Our Endometriosis Services provide comprehensive diagnosis, treatment, and ongoing management for women living with this often challenging condition. We understand the impact endometriosis can have on your quality of life and fertility, and our team is dedicated to providing compassionate, expert care.
What Is Endometriosis?
Endometriosis is a condition where tissue similar to the lining of the uterus (endometrium) grows outside the uterus. This tissue can be found on the ovaries, fallopian tubes, bowel, bladder, and other areas within the pelvis.
Like the normal uterine lining, this tissue responds to hormonal changes during the menstrual cycle, causing inflammation, pain, and the formation of scar tissue (adhesions).
How Common Is Endometriosis?
- Affects approximately 1 in 10 women of reproductive age
- Often takes 7-10 years to diagnose due to symptom variability
- Can begin in adolescence and continue until menopause
- May run in families (genetic component)
Symptoms of Endometriosis
Endometriosis symptoms vary greatly from woman to woman. Some women have severe symptoms while others have none at all.
Common Symptoms
- Painful periods (dysmenorrhoea) — Pain that is more severe than normal menstrual cramps
- Chronic pelvic pain — Pain that persists throughout the month, not just during periods
- Pain during or after intercourse (dyspareunia)
- Pain with bowel movements or urination — Especially during menstruation
- Heavy or irregular periods
- Fatigue — Persistent tiredness that affects daily life
- Infertility — Difficulty getting pregnant
Less Common Symptoms
- Lower back pain
- Leg pain (sciatica-like symptoms)
- Bloating (“endo belly”)
- Nausea
- Blood in urine or stool during periods
When to Seek Help
You should consult a specialist if you experience:
- Pelvic pain that interferes with daily activities
- Painful periods that don’t respond to standard painkillers
- Pain during intercourse
- Difficulty conceiving after 12 months of trying
- Worsening symptoms over time
Diagnosis
Medical History and Examination
Your consultation will include:
- Detailed discussion of your symptoms and their pattern
- Menstrual history and pain diary review
- Family history of endometriosis
- Pelvic examination
Ultrasound
Transvaginal ultrasound can identify:
- Ovarian endometriomas (chocolate cysts)
- Deep infiltrating endometriosis in some locations
- Other pelvic abnormalities
MRI Scan
MRI may be recommended for:
- Detailed assessment of deep endometriosis
- Planning surgical treatment
- Evaluating involvement of bowel, bladder, or other organs
Laparoscopy
Laparoscopy (keyhole surgery) remains the gold standard for definitive diagnosis:
- Allows direct visualisation of endometriosis deposits
- Enables biopsy for confirmation
- Treatment can often be performed at the same time
- Determines the stage and extent of disease
Stages of Endometriosis
Endometriosis is classified into four stages based on the location, extent, and depth of the disease:
| Stage | Description |
|---|---|
| Stage I (Minimal) | Few superficial implants |
| Stage II (Mild) | More implants, slightly deeper |
| Stage III (Moderate) | Many deep implants, small cysts on ovaries, some adhesions |
| Stage IV (Severe) | Many deep implants, large cysts, extensive adhesions |
Important: The stage does not always correlate with the severity of symptoms. Some women with Stage I have severe pain, while others with Stage IV have minimal symptoms.
Treatment Options
Treatment is tailored to your individual circumstances, including symptom severity, desire for pregnancy, and previous treatments.
Pain Management
- Over-the-counter pain relief — NSAIDs (ibuprofen, naproxen) taken before and during periods
- Heat therapy — Hot water bottles or heating pads for pain relief
- TENS machines — Transcutaneous electrical nerve stimulation
Hormonal Treatments
Hormonal therapies work by suppressing ovulation and reducing oestrogen levels:
- Combined oral contraceptive pill — Continuous use to prevent periods
- Progestogen-only treatments — Pills, injections, or implants
- Mirena coil (IUS) — Releases progestogen directly into the uterus
- GnRH agonists — Temporarily induce a menopause-like state
- GnRH antagonists — Newer option with fewer side effects
Surgical Treatment
Surgery may be recommended when:
- Medical treatments have not provided adequate relief
- There are ovarian cysts (endometriomas)
- You are trying to conceive
- There is deep infiltrating endometriosis
Types of surgery:
- Laparoscopic excision — Cutting out endometriosis deposits (preferred method)
- Laparoscopic ablation — Burning or destroying endometriosis tissue
- Cystectomy — Removal of ovarian endometriomas
- Adhesiolysis — Releasing scar tissue and adhesions
- Hysterectomy — Removal of the uterus (for severe cases when fertility is not desired)
Complementary Therapies
Some women find relief with:
- Dietary changes (anti-inflammatory diet)
- Acupuncture
- Physiotherapy for pelvic floor
- Psychological support and pain management programmes
Endometriosis and Fertility
Endometriosis is one of the leading causes of infertility, affecting up to 50% of women who have difficulty conceiving.
How Endometriosis Affects Fertility
- Damages or blocks fallopian tubes
- Creates adhesions that distort pelvic anatomy
- Affects egg quality in ovarian endometriomas
- Creates an inflammatory environment that may affect implantation
- Can impact ovarian reserve
Fertility Treatment Options
Surgical treatment:
- Removing endometriosis and adhesions can improve natural conception rates
- Particularly beneficial for mild to moderate endometriosis
- Should be performed by an experienced surgeon to preserve ovarian tissue
IVF (In Vitro Fertilisation):
- Often recommended for moderate to severe endometriosis
- Recommended after failed surgical treatment
- Bypasses damaged fallopian tubes
- May require individualised stimulation protocols
IUI (Intrauterine Insemination):
- May be suitable for minimal/mild endometriosis
- Usually combined with ovarian stimulation
- Less invasive than IVF
Preserving Fertility
If you have endometriosis and are not ready to conceive, consider:
- Egg freezing to preserve fertility for the future
- Regular monitoring of ovarian reserve
- Early fertility consultation to understand your options
Living with Endometriosis
Long-term Management
Endometriosis is a chronic condition that requires ongoing management:
- Regular follow-up appointments
- Monitoring for disease progression
- Adjusting treatment as needed
- Managing symptoms between appointments
Support Resources
- Support groups (online and local)
- Endometriosis associations and charities
- Counselling and psychological support
- Pain management clinics
Lifestyle Modifications
Some women find these helpful:
- Regular exercise
- Stress management techniques
- Adequate sleep
- Anti-inflammatory diet
- Limiting alcohol and caffeine
Our Approach
At Dr Salam Jibrel Medical Center, we provide:
- Expert diagnosis — Using the latest imaging and surgical techniques
- Individualised treatment plans — Tailored to your symptoms and goals
- Fertility-focused care — Preserving and optimising your fertility
- Multidisciplinary approach — Collaboration with pain specialists, physiotherapists, and psychologists when needed
- Ongoing support — Long-term management and follow-up
Book a Consultation
If you’re experiencing symptoms of endometriosis or have been diagnosed and need specialist care, our team is here to help. Contact us at info@salamivf.com or call +973 1725 5095 to schedule a consultation.