Gynaecologist Perth | Specialised in endometriosis


Endometriosis can have symptoms such as heavy and painful periods and infertility. My experience working with women’s health enables me to diagnose this condition and to find treatment that suits you best.

What is endometriosis?

Endometriosis is a condition where there is tissue that is like the tissue that lines the uterus that occurs outside the uterus. Like the tissue lining the uterus, it responds to hormonal stimulus and therefore grows like the lining of the uterus through the menstrual cycle and is shed like the lining of the uterus when the period occurs.

Endometriosis is a disorder that involves your ovaries, fallopian tubes, and the endometrium (the tissue lining the uterus). If you often experience painful periods, excessive bleeding or pain during intercourse, I recommended booking an appointment at our Perth gynaecology clinic.

With endometriosis, the tissue that lines the uterus grows outside of the uterus. There is no cure for the condition, but modern gynaecology allows us to manage and reduce the symptoms for many of our Perth patients.

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Potential complications

One of the potential complications you may experience if you are diagnosed with endometriosis is an increased risk of infertility. This is where my three decades of experience as a gynaecologist can help work out the most suitable treatment plan for you.

Endometriosis Perth WA |Dr Chris Nichols

Endometriosis symptoms

So, what are the signs of endometriosis?

Painful periods

When the period occurs, the endometriosis also sheds but is trapped locally and stretches the lining of the pelvis, triggering pain.

Pain during intercourse

The deposits of the endometriosis can be sensitive and interfourse will bump and stretch those deposits, causing pain.

Pain with bowel movements or pain with urination

In the same way, bowel and bladder activity can upset endometriotic deposits causing pain.


There is an association between endometriosis and fertility delay. It is not a very strong association: Women with endometriosis can conceive, the reduction in conception rate is small. Treating endometriosis surgically improves spontaneous fertility a little.

Endometriosis Causes | Dr Chris Nichols Gynaecologist Perth

Endometriosis causes

The cause of endometriosis is unknown.

Backward menstruation, or retrograde menstruation

Retrograde menstruation is essentially normal. When you bleed through the cervix and vagina, it is very common for some menstrual blood to flow up the tubes into the pelvis. The area where the blood is deposited, at the base of the pelvis, just behind the cervix, is the most common area to see endometriosis. Not every woman has endometriosis so this is not enough to explain the condition.

Some research mentions inheritance as a factor

If your mother or sister had or have the condition, then you are more likely to as well.

Your immune system

If your immune system fails to stop the growth of endometrial tissue outside the uterus, you may be more likely to develop symptoms.

Endometriosis diagnosis

So, how is endometriosis diagnosed?

Your GP may have referred you to us to get clarity if you are showing signs of endometriosis. This is because endometriosis does not usually show up in an internal pelvic examination. As a gynaecologist, I will examine your medical history as this may suggest a possible diagnosis.

Special investigations are required to make a formal diagnosis.


It is difficult to make a diagnosis on ultrasound, with the significant exception of endometriosis affecting the ovary, or an endometrioma.

Blood tests

Blood test have very little value in the diagnosis.


A surgical procedure under general anaesthetic using a camera to examine your pelvic organs remains the primary method of making a diagnosis. This is a moderately invasive procedure and we need to think carefully about performing this operation.


The same principle is used to examine the bowel if we suspect that endometriosis may be affecting the area, a less common presentation of endometriosis.

Endometriosis treatment

Endometriosis treatment does not cure the condition. However, medication or surgery can help to reduce the impact of the symptoms you experience.

Treatment will be medical or surgical.

The cells of the tissue that grow outside the uterus behave like endometrial cells and they respond to hormones. The oral contraceptive can be an effective treatment for many women. There are more powerful medications often with a more adverse side effect profile that may be required.

Surgical management is the mainstay of treatment. Burning or removal of endometriotic deposits is conservative treatment as well as the removal of ovarian endometrioma. Removal of the uterus, tube and ovaries is more definitive treatment and is clearly contraceptive and only appropriate when fertility is no longer an issue. Menopause is mother nature’s treatment, as the low oestrogen state after menopause will suppress endometriosis.

Endometriosis & fertility

Endometriosis can be associated with a fertility problem. If conceiving is difficult, a condition like endometriosis may be contributing.

Treating endometriosis will improve spontaneous pregnancy rates.

Endometriosis & pregnancy

Pregnancy will usually have a positive impact on endometriosis and breastfeeding will have an even better effect on suppressing endometriosis.

How I can help you

These pages contain general information. Its specific application to your situation may vary. I would be very happy to discuss your specific situation with you. I work in fertility, obstetrics and gynaecology. Problems in women’s health don’t always fit neatly in to one of these three areas but intersect and overlap. Applying my decades of experience to your particular position is the aspect of my job that I enjoy the most, working to find the best options for your specific circumstances.
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Dr Chris Nichols Obstetrician - Gynaecologist - Fertility Specialist Perth

Dr Chris Nichols

I deliver babies at SJOG Murdoch Hospital and have gynaecology theatre lists at both Murdoch and South Perth Hospital. With the help of Fertility Specialists of WA, I established the first fertility clinic south of the river, Fertility Specialists South, located in Applecross.
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Ruth McCloskey Practice Nurse

Ruth McCloskey

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As a practice nurse I have worked at several hospitals and clinics around Perth including SJOG Murdoch Hospital. I enjoy assisting Dr Nichols with minor procedures in the rooms.