Common Questions About Endometriosis Answered by a GP

A clear, compassionate guide to understanding endometriosis, why diagnosis is often so delayed, and how lifestyle support can help alongside medical care.

Endometriosis is one of the most common chronic conditions affecting women in the UK, yet it remains one of the most misunderstood. It affects around one in ten women, which means millions of people are living with it, often without a diagnosis.

Despite how common it is, awareness is still low. Many women spend years being told that their pain is normal, that they are overreacting, or that nothing serious is wrong. According to the latest report from Endometriosis UK, the average time to receive a diagnosis in the UK is now 9 years and 4 months. That is a long time to live with pain, uncertainty and a sense of not being heard.

If you suspect you might have endometriosis, or you have recently been diagnosed, the questions below are some of the most common ones I am asked as a GP and Health Coach.

The aim is to offer clear, evidence informed answers, and to show how lifestyle medicine can play a meaningful role alongside medical care.

What Is Endometriosis?

Endometriosis is a long term condition where tissue similar to the lining of the womb grows in other parts of the body. Most commonly, this tissue is found on the ovaries, fallopian tubes, bowel, bladder or the lining of the pelvis. In rarer cases, it can be found further afield.

Each month, this tissue responds to hormonal changes in a similar way to the lining of the womb. It builds up, breaks down and bleeds, but unlike a period, it has no way to leave the body. This causes inflammation, pain and over time can lead to scarring and adhesions.

Endometriosis is a real, physical condition. It is not in your head, and it is not something you have caused. It is a recognised gynaecological and inflammatory condition that often affects far more than the reproductive system alone.

What Are the Most Common Symptoms?

Symptoms can vary enormously from one woman to another, which is part of what makes endometriosis so difficult to diagnose. Some women have very few symptoms, while others find their daily life is significantly affected.

Common features include:

• Painful periods that interfere with work, school or daily activities.

• Pelvic pain that may not be limited to your period.

• Pain during or after sex.

• Pain when going to the toilet, particularly during your period.

• Heavy or irregular bleeding.

• Persistent fatigue.

• Bloating, constipation, diarrhoea or other gut symptoms.

• Difficulty getting pregnant.

You do not need to have all of these symptoms to have endometriosis. If any of these feel familiar and are affecting your quality of life, it is worth speaking to your GP.

Is Endometriosis Just Bad Period Pain?

This is one of the most important questions, because the misunderstanding behind it is part of the reason diagnosis takes so long.

Period pain that interferes with your daily life is not something to dismiss. Many women with endometriosis describe pain so severe they cannot go to work, study, or function normally.

Some end up in A&E. Some have been told for years that this is just part of being a woman.

The recent Endometriosis UK report found that 83 per cent of women had been told by a healthcare practitioner that they were making up or exaggerating their symptoms before being diagnosed. That is a striking figure, and it reflects how often this condition is missed or minimised.

If your pain regularly stops you living your life, it is worth investigating further. Painful periods are common, but they are not necessarily normal.

Why Does It Take So Long to Be Diagnosed in the UK?

The current average diagnosis time in the UK is 9 years and 4 months. This has actually increased in recent years, despite growing awareness.

There are several reasons for this.

Symptoms are often dismissed as normal period pain or attributed to other conditions such as IBS.

There is no simple blood test or scan that can confirm endometriosis. Diagnosis usually requires a specialist assessment, and in many cases a laparoscopy.

Gynaecology waiting lists in the UK are long, and access to specialist endometriosis services varies depending on where you live.

Many women are not aware that what they are experiencing is not typical, so they delay seeking help.

If you feel your symptoms are not being taken seriously, you are not alone. Keeping a symptom diary, asking specifically about endometriosis, and asking for a referral to a gynaecologist can help.

How Is Endometriosis Diagnosed?

Diagnosis usually begins with your GP. They will ask about your symptoms, your cycle and your medical history. An examination may be carried out, and you may be offered an ultrasound scan.

Ultrasound can sometimes show signs of endometriosis, such as endometriomas (cysts on the ovaries) or deeper lesions, but it does not always pick up endometriosis. A normal scan does not rule the condition out.

