This guide is general information, not medical advice. Medicines and treatments must be prescribed or recommended for you by a doctor or pharmacist. We do not give doses here.
What endometriosis is
In endometriosis, cells similar to the lining of the womb grow outside the womb. They are most often found on the ovaries, the fallopian tubes and the lining of the pelvis. They can also grow on the bladder, the bowel and, rarely, in the chest.
These patches react to the monthly cycle. They can bleed and become inflamed, which causes pain and can lead to scar tissue that sticks organs together.
It can affect anyone who has, or has had, a womb, from their first period through to the menopause and sometimes after. Endometriosis UK estimates it affects about 1 in 10 women and people assigned female at birth in the UK, which is around 1.5 million people. No one knows exactly what causes it.
The effect on work can be serious. Office for National Statistics research in England found that, five years after diagnosis, women with endometriosis were less likely to be in work and earned less than before.
Types of endometriosis
Doctors describe endometriosis by where it is found. You can have more than one type. How much endometriosis there is doesn't always match how much pain you feel.
Superficial endometriosis
Patches on the thin lining of the pelvis (the peritoneum). This is the most common type.
Ovarian endometriosis
Cysts on the ovaries filled with old blood, called endometriomas or "chocolate cysts".
Deep endometriosis
Grows deeper into tissue, such as the bowel, the bladder or the area between the vagina and rectum. NICE says suspected deep endometriosis should be referred to a specialist endometriosis centre.
Endometriosis outside the pelvis
Rare. Found in places such as the chest or a caesarean scar. In the chest it can cause chest pain, coughing up blood or breathlessness around your period.
Adenomyosis
A related condition where similar tissue grows into the muscle wall of the womb. It can cause heavy, painful periods. Endometriosis UK says it affects about 1 in 10 women.
Symptoms and flares
Symptoms vary a lot from person to person. Some people have few symptoms, and others have pain that stops them working or getting out of bed. Common symptoms include:
For many people, pain follows the monthly cycle, building in the days before a period and peaking during it. Over time, pain can spread to more days of the month and become constant. Bowel and bladder symptoms often get worse around a period.
Endometriosis is a long-term condition. Treatment can control symptoms well for many people, but they can come back, including after surgery.
Keep a pain and symptom diary
NICE suggests a pain and symptom diary to help with diagnosis. Note your pain each day, where it is and how bad it is, when your period starts and ends, any bowel or bladder symptoms, and what medicines you took. Track at least 2 or 3 cycles. A diary is also useful evidence for your employer and for a funding application.
When to get urgent help
Call 999 or go to A&E if you have
- sudden or very severe tummy or pelvic pain
- a tummy that hurts a lot when you touch it
- chest pain or difficulty breathing
- vomit with blood in it, or black or bloody poo
- no wee, or you can't poo or pass wind
- collapsed or fainted
Call NHS 111 or your GP urgently if
- you have tummy pain and feel or are being sick
- your pain keeps getting worse or won't go away
- you have pain and could be pregnant
- you have unusual vaginal bleeding or discharge
- you bleed from your bottom
See your GP if
- period pain stops you working or doing daily tasks
- you have pelvic pain that keeps coming back
- sex, pooing or peeing is painful
- you are finding it hard to get pregnant
- your treatment isn't helping
Diagnosis and referral
There is no single quick test for endometriosis, which is one reason diagnosis takes so long. Your GP will ask about your symptoms and may offer an internal examination. A normal examination doesn't rule endometriosis out.
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GP assessment and first treatment
A trial of about 3 months
Your GP may suggest painkillers or hormone treatment while you are being investigated. You don't have to wait for a diagnosis to start treatment.
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Ultrasound scan
Can be arranged by your GP
NICE recommends an internal (transvaginal) ultrasound, even if your examination was normal. It can find ovarian cysts and some deep endometriosis. A normal scan doesn't rule out smaller patches.
