Last updated: October 2026
Endometriosis is a long-term condition where tissue similar to the womb lining grows elsewhere, usually in the pelvis. It affects about 1 in 10 women and those assigned female at birth of reproductive age. Symptoms include painful periods, pelvic pain, painful sex and fatigue. There’s no cure, but treatment helps. Diagnosis starts with your GP.
Below: symptoms, how testing works in the UK, whether it can be cured, treatment options and support.
Endometriosis in numbers: around 1.5 million people in the UK live with it, and it takes an average of 9 years and 4 months from first seeing a doctor to getting a diagnosis, according to Endometriosis UK. A normal scan doesn’t rule it out. If your symptoms are affecting your life, keep asking.
What is endometriosis?
Endometriosis happens when cells similar to those lining the womb grow elsewhere, most often around the womb, ovaries and fallopian tubes. These patches respond to the monthly cycle: they break down and bleed, but the blood can’t leave the body, causing inflammation, pain and sometimes scar tissue (adhesions).
It can affect anyone who has, or has had, a womb, from puberty to the menopause. Endometriosis UK estimates it affects about 1.5 million people in the UK. Nobody yet knows exactly what causes it.
Endometriosis UK describes four main types, and you can have more than one:
- Superficial: on the thin lining of the pelvis.
- Ovarian: cysts on the ovaries (endometriomas or “chocolate cysts”).
- Deep: into the bladder, bowel or tissue between the vagina and rectum.
- Outside the pelvis: less common, for example in the chest or scars.
A related condition, adenomyosis, is when similar tissue grows into the muscle of the womb wall. It’s common to have both.
Endometriosis symptoms
Symptoms vary a lot from person to person, and some people have none at all. The most common are:
| Symptom | What it can be like |
|---|---|
| Painful periods | Pain severe enough to stop you doing normal things like work, school or sleep |
| Pelvic pain | Lower tummy or back pain, which may change through your cycle |
| Pain during or after sex | Often a deep pain |
| Pain when pooing or peeing | Often worse during your period, sometimes with blood |
| Heavy periods | Changing a pad or tampon every 1 to 2 hours, or bleeding through clothes |
| Fatigue | Extreme tiredness |
| Difficulty getting pregnant | See the fertility section below |
| Low mood or anxiety | Living with long-term pain takes a toll |
Bloating and nausea are common too. Symptoms overlap with irritable bowel syndrome (IBS), adenomyosis, fibroids and pelvic inflammatory disease, which is one reason diagnosis is slow.
Ordinary period pain is common and usually manageable: see period pain relief. Pain that stops you working, studying or sleeping is not something to put up with. For cycle-related mood and body changes that aren’t about pain, see PMS symptoms, and for wider hormone questions, hormonal imbalance symptoms in women. If heavy periods leave you exhausted, it’s worth reading about iron deficiency symptoms too.
How do they test for endometriosis?
There’s no single simple test. In the UK, the NICE guideline on endometriosis (NG73) sets out a step-by-step route:
| Step | What happens | Where |
|---|---|---|
| 1. Talking about symptoms | Your GP asks about pain, periods, sex, bowel and bladder symptoms, and whether your mother or sister has endometriosis | GP |
| 2. Examination | An abdominal and internal (vaginal) examination, with a chaperone offered. You can choose an abdominal exam only | GP |
| 3. Ultrasound scan | NICE says everyone with suspected endometriosis should be offered a transvaginal (internal) ultrasound, arranged by their GP practice, even if the exam was normal | GP arranges |
| 4. Treatment at the same time | You don’t have to wait for results to start painkillers or hormonal treatment | GP |
| 5. Referral | To a gynaecology service, or a specialist endometriosis centre if deep endometriosis or ovarian cysts are suspected | Hospital |
| 6. Specialist scan or MRI | Used to look for deep endometriosis and plan any surgery | Hospital |
| 7. Laparoscopy | Keyhole surgery under general anaesthetic that can confirm and often treat it | Hospital |
Worth knowing: a normal examination or scan does not rule out endometriosis, because it doesn’t always show up on scans, and NICE says referral may still be needed. There’s no blood test for it (NICE says CA125 shouldn’t be used). A laparoscopy is the only way to confirm it for certain, though treatment can start before then.
Endometriosis UK puts the average time from first seeing a doctor to diagnosis at 9 years and 4 months, and NICE notes it can take longer for people from ethnic minority backgrounds.
How to get tested for endometriosis
On the NHS, the route is through your GP. Preparing well helps things move faster.
- Keep a pain and symptom diary for one or two cycles, as NICE suggests. Note when pain happens, how bad it is (0 to 10), what it stops you doing, painkillers taken, bleeding, bowel and bladder symptoms, and pain during sex.
- Say the word. “I’m worried I might have endometriosis” is a perfectly reasonable opening line.
- Describe the impact. Days off work or school and lost sleep say more than “my periods are bad”.
- Mention family history. A mother or sister with endometriosis makes it more likely.
- Ask about an ultrasound scan, which NICE says should be offered alongside any treatment.