For many women, definitive diagnosis is made through a laparoscopy. This is a keyhole procedure that allows a surgeon to look inside the pelvis and identify, and often treat, areas of endometriosis. More recent guidelines also support treating suspected endometriosis without surgery in some cases.

If you are still seeking a diagnosis, advocating for yourself is important. Be clear about how your symptoms affect your life, and ask for a referral if you feel you are not being heard.

Can Diet and Lifestyle Changes Really Help with Endometriosis?

Yes, for many women lifestyle changes can make a real difference, although the effect varies from person to person.

Endometriosis is an inflammatory condition, and this is where lifestyle medicine can be useful. A large international survey of people with endometriosis found that significant numbers reported improvements in pain after changes such as reducing alcohol, reducing caffeine and following gluten free or dairy free diets. That does not mean every woman needs to cut these things out, but it does suggest that what we eat plays a role.

Approaches with good general evidence include:

• A Mediterranean style way of eating, with plenty of vegetables, oily fish, pulses, olive oil and whole grains.

• Reducing ultra processed foods, which are linked with higher levels of inflammation.

• Including sources of omega 3, such as oily fish, walnuts and flaxseeds.

• Checking vitamin D levels, particularly in winter, and supplementing where appropriate.

• Considering magnesium, which some women find helpful for muscle tension and pain.

A food and symptom diary can be useful for spotting your own patterns. This is more helpful than trying to follow a strict, rigid plan that may or may not be relevant to you.

What About Exercise and Stress?

Movement and stress regulation are often underestimated in endometriosis care.

Gentle, regular movement tends to support pain management, mood and energy levels.

Walking, swimming, yoga and Pilates can be particularly helpful. During flare ups, it is usually more helpful to scale back intensity and focus on gentle activity rather than push through.

Stress does not cause endometriosis, but it can influence how pain is experienced and how your body manages inflammation. Chronic stress affects sleep, hormones and the nervous system, all of which can make symptoms feel harder to manage.

Building in regular ways to calm the nervous system, such as breathwork, time outdoors, restorative movement and consistent sleep routines, can all be part of a meaningful approach to managing endometriosis day to day.

Can You Get Pregnant with Endometriosis?

This is one of the most common worries for women newly diagnosed with endometriosis, and it is an understandable one.

The reality is that many women with endometriosis do get pregnant, both naturally and with support. Fertility can be affected for some women, particularly where there are significant adhesions or where the ovaries or tubes are involved, but a diagnosis of endometriosis does not mean you cannot have a baby.

If you are planning a pregnancy and have endometriosis, or suspect you might, it is worth speaking to your GP early so that the right support and investigations can be considered.

How Can a Health Coach Support Women with Endometriosis?

Endometriosis is not just a gynaecological condition. It affects energy, mood, sleep, work, relationships and confidence. Many women find that medical care, while essential, does not always address the full picture of how they feel day to day.

This is where working with a health coach, alongside your medical team, can be valuable.

As a GP and Health Coach, I support women in building sustainable habits that work with their bodies rather than against them. For someone living with endometriosis, this often includes:

• Building anti inflammatory eating patterns in a realistic, non restrictive way.

• Creating gentle, sustainable movement routines that adapt to flares.

• Supporting sleep, stress regulation and nervous system care.

• Helping to pace activity and reduce cycles of pushing through and crashing.

• Reducing overwhelm and all or nothing thinking around food, exercise and self care.

• Working alongside your GP and specialist team, not replacing them.

Coaching does not treat endometriosis. What it can do is help you feel more in control, more supported, and better equipped to manage life with a long term condition.

A More Joined Up Approach to Endometriosis

If you are living with endometriosis, or you suspect you might be, you deserve to feel heard, taken seriously and supported.

Medical care is essential, and so is the wider picture of how you nourish, move and care for your body and mind. The two work best together.

You do not need to overhaul everything overnight, and you do not need to do this alone.

Small, consistent changes, made with the right support, can make a real difference to how you live with endometriosis day to day.

Disclaimer

This content is for general education and wellbeing awareness only and is not intended as individual medical advice. Please speak to your GP or a qualified healthcare professional for personalised guidance.