Endometriosis Signs and Symptoms Everyday Health MenuNewslettersSearch Endometriosis Signs and Symptoms of Endometriosis Pelvic pain is the most common symptom of endometriosis, but some women experience no symptoms at all. By Beth LevineMedically Reviewed by Kara Leigh Smythe, MDReviewed: August 22, 2022Medically ReviewedIntense pain in the pelvis or lower abdomen may be a sign of endometriosis.Peter Dazeley/Getty Images; Everyday Health Endometriosis is a chronic condition in which tissue similar to the endometrium or inside lining of the uterus (womb) grows outside of the uterus on organs such as ovaries, fallopian tubes, bowel, outside uterine walls, kidneys, bladder, or even lungs. The endometrial lesions are thought to be caused by overproduction of prostaglandins and estrogen, which leads to chronic inflammation, according to the American College of Obstetricians and Gynecologists (ACOG). (1) The most common symptom of endometriosis is pelvic pain, but some women experience no symptoms at all.Sponsored Advertising Content Your Pelvic Pain Is Not Normal Tips for Endometriosis Although endometriosis can occur in any woman after her first menstrual period (it has been found in those as young as 11), the condition is most common in women in their reproductive years, ages 25 to 35, according to the Endometriosis Foundation of America. (2) What Are the Signs and Symptoms of Endometriosis br class lsbr It’s important to know that with endometriosis, symptoms are chronic — this is a key aspect of getting a diagnosis. You might experience:Painful menstrual periods with pain that may range from mild to debilitating and may get worse over time (1). Although pain may feel worse during menstruation, pain can occur at any point during your monthly cycle, according to Johns Hopkins Medicine (3)Heavy menstrual periodsSpotting or bleeding between menstrual periodsPain during or after sexPain in the pelvis or lower abdomen (ACOG estimates that endometriosis is present in 87 percent of women suffering from chronic pelvic pain) (1)Infertility (experienced by approximately 30 to 50 percent of women with endometriosis, per the American Society for Reproductive Medicine) (4)Painful bowel movements or urination, especially during menstrual periodsFatigue, diarrhea, constipation, nausea, or bloating, especially during menstruationNeuropathy because of swelling and scar tissue Tip It Forward for Endometriosis Join the hundreds of women — plus doctors, nurses, physical therapists, and others — who have shared their best tips for living with endometriosis. Read them all on Tippi.Tippi What Does Endometriosis Pain Feel Like Pain associated with endometriosis can vary widely from patient to patient. Some women experience no symptoms; some experience severe pelvic pain or pressure. The first sign or symptom for others is having difficulty getting pregnant. Tamer Seckin, MD, founder of the Endometriosis Foundation of America (EndoFound) and the author of The Doctor Will See You Now: Recognizing and Treating Endometriosis, indicates the following symptoms:You may experience cramping and intense pain with menstruation; think throbbing contractions or sudden, sharp, stabbing pains that may leave you breathless. Shireen Hand, a blogger for Endometriosis News, described it as an “electric shock.” It may start before menstruation and not let up for several days. Some women refer to them as “killer cramps.”You may feel a dull, throbbing pain around the time of ovulation.GI distress in common, including bloating, gas, and cramps, sometimes accompanied by diarrhea and constipation. Symptoms are worse around menstruation.Pain during sexual activity can feel like sandpaper, along with sharp pains that radiate toward the abdomen, notes Hand.You may have painful bowel movements or urination due to irritated tissue.Neuropathy may cause sciatica (a sharp, burning, radiating pain down your leg, inner thigh, or back) that can make walking or even crossing your legs uncomfortable. Don t Wait to Talk With Your Doctor It takes on average 3 to 11 years from onset of symptoms for women to receive a correct diagnosis, according to past research, so don’t wait around if you are having issues. (5) Although endometriosis is incurable at this point, there are treatments that can help manage pain and other symptoms. For some women, endometriosis symptoms go away on their own once they’ve reached menopause. Experiences With Endometriosis Every person with endo has their own story. Here are three of them — and these women didn’t hold back.Video Why Does Endometriosis Cause Pain The severity of the disease is not related to the degree of pain. You can have a very early case and feel pain much worse than another woman whose disease is much more advanced. The level of pain depends on:Location If the lesions are in an area rich in nerve endings, the pain will be more intense, noted an article published in Human Reproduction Update. (6)Swelling Lesions swell and bleed much like your uterine lining does during your menstrual cycle. This causes pain because it is expanding and bleeding in an area that has limited room and has no way to expel the blood, notes the Office on Women’s Health. (7)Scarring Scarring of surrounding tissue by the lesions can also increase pain levels by causing organs to stick together, per ACOG. (8) Pain During and After Sex Endo Can Cause Painful Sex Endometriosis can cause pain, and sometimes very severe discomfort, during or after sexual penetration or orgasm. It can be difficult to seek treatment for this sensitive problem. Painful sex, coupled with the anticipatory fear of that pain, can be a big turnoff. Unfortunately, many women are too embarrassed to talk with their physician about the pain