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If you have spent years being told that painful periods are normal, that it will get better, or that you are too young for anything to be wrong. You are not alone.
Endometriosis is one of the most under-diagnosed conditions in women’s health. The gap between when symptoms begin and when a woman finally receives a clear answer can stretch to a decade or more.
That is not acceptable. And it is not something you should have to live with.
At Menovivre, we do not dismiss pain. We do not tell you it is normal when it is not. We listen carefully, investigate thoroughly, and build a care plan around you, not around a standard protocol.
Whether you are a teenager whose periods are unbearable, a woman in your thirties struggling to conceive, or someone in perimenopause whose symptoms have become more confusing. There is a clear path forward, and you do not have to find it alone.
The first clinician involved in your care is Dr Uloma Nkeiruka Okwuosa, our UK-trained Consultant Obstetrician and Gynaecologist with more than 20 years of clinical experience.
When you come to Menovivre, Dr Uloma will:
Because endometriosis rarely affects only the pelvis, our functional medicine physician may also become part of your care team. Their role is to address the wider picture: the inflammation, the gut symptoms, the metabolic patterns, the fatigue, and the lifestyle factors that so often overlap with endometriosis.
This broader support may cover:
When appropriate, hormonal treatment can meaningfully reduce cyclical pain by decreasing the stimulation of endometriosis tissue. Options may include:
• Combined hormonal contraception
• Progestogen-based therapy
• Hormonal suppression strategies
• Menstrual cycle regulation
• Perimenopause-specific hormone planning where relevant
One important note: if you are trying to conceive, hormonal suppression is not the right fertility strategy, as it prevents ovulation. NICE specifically advises against hormonal treatment for endometriosis-related infertility when pregnancy is the goal. Your fertility pathway will be planned differently.
This may include:
• Anti-inflammatory pain management strategies
• Pelvic floor physiotherapy referral, particularly when pelvic
muscle guarding or painful intercourse is present
• Gut support for bloating, constipation, diarrhoea, or food
sensitivity patterns
• Nutritional support for inflammation, iron levels, and
metabolic health
• Sleep and stress regulation
• Movement guidance, especially during flare periods
Your care will be shaped around conception from the start. This may include:
• Ovulation and cycle assessment
• Ovarian reserve evaluation where appropriate
• Pelvic anatomy assessment
• Referral to a fertility specialist when needed
• Surgical discussion if endometriomas or adhesions may be
affecting your chances
Read more about our fertility and pre-conception pathway.
Surgery may be the right path when:
• Pain remains severe despite appropriate medical treatment
• Ovarian endometriomas are present on imaging
• Deep infiltrating endometriosis is suspected
• Bowel or bladder involvement needs further evaluation
• Fertility is significantly affected
• There is genuine uncertainty around diagnosis or anatomy
Our role is to assess carefully, treat where appropriate, and refer to the right surgical specialist when surgery is the correct path for you.
The first thing you should expect is a proper conversation.
Not a rushed appointment. Not a dismissive response. Not being handed a prescription without explanation.
A real, unhurried discussion with a clinician who takes what you are experiencing seriously. Possibly for the first time.
Our functional medicine specialist, leads the hormonal and metabolic assessment, identifies root causes, and builds your personalised treatment strategy including lifestyle medicine, advanced testing, supplementation, and hormonal support.
Our Gynaecology specialist assesses menstrual irregularity, ovulation, fertility concerns, ultrasound findings, and gynaecological differentials that may overlap with PCOS.
Designs sustainable nutrition strategies for insulin resistance, inflammation, weight regulation, and cycle support. For many women, nutrition is the foundation of the entire treatment plan.
A: No. International guidelines from ESHRE and NICE now confirm that diagnosis can be made based on symptoms, examination, and imaging. Laparoscopy may still be needed in certain cases, but it is no longer the mandatory first step for every woman.
A: Yes, in many cases. Hormonal therapies, anti-inflammatory strategies, pelvic floor physiotherapy, gut support, nutritional medicine, and lifestyle management can produce significant, lasting improvement. Surgery is considered when pain persists despite medical treatment, when endometriomas are present, or when fertility is significantly affected.
A: Yes. A normal ultrasound does not exclude endometriosis, particularly for superficial disease. Your symptoms are clinically significant, and a thorough assessment is still warranted. You should not be sent away without answers just because one scan was clear.
A: Seek specialist assessment early rather than waiting. Endometriosis can affect fertility in several ways, and earlier assessment creates more time to act. Hormonal suppression is not the right approach when trying to conceive. At Menovivre, we build a fertility-focused plan from your very first visit.
A: Yes. Endometriosis can begin as early as the teenage years. If a young woman’s period pain is interfering with school, sport, or daily life and is not responding to standard pain relief, she deserves a proper assessment. She should not be told to come back later.
A: Endometriosis does not simply improve at menopause for everyone. During perimenopause, symptoms can become more complex and confusing. A combined gynaecological and hormonal assessment is important so that nothing is missed or misattributed.
A: Endometriosis involves tissue similar to the uterine lining growing outside the uterus. Adenomyosis involves that tissue growing into the uterine muscle wall itself. The two conditions frequently coexist and share many symptoms. Both can be assessed and managed at Menovivre.
A: Endometriosis affects approximately one in ten women of reproductive age globally. In the Middle East, symptoms are frequently normalised or misattributed to other causes, which contributes to significant diagnostic delay. At Menovivre, we take endometriosis seriously at every stage of life.
