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Dr. Chrysoula I. Liakou MD, PhD
- Treated online: Partly. Suspected endometriosis can be assessed by video and treated with pain relief and hormones; scans, the laparoscopy that confirms it, surgery and fertility care are in person.
- What it is: cells similar to the lining of the womb growing elsewhere, usually in the pelvis, causing pain and sometimes fertility problems.
- How common: about 10% of women of reproductive age, some 190 million worldwide. Diagnosis takes 4 to 12 years on average.
- Main signs: period pain that stops normal activities, pelvic pain, pain during or after sex, and pain passing poo or pee during a period.
- Emergency: call 112 for severe or sudden pain low in the tummy, pain with a very high temperature, heavy bleeding with feeling faint, or collapse.
Do not book a video appointment if you have severe or worsening pain low in your tummy, sudden sharp pain, pain with a very high temperature or feeling very unwell, heavy vaginal bleeding with dizziness or fainting, or pain under your right ribs and in your right shoulder. Call 112 or go to an emergency department, and do not drive yourself.
Can an online doctor treat endometriosis?
Partly. Endometriosis is first suspected from your symptoms, and a doctor can assess them by video, start pain relief and hormonal treatment, which guidelines recommend even before the diagnosis is confirmed, and refer you for a scan or to a gynaecologist. The examination, scans, the laparoscopy that confirms endometriosis, surgery and fertility treatment are in person, and the doctor tells you where to go.
How an online consultation helps with endometriosis
- Symptoms taken seriously: Period pain that disrupts your life is not normal, and the doctor recognises the pattern.
- Treatment before a diagnosis: Pain relief and hormonal treatment can start while you wait for tests.
- The right referral: A scan, a gynaecologist or a specialist endometriosis service, depending on your symptoms.
- A longer-term plan: Flare-ups, fertility plans, work and daily life, with treatment reviewed over time.
What the doctor checks in an online endometriosis consultation
The doctor asks about the signs that need urgent care first, then about the pattern of your symptoms. The doctor asks about:
- Warning signs: sudden or severe pain, a high temperature, heavy bleeding, or a chance of pregnancy.
- Period pain: how bad it is, and whether it stops you working, studying or going out.
- Heavy periods: for example, needing to change pads or tampons every 1 to 2 hours.
- Other pain: pelvic pain between periods, pain during or after sex, and pain passing poo or pee, especially during a period.
- Fertility: whether you are trying for a baby, or plan to.
- Your history: endometriosis in close relatives, earlier scans or operations, and the painkillers and hormones you have tried.
Before the call, a symptom diary of your pain, bleeding and cycle over a few months helps. You choose what you share, and the doctor tells you if an examination in person would help.
What is endometriosis?
Endometriosis is a condition where cells similar to those in the lining of the womb grow in other parts of the body, most often on the ovaries, the fallopian tubes and the lining of the pelvis, sometimes on the bladder or bowel, and occasionally outside the pelvis, such as in the chest. It affects an estimated 10% of women of reproductive age, about 190 million worldwide, from puberty to the menopause.
The cause is not known. One theory is that period blood flows back through the fallopian tubes into the pelvis, carrying cells that attach there; changes in the immune system may also play a part, and people with endometriosis have higher rates of conditions such as lupus, multiple sclerosis and inflammatory bowel disease.
Is endometriosis genetic?
It runs in families: having a mother, sister or aunt with endometriosis makes it more likely. Other risk factors include starting periods early, never having given birth, short cycles and heavy periods lasting longer than 7 days.
What are the symptoms of endometriosis?
The main symptom is pelvic pain, usually linked to periods, which may get worse over time. Symptoms vary a lot, and some women have none. They include:
- severe period pain that stops you doing normal activities
- heavy periods, needing to change pads or tampons every 1 to 2 hours
- pelvic pain at other times
- pain during or after sex
- pain when passing poo or pee, especially during a period
- bloating, feeling sick, diarrhoea or constipation
- extreme tiredness, low mood and anxiety
- difficulty getting pregnant
How bad the pain is does not show how much endometriosis there is: some women with a little have severe pain, and some with a lot have none.
What are three signs of endometriosis?
Guidelines tell doctors to suspect endometriosis with period pain that affects daily life, deep pain during or after sex, and pain or bowel or bladder symptoms that come with your cycle, such as painful poo or blood in the urine during a period, especially with fertility problems.
Endometriosis or something else?