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Referral to gynaecology
If symptoms are severe, ongoing or not helped
Your GP should refer you if treatment isn't working, if pain is severe, or if a scan shows endometriosis. Suspected deep endometriosis should go to a specialist endometriosis centre. An MRI scan may be used to plan surgery.
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Laparoscopy
Keyhole surgery under general anaesthetic
A camera is passed through a small cut in your tummy to look for endometriosis. It is the only way to be sure, and the surgeon can often remove patches during the same operation.
8 years 10 months
The average time from first seeing a GP to diagnosis, from Endometriosis UK's 2023 survey. It had risen from 7 years 10 months in 2020. Almost 8 in 10 people said doctors had dismissed their symptoms.
Treatments and medicines
There is no cure, but treatment can ease pain and slow growth. The right choice depends on your symptoms, your age and whether you want to get pregnant. Hormone treatments are not suitable if you are trying to conceive.
Painkillers
From a pharmacy, or prescription
Paracetamol and anti-inflammatory painkillers (NSAIDs) such as ibuprofen. NICE suggests trying them for about 3 months. They often work best started a day or two before pain is expected.
Combined hormonal contraception
Prescription from your GP or sexual health clinic
The combined pill, patch or ring. They can make periods lighter and less painful, or stop them. It can take a few months to see the full effect.
Progestogens
Prescription from your GP
Progestogen-only tablets, the injection, the implant or a hormonal coil (IUS). Some can stop periods. The hormonal coil can last several years once fitted.
GnRH medicines
Usually started by a gynaecologist
Injections or a nasal spray that switch off the ovaries for a while, causing a temporary menopause. They are often used for about 3 months before surgery for deep endometriosis. HRT may be added to ease side effects and protect your bones.
Relugolix combination (Ryeqo)
Newer daily tablet, specialist advice
A once-a-day pill combining a GnRH blocker with hormones to reduce side effects. NICE recommended it in 2025 for people whose endometriosis symptoms continue after medical or surgical treatment. It works faster than injections and can be taken at home.
Pain clinic support
Referral by your GP or specialist
If pain continues despite treatment, a pain management team can help with other medicines, physiotherapy and psychological support.
Hormone treatments are not contraception in every case
Some hormone treatments for endometriosis don't prevent pregnancy, and some could harm a baby. Ask your doctor whether you need extra contraception, and tell them straight away if you might be pregnant.
Surgery and recovery
Surgery may be offered to remove endometriosis, cysts or scar tissue. NICE recommends hormone treatment after surgery, because it can help the benefits last longer. Symptoms can come back after any operation.
| Operation | Typical recovery |
|---|---|
| Laparoscopy to remove endometriosis (excision or ablation), mild disease, desk job | Back to work in 2 to 4 weeks |
| Laparoscopy for moderate or severe disease, or a physical job | About 6 weeks off work |
| Surgery involving the bowel or bladder, at a specialist centre | 1 to 5 nights in hospital, often 6 weeks or more to recover |
| Hysterectomy (removing the womb), with or without the ovaries | About 6 to 8 weeks before returning to a desk job |
After keyhole surgery, most people can drive again after about 4 to 6 weeks, once they can do an emergency stop. A phased return to work often helps. Your surgical team will give advice for your own recovery.
A hysterectomy is a big decision and is not a guaranteed cure, especially if endometriosis outside the womb is left behind. It also ends the chance of pregnancy. Ask your specialist to explain all your options first.
Self-help
During a flare
- Take painkillers early, as your doctor advised
- Use a heat pad or hot water bottle on your tummy or back
- Try a TENS machine, which some people find helpful
- Rest, and plan lighter days around your period
- Keep a flare kit: painkillers, heat pads, spare clothes
Between flares
- Keep active with gentle exercise, such as walking, swimming or yoga
- Ask about pelvic health physiotherapy
- Try relaxation or mindfulness to help manage pain
- Join a support group so you don't feel alone
- Get help for low mood. Talking therapies are available on the NHS
Getting the best care
Many people with endometriosis are told their pain is "normal" for years. It isn't normal for period pain to stop you living your life. These steps can help you be heard.
