The Cotswold Endometriosis and Pelvic Pain Clinic

The specialist clinic provides high-quality, evidence-based care to diagnose and treat endometriosis-related pain and infertility as well as chronic pelvic pain. This specialist multi-disciplinary clinic is run weekly by two NHS consultant gynaecologists with more than 20 years experience of managing all stages of endometriosis both medically and surgically. Because of the complex nature of endometriosis and pelvic pain our team also includes Consultant bowel surgeons, a Consultant urologist, pain specialists, women’s health physiotherapists, dietician and an acupuncturist. Onward referral for alternative therapies can also be made.

The clinic runs weekly at the Nuffield Hospital, Cheltenham. At the initial appointment a complete history is taken including any previous medical or surgical treatments. It is often useful to have a ‘pain diary’ completed beforehand. An examination and pelvic ultrasound may then be undertaken.

Diagnosis – At present the diagnosis of endometriosis can only be made by a ‘diagnostic laparoscopy’. This will be offered to you unless a recent laparoscopy has been undertaken by an experienced consultant gynaecologist.

Treatment – The numerous treatment options will be discussed which include analgesia, hormonal treatments (Including Progesterones i.e Mirena coil™, Combined contraceptive pills, GnRh analogues) and surgery. Almost all surgery undertaken by the team is completed laparoscopically with endometriosis usually being excised rather than only diathermied (heated) as this technique is more likely to remove deep endometriosis completely.

The Gloucestershire Menstrual Disorders Clinic

A woman’s menstrual cycle is unique to her and usually it causes no problems. More than 1/3 of women however experience irregular, heavy or painful periods at some stage. These problems often have negative effects on their work, social or sex lives and often women feel they have to ‘just put up with it’! The aim of this clinic is to sensitively and effectively investigate and treat these problems.

The Menstrual Disorders Clinic at the Nuffield Hospital is run by the most experienced consultant gynaecologists in the region with a particular interest and expertise in managing problematic periods. The consultants are able to manage all aspects of investigating and treating period problems from simple reassurance to medical or surgical treatments.

This dedicated clinic allows women with such problems to be seen by the most appropriate Consultant Gynaecologist and have the appropriate investigations and often treatment started at one clinic appointment. Any additional treatments/investigations that are opted for can also be discussed, booked or undertaken at the same appointment. The consultant will take a medical history from you and then depending on this will usually suggest one or more ways of investigating the problem (See below). The results of which will then be discussed with you and treatment options offered.

Possible investigations suggested either at the time or later include cervical smears, swabs, Hysteroscopy, and Endometrial biopsy. Please see our treatments page for more information.

After you have had one or more of the investigations the consultant will discuss with you the findings and all of your suitable options. These may include commencing medical treatment i.e. non-hormonal and hormonal medications including hormone-containing coil (Mirena™ coil); considering various surgical options i.e. endometrial ablation, laparoscopy (‘Key-hole’ surgery) to investigate the cause of pelvic pain or laparoscopic sub-total or total hysterectomy. Your consultant will discuss these issues with you in detail.