Several conditions share symptoms with endometriosis, and they can happen together:
Swipe sideways to compare →
| Condition | Shared symptoms | Clues | How it is checked |
|---|---|---|---|
| Endometriosis | Period pain, pelvic pain, pain during sex | Symptoms that follow your cycle, including bowel and bladder symptoms | Ultrasound, MRI, laparoscopy |
| Pelvic inflammatory disease | Pelvic pain, deep pain during sex, heavy or painful periods | Unusual discharge, bleeding between periods or after sex, a temperature | Examination, swabs, antibiotics |
| Adenomyosis or fibroids | Heavy, painful periods | Symptoms overlap with endometriosis | Ultrasound or MRI |
| Irritable bowel syndrome | Cramps, bloating, diarrhoea or constipation | Symptoms that do not follow your cycle point more to IBS | From your symptoms and tests |
How is endometriosis diagnosed?
From your symptoms first, then tests. A doctor asks about your symptoms and family history and may examine your tummy and pelvis. A transvaginal ultrasound scan, or a scan through the tummy, can show endometriosis on the ovaries and deep endometriosis affecting the bowel or bladder, and an MRI scan is sometimes used. A laparoscopy, keyhole surgery to look inside the pelvis, is the test that confirms it, and areas of endometriosis can be removed at the same time.
A normal examination, ultrasound or MRI does not rule endometriosis out. If your symptoms continue, ask for a referral rather than accepting a normal scan as the end of the story.
Why does diagnosis take so long?
Symptoms vary and overlap with other conditions, some people have none, and doctors may not recognise it easily. Worldwide, diagnosis takes 4 to 12 years on average. Keeping a symptom diary and describing how the pain affects your life helps doctors recognise the pattern sooner.
How is endometriosis treated?
There is no cure, but treatment can ease the pain and other symptoms. Medicines are often the first treatment, and hormonal treatment can start before the diagnosis is confirmed:
Swipe sideways to compare →
| Treatment | What it does | Good to know |
|---|---|---|
| Painkillers | Paracetamol or an anti-inflammatory painkiller such as ibuprofen, alone or together | Often tried first, for example for 3 months, then reviewed |
| Hormonal treatment | The combined pill or a progestogen, or GnRH analogues | Not used while trying to get pregnant; symptoms can return when it stops |
| Surgery | Removes areas of endometriosis or ovarian cysts by keyhole surgery and, if needed, part of the bowel or bladder | Symptoms can come back, and surgery can cause adhesions |
| Hysterectomy | Removes the womb, sometimes with the ovaries | For some women whose symptoms have not responded to other treatments and who do not plan a pregnancy |
| Physiotherapy and CBT | Part of a wider pain management plan | Helps with long-term pain |
| Fertility treatment | Ovulation induction, IUI or IVF | Through a fertility specialist |
Is endometriosis curable?
No, there is currently no cure, and many people need treatment over the long term. Symptoms usually stop after the menopause, although they can continue for some.
Does endometriosis cause weight gain?
Endometriosis does not cause weight gain, but bloating and fluid retention can make you feel as if you have put on weight.
Can you get pregnant with endometriosis?
Yes, many women with mild to moderate endometriosis can get pregnant, though it can be harder. Up to half of people with endometriosis have difficulty conceiving, and 25 to 50% of women with infertility have endometriosis. Hormonal treatment is not used while you are trying for a baby; surgery can sometimes improve fertility, and a fertility specialist can offer treatments such as IVF. Tell the doctor about your plans, because they change which treatment fits.
Can endometriosis be serious?
It is a long-term condition that can affect work, relationships and mental health, and long-lasting pain and tiredness are hard to live with. Some studies suggest a slightly higher risk of ovarian cancer, but the overall lifetime risk stays low. Endometriosis that affects the bowel or bladder may need surgery.
Which endometriosis treatment might the doctor recommend?
Treatment depends on your symptoms, your plans for pregnancy and what you have tried. This is the framework the doctors use, in line with NICE guidance:
Swipe sideways to compare →
| What you have | Likely first step | Suitable for online care? | When in-person care is needed |
|---|---|---|---|
| Painful periods that affect daily life, not trying to conceive | Painkillers and hormonal treatment, such as the combined pill or a progestogen | Yes | If treatment does not help, for a scan |
| Suspected endometriosis, symptoms persisting despite treatment | A referral for an ultrasound and a gynaecologist | Partly | For the scan and specialist care |
| Bowel or bladder symptoms with your periods | A referral for a scan and specialist assessment | Partly | For the scan and specialist care |
| Trying for a baby | Advice, and a referral to a gynaecologist or fertility specialist | Partly | For fertility care |
| Diagnosed endometriosis, a flare-up of pain | A review of pain relief and hormonal treatment | Yes | If the pain is severe or different |
| Sudden severe pain, a fever, or heavy bleeding with feeling faint | Emergency care | No | Call 112 now |
Period pain that stops you living normally? A doctor can start treatment and plan your tests in one consultation.