- Ask about referral. NICE says to refer to gynaecology if first treatments don’t work or don’t suit you, if symptoms affect daily life, or if they keep coming back.
- Under 18? NICE says young people should be referred to a specialist adolescent gynaecology service or endometriosis centre.
- Don’t be put off. If you’re not being heard, ask to see another GP. Endometriosis UK’s nurse support line can help you make your case.
Is there a saliva test for endometriosis?
Possibly, soon. NICE is assessing tests GP surgeries could use to speed up diagnosis. In updated draft guidance (September 2026), NICE said a saliva test called Endotest, which looks for tiny genetic markers called microRNAs, could be used in the NHS in England for 4 years while more evidence is collected. It would be used when the examination is normal and an ultrasound is negative, unclear or not possible.
An earlier July 2026 draft had also backed a test called EndoSure, which measures electrical signals from the gut using pads on the tummy, but the September draft said more research is needed on it and two other tests first. None of these tests can show the type or severity of endometriosis. Final guidance is expected in January 2027.
Is endometriosis curable?
No. The NHS says there are currently no treatments that can cure endometriosis, but treatment can manage pain and other symptoms well for many people.
- Surgery can remove patches of endometriosis and cysts, but endometriosis can come back, and further operations are sometimes needed.
- Hormonal treatments can keep symptoms under control while you take them, but they don’t remove the endometriosis itself.
- Hysterectomy (removing the womb) isn’t a guaranteed cure either. NICE says it should be combined with removing all visible endometriosis.
NICE recommends basing treatment on your symptoms and priorities, such as whether you want to get pregnant, rather than the “stage” found at surgery.
Is endometriosis an autoimmune disease?
No, endometriosis isn’t classed as an autoimmune disease. It’s a long-term gynaecological condition with an unknown cause. But researchers have studied the overlap.
A 2019 University of Oxford review of 26 population studies found links between endometriosis and several autoimmune conditions, including lupus, Sjögren’s syndrome, rheumatoid arthritis, autoimmune thyroid disease, coeliac disease, multiple sclerosis and inflammatory bowel disease. However, most of the studies were low quality: only 5 gave high-quality evidence, and 4 of those found a link with at least one autoimmune condition. Whether one causes the other is unknown.
Genetics play a part too. A 2023 study of more than 60,000 people with endometriosis found 42 regions of DNA linked to it, and genetic overlap with 11 other pain conditions, including migraine, back pain and widespread chronic pain, as well as asthma and osteoarthritis. If you have pain elsewhere too, tell your GP about all of it. See our guides to fibromyalgia and lower back pain.
Endometriosis treatment options
Treatment depends on your symptoms, where the endometriosis is, and whether you want to get pregnant. The main options in the NHS are:
| Treatment | What it involves | Good to know |
|---|---|---|
| Painkillers | Paracetamol and anti-inflammatories such as ibuprofen, alone or together | NICE suggests a trial of around 3 months, then other options or referral if needed |
| Combined hormonal contraception | The pill or patch, often taken continuously without a break | Aims to make periods lighter or stop them. Not used while trying to get pregnant |
| Progestogens | The mini pill, implant, injection or a hormonal coil (IUS) | The RCOG suggests giving hormone treatment 3 to 6 months to work |
| GnRH medicines | Medicines that lower oestrogen, causing a temporary menopause-like state. NICE has approved two newer ones (relugolix combination therapy and linzagolix) when other treatments haven’t worked | Usually given with add-back hormones to limit side effects |
| Laparoscopic surgery | Keyhole surgery to cut out (excise) or destroy (ablate) patches and treat ovarian cysts | Deep endometriosis on the bowel, bladder or ureter is treated at specialist centres |
| Hysterectomy | Removing the womb, sometimes with the ovaries, plus all visible endometriosis | A big decision with lasting effects; discuss HRT and recurrence risk first |
| Pain management service | May include physiotherapists and psychologists | Helpful when pain has become long-term |
NICE says hormonal treatment has no permanent negative effect on future fertility and can start while you wait for tests. If one option doesn’t suit you, go back to your GP: there are usually others. If you take other medicines, check with your GP or pharmacist before adding anything, including over-the-counter painkillers.
Endometriosis and fertility
Endometriosis is linked with fertility problems, although having it doesn’t mean you can’t get pregnant: Endometriosis UK estimates that 30 to 50% of women with infertility have endometriosis.
- Hormonal treatments don’t help you get pregnant and aren’t used while you’re trying to conceive.
- For endometriosis that doesn’t involve the bowel, bladder or ureter, NICE says removing it with keyhole surgery improves the chance of a natural pregnancy. Surgery for ovarian cysts can too, though it needs to be weighed against the effect on egg reserve.
- For deep endometriosis, the pros and cons of surgery should be discussed carefully with a specialist team.
- You can ask for referral to a fertility specialist. Fertility treatments such as IVF are another route.
If you’re planning a pregnancy, tell your GP or gynaecologist early, as it changes which treatments make sense.