- Bring your diary. Written evidence of pain, days missed and treatments tried is harder to dismiss.
- Say how it affects your life. Tell your doctor about time off work, missed plans and pain that stops you sleeping.
- Ask directly. "Could this be endometriosis?" and "Can I have a transvaginal ultrasound?"
- Ask for a referral if treatment hasn't helped after about 3 months. If deep endometriosis is suspected, ask to be referred to a specialist endometriosis centre.
- Choose your hospital. In England you can usually choose where you are referred for your first appointment. The BSGE lists accredited endometriosis centres.
- Ask for a second opinion if you feel you aren't being listened to. You can also see a different GP at your practice.
- Take someone with you to appointments, and write your questions down beforehand.
Endometriosis and work
Endometriosis can count as a disability under the Equality Act 2010 (the Disability Discrimination Act in Northern Ireland). This applies if it has more than a minor effect on your daily life and has lasted, or is likely to last, at least 12 months. Conditions that come and go can count. The law looks at how you would be without treatment.
If it does, and your employer knows or should know about it, they must make reasonable adjustments. Adjustments might include:
- Easy access to a toilet
- Flexible hours around bad days
- Working from home during flares
- Regular breaks and somewhere to rest
- A supportive chair or sit-stand desk
- A heat pad or a warm place to work
- Time off for appointments and surgery
- A phased return after an operation
- Flexibility on endometriosis-related absence
- Lighter duties in physical jobs
Access to Work is a government grant that can pay for equipment and support at work. Endometriosis UK runs an Endometriosis Friendly Employer scheme you could share with your employer. For advice on your rights, contact Acas or Citizens Advice.
£130 less a month earned on average by women in England five years after an endometriosis diagnosis, compared with before. (Office for National Statistics)
Benefits
If you can't work for a while, you may get Statutory Sick Pay from your employer. Depending on how endometriosis affects you, you may also be able to get Personal Independence Payment (PIP), or Adult Disability Payment in Scotland, Universal Credit or Employment and Support Allowance. Turn2us and Citizens Advice can help you check.
How The Beyond Pain Foundation can help
If NHS waits are too long, or the help you need isn't available to you on the NHS, we may be able to fund:
- A private consultation with a gynaecologist who specialises in endometriosis
- A private transvaginal ultrasound scan to help speed up diagnosis
- A course of pelvic health physiotherapy
- A pain management programme
- A TENS machine or heat therapy recommended by your doctor or physiotherapist
- Workplace or home equipment, such as a supportive chair, a sit-stand desk or a home working setup
- Travel to a specialist endometriosis centre
We can't pay for everyday living costs, or for treatment you have already paid for. Prices vary a lot, so always get a written quote to include with your application.
Support and sources
Endometriosis UK
Information and support charity
Free helpline 0808 808 2227, run by trained volunteers. Opening times vary, so check the website. Also a nurse support service, web chat and support groups.
endometriosis-uk.orgBSGE endometriosis centres
Specialist NHS and private centres
The British Society for Gynaecological Endoscopy accredits centres that treat severe and deep endometriosis.
bsge.org.ukNHS
Health information
Symptoms, diagnosis and treatment of endometriosis.
nhs.uk/conditions/endometriosisSources for this guide
- NHS: endometriosis
- NICE NG73: endometriosis, diagnosis and management
- NICE TA1057: relugolix–estradiol–norethisterone for endometriosis
- Endometriosis UK: understanding endometriosis and its types
- Endometriosis UK: diagnosis survey report (2024)
- Endometriosis UK: helpline and support services
- Office for National Statistics: the hidden costs of endometriosis
- North Bristol NHS Trust: laparoscopic excision of endometriosis, recovery
- NHS: recovering from a hysterectomy
- NHS: stomach ache, when to get help
- NHS: ovarian cyst
- GOV.UK: reasonable adjustments for disabled workers
Last reviewed: October 2026.