See available times →Treatment options for endometriosis
What you can do yourself
- Keep a diary of your pain, bleeding and cycle, and note how it affects your daily life.
- Take paracetamol or ibuprofen as the pack says.
- Ask for help with low mood or anxiety, which often come with long-term pain.
- Look for support groups for people living with endometriosis.
- Go back to a doctor if treatment is not helping, or your symptoms get worse.
Prescription treatment
A prescription is never issued without a consultation. For suspected or confirmed endometriosis, the doctor may prescribe pain relief and hormonal treatment, such as the combined pill or a progestogen, when it suits you and you are not trying to get pregnant, and refers you for a scan, a gynaecologist or fertility care when you need them. Codeine and other opioid painkillers are never prescribed online. If the doctor prescribes, use the prescription at a pharmacy near you.
What does not help
Accepting severe period pain as normal. Taking a normal scan as proof that you do not have endometriosis. Stronger and stronger painkillers without a plan or a referral. Hormonal treatment while you are trying for a baby.
Special situations
Trying for a baby
Tell the doctor early: hormonal treatment is stopped, and a referral to a gynaecologist or fertility specialist may help sooner.
Work and daily life
Long-lasting pain and tiredness can affect work and relationships. A clear diagnosis and a written treatment plan make it easier to explain what you need.
Around the menopause
Symptoms usually stop after the menopause, but not always. The menopause page covers hormone treatment and the change itself.
Young women
Endometriosis can start at puberty. Under 18s are referred to a specialist gynaecology service for young people when needed, and Mobi Doctor consultations are for adults aged 18 and over.
Children
Mobi Doctor consultations are for adults aged 18 and over. A child who is unwell needs a paediatrician or a local doctor in person, and emergency signs in a child mean 112.
When endometriosis is treated online, and when you need in-person care
Treated online: assessment of suspected endometriosis, pain relief and hormonal treatment, reviews of treatment and flare-ups, and referrals for scans, specialists and fertility care.
In-person care: examinations, ultrasound and MRI scans, laparoscopy, surgery, fertility treatment, and any emergency sign.
When to get in-person care
Call 112 or go to an emergency department now for:
- severe or worsening pain low in the tummy, or pain when you move or touch the area
- sudden, sharp, intense pain low in the tummy
- pelvic pain with heavy vaginal bleeding, or with dizziness or fainting
- a very high temperature, being sick or feeling very unwell with pelvic pain
- pain under your right ribs and in your right shoulder
Get medical advice the same day for:
- pelvic pain with a temperature or unusual discharge
- shortness of breath or coughing up blood around your period
- pelvic pain when you could be pregnant
How Mobi Doctor works
- Book a time that suits you: daily 7am–11pm CEST. You can see a doctor over video, usually within 15 minutes. No subscription, and the exact price is shown before you pay.
- Speak to a licensed doctor about your symptoms: describe your period pain and how it affects you, mention pain during sex or on the toilet, and say whether you are trying for a baby.
- Leave with a plan: what to do, what to take and for how long, and which signs mean you should be seen in person. If the doctor prescribes, use the prescription at a pharmacy near you.
No sign-up needed
Not sure it’s endometriosis? Tick every symptom you have to see each condition page that mentions it. It finds the right page, not a diagnosis: a doctor gives you that on a video call.
Tap the body — an area or a point — to browse symptoms anywhere
Similar symptoms, different condition? Irritable Bowel Syndrome (IBS) can start the same way. Compare them, or look up any other symptom in the full symptom checker.
Frequently asked questions about endometriosis
What is endometriosis?
Endometriosis is a condition where cells similar to the lining of the womb grow in other places, usually in the pelvis. It affects about 10% of women of reproductive age and can cause pain, heavy periods and fertility problems.
What are the first signs of endometriosis?
The first signs of endometriosis are period pain that stops you doing normal activities, heavy periods, pelvic pain, pain during or after sex, and pain passing poo or pee during a period. Some women have no symptoms.
What does endometriosis pain feel like?
Endometriosis pain is often very painful cramps, and pain in the tummy, back or pelvis, during sex or on the toilet. It can be mild or intense, and it often gets worse just before and during a period.
What can I do at home to manage endometriosis pain?