Living with endometriosis
NICE recognises that endometriosis can have a significant physical, sexual, psychological and social impact, and people may need long-term support.
Managing pain day to day
For period pain, the NHS suggests a heat pad or hot water bottle wrapped in a tea towel, warm baths, gentle exercise like walking, swimming or yoga, and massaging your tummy and back. Keep your diary going to track how treatment is working.
Work and study
Endometriosis isn’t automatically classed as a disability, but under the Equality Act 2010 a condition can count if it has a substantial and long-term (12 months or more) effect on your ability to do everyday activities. Talk to your manager, HR or occupational health about flexibility on bad days.
Mental health
Long-term pain and fertility worries can affect your mood. The NHS says support for low mood and anxiety is part of endometriosis care, so ask your GP. Our guide to low mood vs depression explains the signs to watch for. If you’re in distress, Samaritans are there 24 hours a day on 116 123.
Support
Endometriosis UK runs a free volunteer helpline on 0808 808 2227 (open at set times listed on their website), a web chat, a bookable nurse support line and local support groups.
Do supplements help endometriosis?
Honestly, there’s no good evidence that they do. NICE advises that the evidence doesn’t support Chinese herbal medicines or other supplements for treating endometriosis. Our products aren’t a treatment for endometriosis, and they’re not a substitute for seeing your GP or for the treatments above.
Some people with endometriosis ask us about CBD: we’ve covered what the research does and doesn’t show in our guide to CBD and endometriosis.
For your general wellbeing, magnesium contributes to a reduction of tiredness and fatigue and to normal muscle function. Our Magnesium Glycinate Sleep Complex is a caffeine-free evening drink with magnesium bisglycinate and citrate, L-theanine and chamomile. See magnesium for women for how much you need.
We don’t recommend our products during pregnancy or breastfeeding. If you’re trying to get pregnant, talk to your GP or fertility clinic before taking any supplement. Our products are for adults only. If you take any medication, including hormonal treatments, check with your GP or pharmacist before adding a supplement.
When to get urgent help
See a GP if you think you might have endometriosis, if symptoms are affecting your daily life, work or relationships, or if treatment hasn’t helped or symptoms are getting worse.
Get help from NHS 111 if you have pelvic pain and you find it hard to pee or poo, there’s blood in your pee or poo, you have unusual discharge or bleeding from your vagina, a very high temperature, you’re being sick, or you are or might be pregnant.
Call 999 or go to A&E if you have pelvic pain and it’s severe, getting worse or hurts when you move or touch the area, you feel faint or dizzy or pass out, you have pain in the tip of your shoulder, you have difficulty breathing, you have heavy vaginal bleeding, or you suddenly feel confused.
FAQs
Is endometriosis curable?
Not yet. The NHS says no treatment can currently cure endometriosis. Painkillers, hormonal treatments and surgery can control symptoms well for many people, but it can come back after surgery.
How do they test for endometriosis?
Your GP asks about symptoms and family history, offers an examination and arranges an ultrasound. You may be referred for a specialist scan, MRI or laparoscopy, the only way to confirm it for certain. A normal scan doesn’t rule it out.
How long does it take to get diagnosed with endometriosis in the UK?
Endometriosis UK puts the average at 9 years and 4 months from first seeing a doctor to a firm diagnosis. Keeping a symptom diary and asking about referral if treatment isn’t working can help.
Is endometriosis an autoimmune disease?
No, it isn’t classed as one, and its cause is unknown. Studies have found links with some autoimmune conditions, such as lupus, rheumatoid arthritis and coeliac disease, but most of the evidence is low quality.
Is endometriosis genetic?
Partly. You’re more likely to have it if your mother or sister does, and a large 2023 study found 42 regions of DNA linked to endometriosis. Genes are only part of the picture.
Is endometriosis cancer?
No, endometriosis isn’t cancer. Cancer Research UK notes that studies have found an increased risk of ovarian cancer in women with endometriosis, so tell your GP about any new or changing symptoms.
Is endometriosis a disability in the UK?
Not automatically. Under the Equality Act 2010, it can count as a disability if it has a substantial and long-term effect on your ability to do everyday activities.
Sources
- NHS. Endometriosis.
- NICE (2017, updated 2024). Endometriosis: diagnosis and management (NG73).
- NICE (draft, September 2026). Technologies for diagnosing endometriosis in primary care: early use assessment.
- Endometriosis UK. What is endometriosis? and Talk to someone.
- Royal College of Obstetricians and Gynaecologists. Endometriosis: patient information.
- Shigesi N et al (2019). The association between endometriosis and autoimmune diseases: a systematic review and meta-analysis. Human Reproduction Update.
- Rahmioglu N et al (2023). The genetic basis of endometriosis and comorbidity with other pain and inflammatory conditions. Nature Genetics.
- NHS. Pelvic pain and Period pain.
- Cancer Research UK. Ovarian cancer risks and causes.
- GOV.UK. Definition of disability under the Equality Act 2010.
This guide is general information, not medical advice. Evopure makes the Magnesium Glycinate Sleep Complex.
