What is endometriosis?

Endometriosis is a long-term condition in which tissue similar to the lining of the womb grows elsewhere in the body. It most commonly affects areas within the pelvis, but it can also affect the bowel, bladder and, less commonly, other parts of the body.

Symptoms vary considerably from person to person. Common symptoms include pelvic pain, painful periods, heavy bleeding, pain during or after sex, and pain when opening your bowels or passing urine. Some people also experience fatigue, digestive symptoms and difficulties getting pregnant.

Endometriosis affects approximately one in ten women of reproductive age worldwide. Despite its prevalence, diagnosis can be delayed, leaving many people living with symptoms for years before receiving appropriate care.

Although there is currently no cure, treatments and supportive approaches can help people manage symptoms and improve their quality of life.


A few important things to understand about endometriosis:

• It can affect more than your periods. Symptoms may involve the digestive system, bladder, pelvic floor, muscles and joints, as well as your emotional wellbeing.
• Symptoms do not always reflect the extent of the condition. The severity of pain does not necessarily correspond to the stage or amount of endometriosis present.
• Everyone's experience is different. Some people have few symptoms, while others experience pain that affects work, exercise, sleep and relationships.
• It deserves proper assessment and support. Severe or persistent symptoms should not simply be accepted as part of having a period.

What are the symptoms of endometriosis?

Endometriosis can present in different ways, and not everyone experiences the same symptoms.

Some people experience:

• Digestive symptoms
• Abdominal pain and bloating, sometimes referred to as “endo belly”.
• Constipation, diarrhoea or symptoms resembling irritable bowel syndrome (IBS).
• Pain when opening the bowels, particularly around menstruation.
• Nausea or discomfort after eating.
• Bladder and pelvic symptoms
• Possible symptoms include:
• Pain when passing urine, particularly during your period.
• Urinary symptoms that follow a cyclical pattern.
• Pain during or after sex.
• Pelvic floor tension or persistent pelvic pain.
• Painful periods that interfere with everyday activities.
• Heavy menstrual bleeding.
• Fertility and pregnancy

Endometriosis can be associated with difficulties conceiving, although many people with the condition become pregnant naturally. If you are trying to conceive, your individual circumstances and treatment options are best discussed with your GP, gynaecologist or fertility specialist.

Impact on everyday life

Living with persistent pain can affect much more than your menstrual cycle.

Some people experience:

• Fatigue and disrupted sleep.
• Difficulty concentrating or “brain fog”.
• Lower back, pelvic, abdominal or hip pain.
• Buttock or leg pain.
• Difficulty sitting for long periods, exercising or carrying out everyday activities.
• Anxiety, low mood or reduced confidence.

This list is not exhaustive. If symptoms are affecting your daily life, it is worth seeking advice rather than assuming they are normal.

What is adenomyosis?

Think of adenomyosis as endometriosis's close relative. The two conditions can share symptoms, but they affect different areas of the body.

With adenomyosis, tissue similar to the lining of the womb is found within the muscular wall of the uterus (the myometrium). With endometriosis, similar tissue grows outside the womb, commonly within the pelvic cavity.

Adenomyosis can cause painful periods, heavy menstrual bleeding, pelvic pain, bloating and a feeling of heaviness or fullness in the abdomen. Some people have no symptoms.

The two conditions can occur together, and it is important to recognise that they are distinct conditions requiring appropriate assessment.

If your periods have become increasingly painful or heavy, or you experience ongoing pelvic pain, speak to your GP about possible causes and whether further investigation is appropriate.

How can osteopathy help if I have endometriosis or adenomyosis?

Endometriosis and adenomyosis can be associated with persistent pelvic pain, muscle tension and changes in how you move and carry out everyday activities.

Although osteopathy does not treat or cure the underlying conditions, an individualised approach may help address some of the musculoskeletal symptoms that accompany them.

Depending on your symptoms and assessment findings, osteopathic care may include:

• Addressing muscle tension: Gentle hands-on techniques may help ease tension in the lower back, hips, buttocks and surrounding muscles.
• Supporting comfortable movement: Treatment and tailored movement advice may help you move more comfortably and manage activities that aggravate your symptoms.
• Considering pelvic floor function: Pelvic floor tension or coordination difficulties may contribute to pelvic pain. Where appropriate, we can discuss assessment and referral to a suitably trained pelvic health physiotherapist.
• Supporting recovery after surgery: Following appropriate medical clearance, treatment may focus on movement, scar-related discomfort, muscle tension and returning to everyday activities.
• Helping you understand your symptoms: We can discuss your movement patterns, activity levels and practical strategies that may help you manage the physical impact of persistent pain.
• Referring when needed: If your symptoms suggest that further medical assessment is needed, we will recommend that you contact your GP or gynaecologist.

The evidence for osteopathy specifically treating endometriosis or adenomyosis is limited. Our aim is therefore to support your comfort, movement and day-to-day function as part of your wider healthcare, rather than replace gynaecological care.

I think I might have endometriosis or adenomyosis. What should I do?

Recognising your symptoms is an important first step. Period pain that regularly stops you from working, exercising, socialising or carrying out everyday activities deserves attention.

Speak to your GP if you experience:

• Period pain that affects your daily activities.
• Heavy periods, particularly if you need to change your period products every one to two hours.
• Persistent or recurrent pelvic pain.
• Pain during or after sex.
• Pain when opening your bowels or passing urine, especially around your period.
• Unexplained bleeding between periods or after sex.
• Symptoms that are worsening or not responding to treatment.
• A close relative with endometriosis can also increase your likelihood of having the condition.

Your GP can assess your symptoms and arrange appropriate investigations or referral to gynaecology. A normal ultrasound scan does not always rule out endometriosis, so further assessment may still be appropriate.

You can find reliable information and support through:

NHS: Endometriosis

NHS: Adenomyosis

NICE: Endometriosis diagnosis and management

Endometriosis UK

Women's health osteopathy at Osteopathy West London

At Osteopathy West London, we understand that pelvic pain can affect many aspects of your life. Our approach is to listen to your experience, understand how your symptoms affect you and develop an individualised plan where osteopathic care is appropriate.

Your appointment may include a detailed discussion of your symptoms and medical history, alongside a musculoskeletal and functional assessment. Depending on your presentation, we may assess spinal and hip movement, strength, muscle tension and the movements or activities that aggravate your symptoms.

Where clinically appropriate, and with your informed consent, an internal pelvic examination may be discussed to assess pelvic floor function. This is optional and is not a diagnostic test for endometriosis or adenomyosis.

If we identify musculoskeletal factors that may be contributing to your discomfort, treatment may include appropriate hands-on techniques, medical acupuncture where suitable, movement advice and a tailored exercise plan.

We recognise the importance of working alongside other healthcare professionals. Where needed, we will recommend that you seek further assessment from your GP, gynaecologist or a pelvic health specialist.

If you have undergone surgery, we can also discuss appropriate support during your recovery, taking into account your procedure, symptoms and medical advice.

Our aim is to help you feel heard, supported and better equipped to manage the physical impact of your symptoms.

Would you like to discuss your symptoms?

If you are experiencing pelvic pain, painful periods or musculoskeletal discomfort associated with endometriosis or adenomyosis, we are happy to discuss whether osteopathic care may be appropriate for you.

At Osteopathy West London, we offer a range of women's health services in Ealing.

You can also book a free 10-minute introductory consultation to discuss your concerns and find out more about our approach here. or learn more about our women's health services at Osteopathy West London here.

You do not have to navigate persistent pain without support.

This article is intended for general information and does not replace medical assessment, diagnosis or treatment. Please contact your GP if you are concerned about your symptoms.