ALTHOUGH endometriosis is the second commonest gynaecological condition in the UK, it takes an average time of seven-and-a-half years from the start of symptoms until a diagnosis is reached; a startling figure.

Complaints can be varied and often suggestive of other conditions. The Royal College of Obstetricians and Gynaecologists (RCOG), and leading charity; Endometriosis UK, hope that by raising awareness, both doctors and patients will be more attuned to spotting it.

Endometrial tissue forms the lining of the womb. During a period this is shed, leaving the body via the vagina. If this tissue is elsewhere in the body, though it also bleeds, the body has no way of getting rid of it. This can cause inflammation and severe pain.

One theory is that endometrial tissue travels backwards up the fallopian tubes during a period and then deposits in the abdomen and pelvis. This tissue then attaches to other organs in the abdomen, typically the bowel and bladder. It has even been found as far up as the lungs.

Symptoms are based on where the endometrial tissue is. It can cause pain during sex, issues with your bladder and bowels, and rarely bleeding when urinating or opening your bowels. If it distorts the fallopian tubes, you may struggle to fall pregnant. Some women have bleeding between periods.

The activity of endometrial tissue is driven by the hormone oestrogen, and although pain may be there most or indeed all of the time, the hallmark of endometriosis is that this pain is far worse during a period.

Due to the realisation that pain can be difficult to explain, the RCOG recommend that you write down your symptoms so that a consultation with your GP can be more productive. If you think endometriosis is the diagnosis; tell your doctor this is your concern.

Some GPs have a specialist interest in women’s health, and if they are confident in the diagnosis, treatment may be started immediately.

Most women will have already tried over the counter painkillers, but prescription medicines are available for episodes of severe pain.

Hormonal contraceptives including the combined pill and the Mirena “coil” are first line. These lighten periods as well as reducing period pain. If the diagnosis is uncertain, or symptoms do not improve with initial treatment, a referral to gynaecology is the next step.

Here, medications known as Gonadotropin Releasing Hormone Analogues, sometimes called GnRH may be commenced. Gonadotropin, released in the brain, increases oestrogen, so by blocking this; oestrogen levels and activity fall.

To definitely diagnose the disease, keyhole surgery or a laparoscopy is required. This will allow the gynaecologist to directly see any endometrial tissue, take samples, and remove it if possible. If the amount of tissue affecting the reproductive organs is small, stripping it may improve chances of pregnancy in those struggling to conceive. Removal of the womb and ovaries is the last resort, mostly reserved for those who have had completed their family.

Both the RCOG and Endometriosis are keen for women not to suffer in silence and to come forward for help.