Endometriosis Assessment in London

Endometriosis is a chronic condition that affects approximately 1 in 10 women of reproductive age in the UK — yet average diagnosis takes seven to eight years from the onset of symptoms. A specialist private assessment can significantly shorten this diagnostic journey and open the door to effective management. At AristoGP, our consultant gynaecologist provides specialist endometriosis assessment with same-day specialist pelvic ultrasound at our Central London EC1 clinic.

What Is Endometriosis?

Endometriosis is a condition in which tissue similar to the lining of the uterus (the endometrium) grows in other locations outside the uterus. This tissue may be found on the ovaries, fallopian tubes, the lining of the pelvis (peritoneum), the bowel, the bladder, and, in rare cases, further afield. Like the normal uterine lining, this ectopic tissue responds to the hormonal cycle — thickening and breaking down with each menstrual cycle. Because it cannot leave the body in the same way as a normal period, it causes inflammation, scarring (adhesions), and the formation of cyst-like structures known as endometriomas on the ovaries.

Endometriosis is not contagious and is not caused by poor health or lifestyle choices. It has a significant genetic component — women with a close family member with endometriosis are at higher risk. It is a chronic condition, but with appropriate management, most women can achieve meaningful improvement in their symptoms and quality of life.

Symptoms of Endometriosis

The symptoms of endometriosis can vary widely in type and severity. They do not necessarily reflect the extent of the disease — some women with extensive endometriosis have mild symptoms, while others with limited disease experience significant pain. Common symptoms include:

• Painful periods (dysmenorrhoea) — Pain that may be severe and begin before the period starts, often described as significantly worse than ‘normal’ period pain.
• Chronic pelvic pain — Pain that is present throughout the month and not limited to menstruation.
• Pain during or after intercourse (dyspareunia) — Particularly with deep penetration, which may indicate endometriosis in the pouch of Douglas or uterosacral ligaments.
• Heavy or irregular periods — Including spotting between periods.
• Fatigue — Persistent and often debilitating tiredness that goes beyond what can be accounted for by disturbed sleep alone.
• Difficulty conceiving — Endometriosis is found in approximately 30–50% of women investigated for infertility.
• Pain with bowel movements or urination — Particularly around the time of menstruation, which may suggest endometriosis involving the bowel or bladder.
• Bloating — Sometimes referred to as ‘endo belly’, significant abdominal bloating particularly around the time of menstruation.

If your symptoms are affecting your quality of life, a proper assessment can help clarify what is causing your symptoms — not reassurance that painful periods are ‘normal’. They are common, but they are not normal, and they are not something you should have to endure.

The Diagnostic Challenge

One of the most frustrating aspects of endometriosis is the significant delay between the onset of symptoms and formal diagnosis. Studies consistently show that the average time from symptom onset to diagnosis in the UK is seven to eight years. This delay occurs for several reasons: symptoms can sometimes be attributed to normal menstrual variation; endometriosis cannot be diagnosed from a blood test or simple scan alone; and definitive diagnosis traditionally requires a surgical procedure (laparoscopy).

A specialist private assessment cannot replace a laparoscopy if surgical diagnosis is ultimately required, but it can substantially advance the process. An experienced consultant gynaecologist can correlate your symptoms with the findings from a specialist ultrasound examination to build a much clearer clinical picture — and can guide you towards the most appropriate next steps, whether that is hormonal management, further imaging, or laparoscopic diagnosis and treatment.

Endometriosis Assessment at AristoGP

Dr Anastasia Mermigka (GMC 7640566), Consultant Gynaecologist at AristoGP, provides a thorough specialist assessment for women with suspected or confirmed endometriosis. Your appointment will include:

• Detailed symptom assessment — A careful, unhurried consultation exploring the nature, timing, and impact of your symptoms, including their effect on work, relationships, and daily life
• Full gynaecological and medical history — Including any previous investigations, treatments, and family history of endometriosis or related conditions
• Pelvic examination on our dedicated gynaecology examination plinth — examining for tenderness, nodularity, or other clinical signs of endometriosis
• Same-day specialist transvaginal pelvic ultrasound — Using high-resolution equipment capable of identifying endometriomas (ovarian cysts associated with endometriosis), deep infiltrating endometriosis at key anatomical sites, adenomyosis (a related condition affecting the uterine muscle), and other relevant findings
• Immediate discussion of findings — Dr Mermigka discusses the ultrasound results with you in real time, explaining what has been seen and what it means for your management

It is important to be transparent about the limitations of ultrasound: a normal pelvic ultrasound scan does not exclude endometriosis. Many deposits — particularly superficial peritoneal endometriosis — are not visible on ultrasound. Clinical assessment by an experienced specialist, combined with imaging, provides the most accurate pre-surgical picture, but laparoscopy remains the gold standard for definitive diagnosis. Our assessment will help determine whether and how urgently laparoscopic investigation is warranted.

Women with suspected gynaecological conditions including endometriosis often benefit from a comprehensive assessment that looks at the whole picture. Our Well Woman Check provides exactly that.

Management Options for Endometriosis

Pain Management

Non-steroidal anti-inflammatory drugs (NSAIDs) such as ibuprofen or naproxen are often the first-line approach for managing endometriosis-related pain. They are most effective when started before the onset of menstrual pain and taken regularly throughout the period. For many women, this alone provides significant relief.

Hormonal Treatments

Since endometriosis is driven by oestrogen, hormonal treatments that reduce oestrogen levels or suppress menstruation can significantly improve symptoms. These include the combined oral contraceptive pill, progestogen-only treatments (such as the Mirena coil or Depo-Provera injection), and GnRH agonists. The most appropriate hormonal treatment depends on your individual circumstances, including whether you wish to conceive.

Surgical Treatment

Laparoscopy allows direct visualisation of the pelvis and simultaneous treatment of endometriosis deposits, adhesions, and endometriomas. It is both a diagnostic and therapeutic procedure. For women who have not responded to medical management, or whose endometriosis is significantly affecting fertility, surgical referral will be arranged to a specialist endometriosis surgeon. AristoGP works with a network of highly regarded surgical colleagues across London.

Lifestyle and Integrative Approaches

While no diet or lifestyle change can cure endometriosis, some women find that an anti-inflammatory diet, regular exercise, and stress management techniques contribute to improved symptom control alongside medical treatment. These approaches are best discussed in the context of your overall management plan.

Why Consultant-Led Assessment Matters for Endometriosis

Endometriosis is a condition where clinical expertise makes a meaningful difference. The pattern and character of pain, the findings on examination, and the nuances of ultrasound imaging all require specialist interpretation. A consultant gynaecologist who performs both the clinical assessment and the ultrasound — as is the model at AristoGP — is able to correlate these findings in real time in a way that a separated pathway (GP referral → separate radiology scan → separate follow-up) cannot.

At AristoGP, you are seen by a qualified consultant from the moment you walk in. Our female gynaecologist provides a confidential and compassionate environment in which you can discuss your symptoms fully. For women who feel their symptoms have not yet been fully explored, this specialist consultation can be genuinely transformative. You can also read about our full gynaecology services to understand the breadth of care available.

Endometriosis Assessment: Pricing

The Consultation + Pelvic Ultrasound package (£250) is the most appropriate starting point for endometriosis assessment. Please visit our contact page for any pricing queries.

Frequently Asked Questions — Endometriosis

This page has been reviewed and approved by Dr Anastasia Mermigka, Consultant Gynaecologist, GMC 7640566. Dr Mermigka holds subspecialty training in reproductive medicine and provides consultant-led gynaecology services at AristoGP, Central London EC1.