• Dysmenorrhoea (Painful menstruation)

• Infertility

• Pain (Which can occur prior to commencing a period, during ovulation, on internal examination, as back pain radiating to legs, umbilical/midline pain)

• Fatigue

• Dyspareunia (Painful sexual intercourse)

• Heavy, prolonged or irregular periods

• Premenstrual spotting may occur

• Painful bowel movements

• Bleeding from bowel

• Pain before, during or after micturition

Some women may not experience any of these symptoms, and may be diagnosed inadvertently during investigations for infertility or surgery for other reasons.

While a preliminary diagnosis of endometriosis can be based on the above symptoms, it can only be diagnosed definitively via a laparoscopy. (A surgical procedure performed through very small incisions in the abdomen, using specialized instruments. A pencil-thin instrument called a laparoscope is used, and it gives the surgeon a clear view, on a TV monitor, of the inside of the abdominal cavity)

There is no cure for endometriosis, however there are a variety of treatments used to relieve symptoms, reduce or slow endometrial growth, prevent recurrence and if possible restore or preserve fertility.

Medical treatments include:

• Combined oral contraceptive pill

• Progestogens

• Testosterone derivatives

• Mirena Intra-uterine System

• GnRH analogues

These treatments can not be used if a woman is attempting to become pregnant.

Surgical treatments include:

• Laparoscopic ablation using cautery or laser- Aims to remove and destroy endometrial growths

• Laparotomy – (open operation in pelvis) As above

• Hysterectomy- (removal of the uterus). Used in severe cases. The chance of persistent disease is raised if the ovaries remain, therefore they may also be removed.