Endometriosis is a very common condition, and affects around one in ten women.  Endometriosis is present in approximately half of all women with otherwise unexplained infertility; and in women who have pelvic pain or period pain, endometriosis is even more common.  The only truly reliable method of endometriosis diagnosis is by laparoscopy (a minimally invasive surgery), however gynaecologists with expertise in endometriosis surgery can often get a very good idea as to the likelihood of endometriosis by listening to patients describe the symptoms and performing a vaginal examination. 


The types of symptoms women with endometriosis may experience include:
  •  Period pain
  • Pelvic pain at times unrelated to periods
  • Mid-cycle pain (particularly when it occurs predominantly on one side)
  • Pain or discomfort with sex
  • Bladder symptoms such as frequency or painful urination
  • Pain with bowel motions, particularly during a period
  • Infertility
  • Spotting before full menstrual flow (premenstrual spotting)
  • Heavy periods
  • Pain that is not controlled by hormonal contraception
  • Irritable bowel syndrome


Endometriosis treatment involves laparoscopic surgical excision. This is a minimally invasive surgery, which is performed under general anaesthetic. A laparoscope (a tiny camera) is inserted, usually through a small incision in the belly button so the surgeon can view the abdomen and pelvis.  2-3 further incisions are usually required in the lower abdomen to insert instruments in order to remove the endometriosis. Surgery for endometrosis diagnosis and removal generally takes one or two hours, and most women need one night in hospital. Within 4-5 days after endometriosis surgery patients can generally resume normal activity such as lifting, driving, walking, and most are ready to return to work after 7-10 days’ rest. Treatment may also involve non-surgical adjuncts such as hormonal contraceptive pills, Mirena IUS or other pain medications.


Over eighty percent of women with endometriosis appropriately treated at initial surgery do not require further treatment for the disease. 10-20% have recurring symptoms of endometriosis, however only some of these women will require further surgical treatment to improve their symptoms. Endometriosis can be removed in 95% of initial surgeries, and surgical risks and complications are low. Five percent of women are diagnosed with ‘severe endometriosis’ which involves the bowel wall/rectum and the ovaries. If severe endometriosis is diagnosed at an initial surgery, Phill will discuss your options with you thoroughly and a second operation may be recommended. Endometriosis pain can take up to three months to resolve as the nerves affected by endometriosis are affected by the removal operation and need to repair.


Conceiving a baby can take longer as endometriosis can affect fertility rates, however most women with endometriosis can conceive eventually, with some requiring assistance such as intrauterine insemination (IUI) or in vitro fertilisation (IVF). If endometriosis is the only fertility issue identified, surgical removal will improve your chances of pregnancy. Ask about endometriosis diagnosis and treatment.