Endometriosis Symptoms: Signs, Testing & Specialist Support
Painful periods, pelvic discomfort, bloating or difficulty conceiving? Understand the possible signs of endometriosis, how it differs from PCOS/PMOS and where to seek appropriate specialist gynaecology support in London.
Common endometriosis symptoms include painful periods, persistent pelvic pain, pain during or after sex, painful bowel movements or urination around menstruation, and sometimes difficulty becoming pregnant.
Some people experience fatigue or bloating, while others have few or no symptoms. Symptoms alone cannot confirm endometriosis, and their severity does not reliably indicate how extensive the condition is.
At Marylebone Diagnostic Centre, we can support appropriate blood investigations, help coordinate further assessment and connect patients with specialist gynaecology care. A routine blood test cannot diagnose endometriosis.
What is endometriosis?
Endometriosis is a condition in which tissue similar to the lining of the womb grows outside the uterus.
It most commonly affects areas within the pelvis, including around the ovaries, fallopian tubes and surrounding tissues. It can trigger inflammation, pain, scarring and, in some cases, fertility difficulties.
Endometriosis is not the same as having ordinary period cramps. Pain that repeatedly interferes with work, education, sleep or daily activities deserves proper assessment.
Seven symptoms that may suggest endometriosis
Very painful periods
Period pain that affects daily life or is difficult to manage.
Pelvic pain
Recurring or persistent pain in the lower abdomen or pelvis.
Pain during sex
Deep discomfort during or after sexual intercourse.
Bowel symptoms
Painful bowel movements, particularly around menstruation.
Urinary symptoms
Period-related pain when urinating or other cyclical urinary symptoms.
Fertility difficulties
Difficulty conceiving, sometimes alongside pelvic symptoms.
Fatigue and bloating
Symptoms that may occur alongside pain, but are not specific to endometriosis.
Endometriosis vs PCOS/PMOS: what is the difference?
Endometriosis and polycystic ovary syndrome (PCOS) – PMOS new name are different conditions. They can both affect reproductive health, but they usually present with different patterns of symptoms.
Endometriosis
PCOS
Yes. The conditions can coexist. Having PCOS does not rule out endometriosis, and having endometriosis does not rule out PCOS.
Persistent pelvic pain should not automatically be attributed to PCOS.
Can a blood test detect endometriosis?
No routine blood test can reliably confirm or exclude endometriosis. NICE specifically advises against using CA125 blood testing to diagnose the condition.
However, blood tests can be useful for investigating other problems that may occur alongside symptoms, or for evaluating alternative explanations.
Full blood count
May help assess anaemia when periods are heavy or there are other relevant symptoms.
Ferritin and iron studies
May help investigate iron deficiency when clinically indicated.
Hormone investigations
May support investigation of irregular cycles, possible PCOS or fertility concerns. They do not diagnose endometriosis.
How is endometriosis diagnosed?
Assessment usually begins with your symptom history, including the relationship between pain and your menstrual cycle, previous treatments and fertility plans.
Pain, bleeding, cycle patterns, bowel or bladder symptoms.
Review history and consider examination when appropriate.
Pelvic ultrasound; specialist imaging if indicated.
Symptom treatment, referral and possible laparoscopy.
Endometriosis symptoms: frequently asked questions
Tap a question for a straightforward clinical answer.
What are the first signs of endometriosis?
Early signs may include increasingly painful periods, pelvic pain or pain during sex. Some people have no obvious symptoms. Persistent or disruptive symptoms deserve assessment.
What does endometriosis pain feel like?
Pain may feel cramping, deep, aching or sharp. It may occur before or during periods, during sex or with bowel movements. Pain patterns vary between individuals.
Can you have endometriosis with regular periods?
Yes. Regular menstrual cycles do not exclude endometriosis. The nature of the pain and other symptoms can be more informative than cycle regularity alone.
Can endometriosis cause bloating?
Bloating can occur alongside endometriosis, but it is not specific to the condition. Persistent bloating may have other causes that also need consideration.
Does endometriosis cause infertility?
Endometriosis can affect fertility in some people, but many conceive naturally. Assessment should take account of age, symptoms, reproductive history and other possible fertility factors.
Can PCOS cause the same symptoms?
There can be overlap, especially with menstrual and fertility concerns. However, significant cyclical pelvic pain is more suggestive of endometriosis than uncomplicated PCOS.
Will a normal ultrasound rule it out?
No. Ultrasound can identify some forms of endometriosis and other pelvic conditions, but superficial disease may not be visible. Persistent symptoms still need assessment.
Is endometriosis curable?
There is currently no guaranteed permanent cure. Hormonal treatment, pain management and surgery may help control symptoms. Treatment depends on individual circumstances and fertility preferences.
Can endometriosis cause pain outside periods?
Yes. Some people experience persistent pelvic pain throughout the month rather than only during menstruation.
When should I see a gynaecologist?
Consider assessment if pain interferes with daily life, symptoms persist despite initial treatment, or you have fertility concerns alongside possible endometriosis.
Specialist gynaecology support through MDC
Gynaecology & Fertility Specialist
When pelvic symptoms, menstrual concerns or fertility difficulties require further investigation, MDC can help patients access specialist gynaecology and fertility assessment through our partner pathway.
Dr Simone Rofena provides specialist expertise in gynaecology, fertility and assisted conception. Patients with suspected endometriosis can be directed for appropriate specialist evaluation, with referral onwards to a dedicated endometriosis service when clinically indicated.
With your consent, MDC can share relevant results and clinical information with the specialist and remain available to coordinate further diagnostic investigations.
You do not need to arrive with a confirmed diagnosis to ask about specialist assessment.
How to prepare for a gynaecology assessment
You do not need to complete a long questionnaire. A few useful details can make your appointment more productive:
Your symptoms
Where is the pain, when does it occur and how does it affect daily life?
Your menstrual cycle
Are periods regular? Are they heavy or especially painful?
Your medical history
Bring previous ultrasound reports, relevant blood results and treatment details.
Sudden severe pelvic pain, fainting, heavy bleeding, fever with significant pelvic pain or pelvic pain with a possible pregnancy requires urgent assessment. These symptoms should not automatically be attributed to endometriosis.
NICE: Endometriosis: diagnosis and management (NG73)
NHS: Endometriosis
NHS: Polycystic ovary syndrome (PCOS)
This article is for general education and does not replace individual medical assessment. Specialist medical review is pending approval.
Pelvic pain deserves answers, not assumptions.
If you are experiencing painful periods, persistent pelvic symptoms or fertility concerns, MDC can help you take the next step.
From appropriate blood investigations to coordination with specialist gynaecology and fertility services, our focus is on making your diagnostic journey clearer.
Marylebone Diagnostic Centre · 73 Baker Street, London W1U 6RD
