What happens at our clinic?

On arrival you will be asked to complete a symptom questionnaire.

You will then see a member of the team to discuss these symptoms. You may be asked specific questions about your periods and sex life. The consultation will cover previous investigations and treatments you may have tried, and the effect of your symptoms on your day-to-day life.

Your gynaecologist may ask to examine your abdomen and pelvic area (this involves an internal examination), with the support of a nurse chaperone. There is always privacy to undress and dress. An ultrasound may be recommended; this is often completed transvaginally, via a thin probe inserted into the vagina.

The effect of endometriosis varies hugely between women. Individualised recommendations will then be discussed with you including the risks and benefits of each approach. You will have the opportunity to ask questions.

Below are examples of possible plans of care. One or more may take place in sequence or in parallel.

Further investigations may be suggested. This could include blood tests, vaginal swabs to look for infection, biopsies from the womb lining or an MRI (Magnetic Resonance Imaging) scan. More specialist tests may be necessary involving the bladder (e.g. cystoscopy) and/or bowel (e.g. sigmoidoscopy), meaning additional appointments having to be arranged.

Medical treatments for endometriosis may be offered. This can involve taking extra hormones or treatments that result in lower hormone levels.

Surgical investigation and treatment may be offered.

Mild to moderate endometriosis can sometimes be treated if discovered at the time of surgery.

Surgery for moderate and severe endometriosis may require a longer operation time, additional surgical support and different pre operative planning, in which case the endometriosis is often treated at a second procedure. This usually involves an overnight stay on our Cotswold ward.

When factors make endometriosis surgery complex or high risk, we discuss cases at our Endometriosis MDM. This is a full review of your history, examination findings and the results of any investigations (or previous surgery) with the whole team. We use this to ensure we are recommending the best plan of care and to discuss surgery if proposed.

This meeting also helps us review and guide improvements to our service.

Some women find it helpful to bring a family member, friend or partner along with them for support. You may find it useful to write down your symptoms or any questions you may have beforehand and take your notes along to the appointment with you.