What is endometriosis?
Endometriosis occurs when tissue similar to the lining of the womb grows outside it — commonly on the ovaries, fallopian tubes and the tissue lining the pelvis. Each month this tissue responds to hormones in the same way as the womb lining, causing inflammation, pain and, over time, scar tissue and adhesions. It mainly affects women and girls of reproductive age, and symptoms often begin in the teenage years.
Diagnosis usually starts with a discussion of symptoms, a pelvic examination and an ultrasound or MRI scan, though scans can miss milder disease. The definitive test is a laparoscopy — keyhole surgery under general anaesthetic that allows a surgeon to see and often treat the tissue in the same procedure.
Common symptoms
- Painful, sometimes debilitating periods
- Chronic pelvic pain between periods
- Pain during or after sex
- Pain when going to the toilet, especially during a period
- Heavy periods
- Fatigue
- Difficulty getting pregnant
How long will you wait?
Gynaecology is one of the most pressured NHS specialties, and endometriosis remains notoriously slow to diagnose — on average it takes several years from first symptoms to a confirmed diagnosis, with routine referral-to-treatment waits for gynaecology surgery often stretching well beyond the 18-week standard.
Privately, you can typically see a consultant gynaecologist within 3–7 days, with scans within 1–2 weeks and a diagnostic laparoscopy usually within 2–6 weeks.
NHS England median referral-to-treatment wait: 12.4 weeks, with 2.5 million people waiting over 18 weeks (May 2026). Individual waits vary by trust and urgency.
Treatment options
- Pain relief. Anti-inflammatory painkillers such as ibuprofen or naproxen taken around period time to reduce pain and inflammation.
- Hormonal treatment. The combined pill, progestogens, hormonal coil or GnRH analogues suppress the menstrual cycle to reduce pain and slow tissue growth.
- Laparoscopic surgery. Keyhole surgery to excise or ablate endometriosis tissue and divide adhesions, which can improve pain and fertility.
- Hysterectomy with removal of ovaries. A last-resort option for severe disease when other treatments have failed and fertility is no longer a consideration.
What does private treatment cost?
As a guide, a private initial consultation typically costs £200–£300, with a diagnostic or therapeutic laparoscopy in the region of £5,000–£9,000 depending on the complexity of surgery and hospital.
Does health insurance cover endometriosis?
Most UK private medical insurance policies cover the investigation and surgical treatment of endometriosis, provided it is not a pre-existing condition when you take out the policy. Because endometriosis can recur, some insurers apply chronic-condition rules to long-term management, covering acute flare-ups and surgery but not ongoing routine care. Always check how your policy defines chronic conditions before claiming.
Frequently asked questions
Why does endometriosis take so long to diagnose on the NHS?
Symptoms overlap with other conditions such as irritable bowel syndrome and painful periods are often normalised, so many women see their GP several times before referral. Once referred, gynaecology waiting lists are among the longest in the NHS, and the definitive test — a laparoscopy — requires theatre time, adding further delay. On average the journey from first symptoms to diagnosis takes years.
Can endometriosis be cured?
There is no outright cure, but treatment can control symptoms effectively for many women. Hormonal treatments suppress the disease, and surgical excision can remove visible tissue, often giving lasting relief. Endometriosis can recur after surgery, which is why specialists focus on long-term management plans tailored to your symptoms, age and fertility plans rather than a one-off fix.
Will endometriosis affect my fertility?
Not necessarily. Many women with endometriosis conceive naturally, but the condition is found more often in women having difficulty getting pregnant, particularly where there is scarring around the ovaries or tubes. If you are struggling to conceive, an early specialist assessment is worthwhile, because surgical treatment or assisted conception may improve your chances depending on the severity of disease.
Related guides
- Fertility Problems
- Heavy Periods (Menorrhagia)
- Ovarian Cysts
- Pelvic Organ Prolapse
- Polycystic Ovary Syndrome (PCOS)
- Uterine Fibroids