Take anti-inflammatory painkillers such as ibuprofen a day before the period is due rather than waiting for the pain, use heat on the tummy or back, try a TENS machine, keep gently active with walking, swimming or yoga, which reduce pain over time, sleep and eat regularly, cut back on alcohol and caffeine if they worsen symptoms, and track the cycle and pain in an app to show the doctor. Endometriosis pain that stops daily life despite this needs hormonal treatment or referral.
How is endometriosis diagnosed?
From your symptoms first, then an ultrasound or MRI scan. A laparoscopy, keyhole surgery to look inside the pelvis, confirms it. A normal scan does not rule endometriosis out.
Is it endometriosis or something else?
Endometriosis is pain that builds before and during periods, often with pain during sex and on the toilet, and heavy periods. Ordinary period pain eases with painkillers and does not stop normal life; IBS brings bloating and changed bowels unrelated to the cycle; pelvic inflammatory disease causes pain with fever and discharge; adenomyosis gives heavy, painful periods with a tender, enlarged womb; and fibroids cause heavy bleeding with pressure. A scan and sometimes a laparoscopy settle it.
Why does it take so long to diagnose endometriosis?
Endometriosis symptoms vary and overlap with other conditions, some people have none, and doctors may not recognise it easily. Worldwide, diagnosis takes 4 to 12 years on average.
What causes endometriosis?
The cause of endometriosis is not known. Period blood flowing back into the pelvis and changes in the immune system may play a part, and it runs in families.
Can endometriosis be prevented?
No. Endometriosis cannot be prevented, because its cause is unknown and it runs in families, but hormonal contraception that lightens or stops periods, started early in women with severe period pain, reduces the growth of deposits and may slow progression; pregnancy and breastfeeding give temporary relief, and exercise is linked to lower rates. What can be prevented is the long delay to diagnosis: period pain that stops normal activities is not normal and should be assessed.
Is endometriosis curable?
There is no cure for endometriosis, but it can be controlled: painkillers taken ahead of the pain, hormonal treatment such as the pill, the hormonal coil or progestogens that suppress the tissue, and keyhole surgery to remove deposits all ease the symptoms, and treatment is chosen around whether you want to get pregnant. Symptoms usually stop after the menopause, although not for everyone, and endometriosis can return after surgery.
How does endometriosis progress, and what is the outlook?
Endometriosis is a long-term condition that tends to persist from the teens or twenties until the menopause, with symptoms that often worsen over the years without treatment and ease with it; it does not shorten life, most women keep working and many have children, and about a third of those with fertility problems conceive with help. Pain usually settles after the menopause, although HRT can keep it going, and surgery gives relief that lasts years in most.
Can you get pregnant with endometriosis?
Yes, many women with mild to moderate endometriosis can, though up to half have difficulty conceiving. Surgery and fertility treatments such as IVF can help.
Does endometriosis cause weight gain?
Endometriosis itself does not cause weight gain, but the bloating that comes with it, sometimes called endo belly, can swell the abdomen by a dress size over a day, and fluid retention makes clothes feel tight; some hormonal treatments, particularly progestogen-only ones, can add a few kilograms in some women. If weight gain is a problem, the doctor can switch treatment, and exercise and a diet lower in salt reduce the bloating.
Can endometriosis cause cancer?
Endometriosis is not cancer and does not turn into cancer in the ordinary sense, but some studies show a slightly higher risk of certain ovarian cancers in women who have it, while the overall lifetime risk stays low, around 1 to 2 in 100 compared with about 1 in 100 without endometriosis; no screening is advised, and hormonal contraception, pregnancy and breastfeeding all lower ovarian cancer risk. Any new persistent bloating or pelvic mass is checked.
Can an online doctor treat endometriosis?
Partly. A doctor can assess endometriosis symptoms by video, start pain relief and hormonal treatment and refer you for tests. Scans, laparoscopy, surgery and fertility treatment are in person.
- Endometriosis, NHS, National Health Service (UK), reviewed 27 August 2024.
- Endometriosis: diagnosis and management (NG73), NICE, National Institute for Health and Care Excellence, 2017, updated 2024.
- Endometriosis: fact sheet, WHO, World Health Organization, 15 October 2025.
- Endometriosis: symptoms and causes, Mayo Clinic (US), updated 30 August 2024.
- Endometriosis, Cleveland Clinic (US), reviewed 16 September 2024.
- Pelvic inflammatory disease (PID), NHS, National Health Service (UK), reviewed 17 December 2025.
This page is for information only and is not a substitute for a medical consultation. Guideline links are provided for transparency; treatment decisions are made with your doctor.
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