associated with sexual intercourse, or they think there is nothing that can be done and try to ignore it or live with it. Some women are told that their pain is psychological or somehow less than real. The truth is that women with endometriosis don’t have to live with pain that interferes with intimacy or sexual relationships. Treatments are available, and sex doesn’t have to hurt. Related: Endometriosis and Severe Sex Pain: How to Cope What Is Bowel Endometriosis Since many people think of endometriosis as only a gynecological issue, bowel endometriosis can be tricky to detect. Bowel endometriosis, sometimes misdiagnosed as irritable bowel syndrome (IBS), occurs when lesions grow on the peritoneum (the membrane lining the inside of the abdomen and covering the abdominal organs), the rectum, the intestines, and other deeper bowel levels. Related: Unrecognized Endometriosis: Despite 40 Years of Severe Pain Misdiagnosed as IBS, This Woman Didn’t Give Up Less Common Symptoms of Endometriosis There is also something known as silent endometriosis, when you don’t feel any pain. Research published in the Journal of Assisted Reproduction and Genetics suggested that 20 to 25 percent of endometriosis patients are asymptomatic. (9) The only way some women discover they have the disease is when they seek help for unexplained infertility. The lack of pain, however, does not mean that the condition is in its early stages; it is possible to have no obvious symptoms and still have advanced disease. Related: The Question of Which to Treat First: Endometriosis or Fertility Problems? Conditions Commonly Confused with Endometriosis The symptoms of endometriosis can easily be confused with other conditions, so it is important to see your gynecologist to obtain a correct diagnosis. According to Penn State Hershey Medical Center, the pelvic pain you feel could also be related to: (10)Adenomyosis, in which endometrial tissue infiltrates the wall of the uterus instead of getting outside the uterusAppendicitisCeliac diseaseDiverticulitisEctopic pregnancyHistory of sexual abuse or traumaInflammatory bowel diseaseInterstitial cystitisIntrauterine device (IUD)Irritable bowel syndromeMiscarriagePelvic cancerPelvic inflammatory diseaseSevere kidney or urinary tract infectionsUterine fibroids (benign tumors in the uterus wall)Uterine polyps NEWSLETTERS Sign up for our Women' s Health Newsletter SubscribeBy subscribing you agree to the Terms of Use and Privacy Policy. Editorial Sources and Fact-Checking ACOG Updates Guideline on Diagnosis and Treatment of Endometriosis. American Family Physician. January 1, 2011.What Is Endometriosis? Endometriosis Foundation of America.Period Pain: Could It Be Endometriosis? Johns Hopkins Medicine.Endometriosis: Does It Cause Infertility? American Society for Reproductive Medicine. 2016.Husby GK, Haugen RS, Moen MH. Diagnostic Delay in Women With Pain and Endometriosis. Acta Obstetricia et Gynecologica Scandinavica. July 2003.Morotti M, Vincent K, Brawn J, et al. Peripheral Changes in Endometriosis-Associated Pain. Human Reproduction Update. September–October 2014.Endometriosis. Office on Women’s Health. February 22, 2021.Endometriosis FAQs. The American College of Obstetricians and Gynecologists. February 2021.Bulletti C, Coccia ME, Battistoni S, et al. Endometriosis and Infertility. Journal of Assisted Reproduction and Genetics. June 25, 2010.Endometriosis. Penn State Hershey Medical Center.Additional SourceEctopic Pregnancy. BabyCenter.com. February 11, 2021.Uterine Fibroids. Mayo Clinic. September 16, 2021.Show Less The Latest in Endometriosis FDA Approves Myfembree for Endometriosis Pain in Premenopausal WomenDoctors were already prescribing the drug to manage uterine fibroid–related heavy menstrual bleeding, and now the medicine will be immediately available...By Lisa RapaportAugust 9, 2022 Endometriosis May Raise Risk of Stroke Study FindsWhile the overall risk is low, the link between endometriosis and cardiovascular disease is worth paying attention to.By Kaitlin SullivanJuly 25, 2022 New Study Finds Link Between Endometriosis and Early MenopauseWomen with endometriosis may have fewer reproductive years than those without the condition, especially if they’ve never had children or taken the pill...By Becky UphamJanuary 28, 2022 Does Low Testosterone Cause Endometriosis A new theory may change diagnosis and treatment of the disease.By Beth LevineMay 28, 2021 Everyday Health s Endometriosis Twitter Chat Here s What You MissedAdvocates and experts took to Twitter to discuss challenges, tips, awareness, and more in honor of Endometriosis Awareness Month.By Brianna MajsiakApril 13, 2021 Does Endometriosis Up Your Risk for Developing Rheumatoid Arthritis There’s a connection between endo and RA, according to a large study.By Beth LevineJanuary 19, 2021 Managing Endometriosis During the Coronavirus Crisis FAQsAn expert answers frequently asked questions from women with endo By Beth LevineApril 2, 2020 Model and Advocate Alaia Baldwin Aronow Opens Up About Her EndometriosisThrough advocacy and sharing vulnerable images of her ‘endo belly,’ Aronow wants other women to feel less alone.By Brianna MajsiakMarch 31, 2020 Together Against Endo Kari and Ryan Anderson Help Raise Endometriosis AwarenessFacing the disease as a couple helped Kari and Ryan Anderson persevere and start a family.By Michael DolanMarch 26, 2020 Experiences With EndometriosisAn open, honest, and raw conversation about what life with endo is really likeBy Kerry WeissMarch 19, 2020 MORE IN 8 Things Women Who Have Ankylosing Spondylitis Need to Know Symptoms of Appendicitis Nausea Fever Abdominal Pain and More Women s Health Worsened in 2021 as Many Women Lack Access to Health Screenings and Preventive Care