Endometriosis

21 November 2025

Endometriosis is a long-term condition where tissue similar to the lining of the womb grows outside the uterus – on the ovaries, fallopian tubes, bladder, bowel, or deeper in the pelvis. This tissue responds to hormones each month and can cause inflammation, scarring and significant pain.

For many women and people assigned female at birth, endometriosis is a major cause of chronic pelvic pain, heavy or painful periods, pain during sex and difficulty getting pregnant. It can also affect energy levels, mood and day-to-day life.

At The New Foscote Hospital in Banbury, Oxfordshire, our gynaecology and radiology teams work closely together to:

Listen carefully to your symptoms and concerns
Arrange appropriate investigations, including pelvic ultrasound and MRI where needed
Plan a treatment approach that targets pain, preserves fertility where possible, and supports your quality of life

Modern guidance recognises that specialist pelvic MRI can be particularly useful for deep endometriosis – for example when the bowel, bladder, ureters or pelvic nerves may be involved – helping to map disease before surgery and guide treatment decisions.

What Is Endometriosis?

In endometriosis, cells similar to the womb lining are found outside the uterus. Each month they can thicken and bleed, but the blood has no normal way to leave the body, leading to:

Inflammation
Swelling and irritation of nearby tissues
Scar tissue and adhesions (organs sticking together)
Cysts, especially on the ovaries (endometriomas)

Endometriosis can be:

Superficial – closer to the surface of pelvic organs
Deep infiltrating – growing more deeply into structures such as the bowel, bladder, ligaments and pelvic nerves (often where MRI adds most value

Symptoms You Might Notice

Symptoms vary from person to person. Some have severe disease with relatively mild symptoms, while others have extensive pain despite only limited visible disease. Common features include:

Pelvic pain that may be constant or cyclical
Painful periods (dysmenorrhoea) – cramping, dragging pelvic or back pain that can begin before bleeding and continue through the period
Heavy or prolonged periods
Pain during or after sex (dyspareunia)
Pain when opening bowels or passing wind, especially around your period
Bloating, bowel changes or symptoms similar to irritable bowel syndrome
Pain when passing urine, blood in urine or needing to pass urine more often, particularly on or around your period
Difficulty getting pregnant or subfertility
Fatigue, low mood and “flare ups” that interfere with daily activities

Symptoms can overlap with other conditions (e.g. fibroids, adenomyosis, pelvic floor dysfunction, bladder syndrome), so a careful assessment is important.

Chronic Pelvic Pain – Not Always Endometriosis

Chronic pelvic pain means pain in the lower abdomen or pelvis lasting six months or more. Endometriosis is a common cause, but not the only one. Other contributors may include:

Adenomyosis
Fibroids or ovarian cysts
Pelvic floor muscle tension
Bladder or bowel conditions
Nerve-related (neuropathic) pain
Previous surgery or adhesions
Psychological factors linked to long-term pain

At The New Foscote Hospital we look at the whole picture – physical findings, imaging, menstrual pattern, sexual health, bowel and bladder symptoms, emotional wellbeing and any impact on work, study or family life.

How Pelvic MRI Helps

Pelvic MRI uses magnetic fields and radio waves (not X-rays) to produce detailed images of the pelvic organs, soft tissues and nerves. For endometriosis and chronic pelvic pain, MRI can help to:

Identify or map deep endometriosis, particularly when it involves:
- Bowel or rectum
- Bladder or ureters
- Uterosacral ligaments and pelvic side wall
- Pelvic nerves (where advanced MRI neurography may be useful)Queen Square Imaging Centre+3PMC+3SpringerOpen+3
Assess the extent and compartments involved – vital for planning laparoscopic surgery
Detect associated conditions such as adenomyosis or ovarian endometriomas
Provide a “roadmap” for surgeons when laparoscopy might be limited by adhesions

NICE guidance now recommends that, in suspected deep endometriosis, a specialist transvaginal ultrasound or pelvic MRI should be considered to diagnose and assess the extent of disease, and that these scans are planned and interpreted by clinicians with expertise in gynaecological imaging.

