Health Insights · Women's Health
Endometriosis: painful periods that need proper assessment
Endometriosis is tissue similar to the womb lining growing elsewhere in the pelvis, where it bleeds and inflames each cycle. It affects around one in ten women, and it takes an average of eight years to diagnose — largely because severe period pain gets normalised, by patients and clinicians alike.
Seek urgent assessment if you have
- sudden severe pelvic pain, particularly one-sided, with faintness or vomiting
- severe pain with a positive pregnancy test — ectopic pregnancy must be excluded
- heavy bleeding with dizziness or breathlessness
- inability to pass urine, or severe pain opening your bowels with bleeding
- pain with fever and abnormal discharge
Sudden severe one-sided pelvic pain may be an ovarian cyst that has twisted or ruptured, or an ectopic pregnancy. Both need same-day assessment. In an emergency call 999, or go to the Royal London Hospital Emergency Department, Whitechapel Road, London E1 1FR.
What is not normal period pain
- pain that stops you doing normal activities, or requires time off work or school
- pain not relieved by over-the-counter painkillers
- pain that starts days before the period and continues after it
- deep pain during or after sex
- painful bowel movements or urination, particularly around your period
- cyclical bloating, fatigue, or bleeding from the bowel or bladder with periods
- difficulty conceiving alongside any of the above
A normal scan does not rule it out
Ultrasound reliably detects endometriomas — cysts on the ovaries — and can suggest deep disease in experienced hands. It frequently does not show superficial peritoneal endometriosis, which is the commonest form. A great many women are told their scan is clear and conclude nothing is wrong. If your symptoms fit, a normal scan should not end the conversation. Diagnosis may need specialist imaging or laparoscopy, and treatment can reasonably be started on symptoms alone.
Treatment
There are two aims, and they are separate: controlling pain, and preserving or achieving fertility. Which matters most to you should shape the plan.
- Pain relief — anti-inflammatories such as naproxen or mefenamic acid, taken regularly from just before the period rather than once pain is established.
- Hormonal treatment to suppress the cycle: the combined pill taken continuously without a break, the progestogen-only pill, the implant, the injection or the hormonal coil. Suppressing periods suppresses the disease activity.
- GnRH treatments induce a temporary menopausal state and are used in specialist care, usually with add-back HRT.
- Laparoscopic surgery to excise or ablate deposits can significantly improve pain, and is also how a definitive diagnosis is made.
- Pelvic physiotherapy for the secondary muscle spasm that develops with chronic pelvic pain, and pain management input for long-standing pain.
Fertility
Many women with endometriosis conceive without difficulty. Some do not, and the relationship between severity and fertility is not straightforward. If you are trying to conceive, hormonal suppression is not an option and treatment planning is different — so tell us early rather than after months of treatment aimed at the wrong goal. Surgery improves conception rates in some circumstances, and assisted conception is effective.
Being believed
Many women with endometriosis have been told repeatedly that their pain is normal, stress-related or exaggerated. If that has been your experience, it is worth saying so at the outset. Pain that is affecting your life is a legitimate reason to be investigated and treated, regardless of what any previous scan showed.
Book an appointment if period pain is affecting your life, sex is painful, or you have been told a scan was normal but still have symptoms. We offer unhurried women's health consultations, specialist pelvic ultrasound, and referral to gynaecology for laparoscopy where it is needed.
Private endometriosis assessment in London
Endometriosis causes painful periods, pelvic pain and sometimes fertility problems, and it is often diagnosed late — so a proper assessment matters. Our private women’s health clinic in London can assess your symptoms, arrange an ultrasound, and plan treatment or onward gynaecology care. A private GP in East London can start pain and hormonal management. Endometriosis is assessed at our private women's health service in Whitechapel, East London, with patients coming from Canary Wharf, the City and Docklands.
Endometriosis: getting a diagnosis and managing pain
How is endometriosis diagnosed?
From symptoms and examination, with ultrasound and sometimes a laparoscopy; we can start assessment and arrange onward care.
What are the main symptoms?
Painful, heavy periods, pelvic pain, pain during sex, and sometimes difficulty conceiving.
How is it treated?
Options include pain relief, hormonal treatment and, in some cases, surgery; treatment is tailored to you.
Can I be seen quickly?
Yes — same-day private appointments are available most days.
Is there a private gynaecologist near me for endometriosis?
Yes — our private women’s health clinic in London at Whitechapel, near Canary Wharf, can assess pelvic pain and arrange pelvic ultrasound in London and specialist referral.
How is endometriosis diagnosed?
Through your history, examination and imaging, with laparoscopy for a definitive diagnosis; our team can start the assessment and arrange onward care.
Specialist pelvic ultrasound and gynaecology
Unhurried women's health appointments 7 days a week.