What's Up Docs? How can we better understand endometriosis?
Feb 24, 2026
Chi Eziefula, Associate Professor in Global Health and Infection and Honorary Consultant physician who researches endometriosis and menstrual health. She discusses why diagnosis is often delayed, biological theories about how endometrial-like cells travel and behave, the wide range of symptoms beyond pelvic pain, diagnostic challenges and limitations, and treatment and advocacy pathways to improve care.
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Diagnosis Delay Reveals Systemic Failure
- Endometriosis diagnosis takes around eight years on average in the UK, reflecting systemic failures in recognition and care.
- Chi Eziefula attributes delays to normalized period pain and poor menstrual education that stop people seeking help early.
What Endometriosis Is Biologically
- Endometriosis is when cells like the uterine lining grow outside the womb, causing hormone-driven inflammation and scarring.
- Chi explains these are stem-like cells sensitive to cycle hormones, growing then degrading each month to produce inflammation and pain.
Multiple Theories For Cell Spread
- How cells reach pelvic and distant sites is uncertain; retrograde menstruation is plausible but incomplete as an explanation.
- Chi notes endometriosis appears in lungs, brain and elsewhere, suggesting multiple mechanisms beyond backward menstrual flow.