At The New Foscote Hospital, pelvic MRI scans are performed on our on-site scanner, with images interpreted by experienced radiologists as part of an integrated radiology service.

Diagnosis At The New Foscote Hospital

1. Specialist Gynaecology Consultation

You will see one of our consultant gynaecologists, who regularly treat endometriosis and complex pelvic pain.

Your appointment may include:

A detailed history of your symptoms and menstrual pattern
Discussion of your fertility plans and any impact on work, study or relationships
Pelvic examination where appropriate

2. Initial Investigations

Depending on your symptoms, your consultant may arrange:

Blood tests (e.g. for anaemia, inflammation, hormones where relevant)
Urine tests, swabs or STI screening
Pelvic ultrasound, often transvaginal, to assess uterus, ovaries and other structures

3. Pelvic MRI Scan

If your symptoms suggest deep endometriosis or if further mapping is needed before surgery, your gynaecologist may recommend a pelvic MRI scan.

At The New Foscote Hospital:

MRI scans are carried out on-site in a calm, modern environment
Our radiology team is experienced in pelvic imaging
Images and reports are sent directly to your consultant for review

4. Laparoscopy And Further Care

While imaging can strongly suggest and map endometriosis, in many cases laparoscopy (keyhole surgery) remains the gold standard for confirming the diagnosis and, where appropriate, treating visible disease.

If you need laparoscopic surgery, your gynaecologist will discuss suitable options and coordinate care, including onward referral to an appropriate surgical centre where necessary. The New Foscote Hospital can also support pre-operative assessment, imaging, and post-operative follow-up close to home.

Treatment & Management Options

Your treatment will be personalised, depending on your symptoms, the extent of disease, fertility wishes and previous treatments. Options may include:

Medicines

Pain relief, including anti-inflammatory medications where appropriate
Hormonal options such as:
- Combined hormonal contraception (pill, patch, ring)
- Progestogen-only methods (tablets, injection, implant, intrauterine system)
- Other hormonal treatments recommended by your specialist

These aim to reduce bleeding and the hormonal stimulation of endometriosis, thereby improving pain.

Surgery

Laparoscopic excision or ablation of endometriosis
Removal of ovarian cysts (endometriomas)
Treatment of deep disease involving bowel, bladder or other structures, typically at specialist centres

Pre-operative pelvic MRI can be very helpful in planning more complex surgery and ensuring the right surgical expertise is involved.

Wider Support

A holistic plan may also involve:

Pelvic floor physiotherapy
Bladder and bowel symptom management
Nutritional advice and lifestyle support
Psychological support or pain management strategies for long-term symptoms

Your consultant will work with you to decide which combination of treatments is most appropriate and realistic for your situation.

When To Seek Specialist Help

You should consider seeing a specialist at The New Foscote Hospital if:

You have severe or persistent period pain that stops you doing normal activities
You experience chronic pelvic pain lasting more than six months
Sex is consistently painful
You have bowel symptoms or bladder discomfort linked to your menstrual cycle
You are struggling to conceive and suspect endometriosis may be a factor
You have been told you may have endometriosis and want a second opinion, imaging or a clearer plan

Seek urgent medical help (A&E/999) if you:

Develop sudden, severe abdominal or pelvic pain
Feel faint, dizzy or very unwell
Have positive pregnancy tests with pain or bleeding, where ectopic pregnancy may be a concern

Why Choose The New Foscote Hospital For Endometriosis & Chronic Pelvic Pain

On-site MRI, ultrasound and X-ray – rapid access to the imaging you need, in a single hospital location in Banbury.
Experienced gynaecologists – consultants who regularly manage endometriosis, heavy periods and complex pelvic pain.
Joined-up care – gynaecology and radiology teams working together to plan investigations and treatment.
Individual, unhurried appointments – time to explore your symptoms, worries and priorities in depth.
Convenient private setting in Oxfordshire – serving patients from Banbury, Oxford, Warwickshire, Northamptonshire and beyond

Next steps:

Make an enquiry – book a consultation with a gynaecologist
Tests & Scans – MRI – arrange a pelvic MRI scan if advised by your consultant

Make An Enquiry

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