriosis. You may need to have a number of tests carried out to help your doctor gather the information they need in order to make a diagnosis. 

When you go to a GP appointment for suspected endometriosis, the first thing your doctor will likely do is ask you about your symptoms. It can be hard to remember everything you need to mention in the moment, particularly if you’re anxious about your appointment, so it’s a good idea to come prepared with a list or journal of your experiences. This can help you to remember not only what symptoms you’ve experienced, but also their severity and frequency. 

As well as asking you questions, your doctor may want to carry out some tests. This might include blood tests or a physical examination. You might then be referred to a gynaecologist for further tests, such as:

• An ultrasound - this may be external or internal and can allow doctors to identify tissue that isn’t where it should be
• A laparoscopy - where a camera is fed into your body through a small incision in your abdomen to allow doctors to visually confirm endometriosis.

It’s important to be aware that the complexity of diagnosing endometriosis can mean that it takes a long time to receive confirmation. In fact, a 2023 Endometriosis UK survey of 5,500 respondents who had received an endometriosis diagnosis found that the average waiting time to get that diagnosis in the UK was eight years and 10 months. However, doing nothing only prolongs your wait to receive treatment. If you think you may have endometriosis, see your doctor as soon as you can.  

How do you treat endometriosis?

Even if you are still waiting to receive a diagnosis of endometriosis, your healthcare team will begin to recommend treatment options to relieve your symptoms. Unfortunately, there is currently no cure for endometriosis, but many people find treatments to ease pain and other symptoms are effective in helping them to get back to their ordinary day-to-day lives. 

First of all, in some cases where a laparoscopy has been carried out as part of the diagnosis journey, doctors may be able to remove endometrial tissue on the same day during the procedure. 

The next form of treatment you’ll likely be advised to try is medication. This is the least invasive option and so can be preferable for some people.  Hormonal medications such as some forms of hormonal contraceptives may help to relieve your symptoms.  

If your symptoms are severe, treatments aren’t working or endometriosis is affecting your ability to conceive, doctors may recommend surgery. This might mean:

• Removing endometrial tissue or ovarian cysts caused by endometriosis
• Removing the ovaries or womb
• Removing parts of the bowel or bladder if these organs are affected by your condition. 

Surgery won’t necessarily stop your endometriosis symptoms. You may need to have further surgery if there are complications or if your symptoms return.  

How to ease endometriosis pain

Beyond treatments that tackle endometriosis as a condition, there are also things you can do that may help to relieve the painful symptoms. Many of these don’t require a prescription from a doctor, so they can be good options if you’re yet to receive a diagnosis or you need additional relief at home. However, if you’re taking prescription medication, you should discuss your situation with a pharmacist before taking any other medications to ensure they won’t counteract each other or cause you harm when taken together.

In terms of medication, painkillers can be a good way to relieve the pain of endometriosis at home. This could include:

• Paracetamol
• Ibuprofen
• Naproxen.

Although Ultravana® Period Pain Relief Tablets contain naproxen, they are not recommended for use if you have endometriosis. This is because they are designed to treat primary dysmenorrhoea - period pain that doesn’t have an underlying cause.

Taking too many painkillers or combining them with other medications can be dangerous. Always read the patient information leaflet to understand how to safely take painkillers. 

If you’re looking for a pain reliever that doesn’t involve medications or you want more relief than medications can offer alone, there are some things you can try. For example, you might find it helpful to apply a warm compress to your abdomen to help ease the pain. If you do this, make sure your hot water bottle or similar compress is well wrapped so you’re not applying it directly to your skin - this could lead to scalds or burns. 

Another similar technique is to take a hot bath, which can help to apply heat more generally than a hot water bottle. Again, it’s important not to submerge yourself in water that’s too hot, so remember to test the temperature before you get in and add cool water if necessary. 

Whether you’re just at the start of your endometriosis journey or you’ve been seeking diagnosis for a while, help and support is there for you. A variety of treatments can help to ease your symptoms and make endometriosis more manageable for you day to day. For more information tailored to your specific situation, speak to your GP.  

Evana Heavy Period Relief Tablets. Tranexamic acid. For the treatment of heavy menstrual bleeding in women with regular, 21-35 day cycles with no more than 3 days individual variability in cycle duration. Always read the label.  

Ultravana® Period Pain Relief 250 mg Gastro-resistant tablets. Naproxen. For the treatment of primary dysmenorrhoea. Always read the label.

Sources:

https://www.nhs.uk/conditions/endometriosis/ 
https://www.nhs.uk/medicines/paracetamol-for-adults/taking-paracetamol-for-adults-with-other-medicines-and-herbal-supplements/  
https://www.nhs.uk/medicines/ibuprofen-for-adults/taking-ibuprofen-with-other-medicines-and-herbal-supplements/  
https://www.nhs.uk/medicines/naproxen/taking-naproxen-with-other-medicines-and-herbal-supplements/  
https://www.endometriosis-uk.org/sites/default/files/2024-03/Endometriosis%20UK%20diagnosis%20survey%202023%20report%20March.pdf  
https://www.nhsinform.scot/healthy-living/womens-health/girls-and-young-women-puberty-to-around-25/periods-and-menstrual-health/endometriosis/