Endometrial tissue that grows outside of the uterus can cause pain, heavy bleeding, and irregular periods.

Endometrial tissue naturally lines the inside of the uterus. Your body grows a new uterine lining during each menstrual cycle to prepare for a potential pregnancy.

If pregnancy doesn’t occur, your body sheds the uterine lining during menstruation. This tissue exits the body alongside blood and discharge.

In the case of endometriosis, the tissue still bleeds, but because the tissue is growing outside the uterus it can’t exit the body.

Endometriosis can affect the length and severity of your overall menstrual cycle. You may experience bleeding between periods, heavy menstrual bleeding, or irregular periods.

Endometriosis symptoms can feel worse leading up to and during menstruation. Pain during your period (dysmenorrhea) can vary from mild to unbearable.

During menstruation, a lining develops on the uterus to house a fertilized egg. When no fertilized egg is implanted, the environment starts to break down and exit the body — your menstrual period begins.

Endometrial tissue that grows outside of the uterus still breaks down, but it doesn’t have the vaginal canal as an exit. This causes irregular bleeding in other places within the body.

Rogue tissue growing outside of the uterus can create a buildup of painful cysts and scar tissue in its new habitat.

This scar tissue can grow and become attached to the surrounding organs including the:

When this tissue bleeds, it may cause inflammation, bowel obstruction, and blood in your stool or urine.

The first step to finding relief is getting a proper diagnosis if you don’t yet have one. Your clinician may recommend noninvasive treatments first to see if your symptoms improve.

Birth control pills and other hormonal medications, for example, may help suppress your menstrual cycle and reduce spotting or irregular bleeding.

Over-the-counter (OTC) anti-inflammatory medications may help ease the pain of endometriosis. This includes ibuprofen (Advil) and naproxen (Aleve). Prescription medication may be used for more severe pain.

In some cases, surgery may be necessary to make a definitive endometriosis diagnosis. Surgery may also be used to remove endometrial tissue, potentially offering short- or long-term symptom relief.

Common surgical procedures for endometriosis include:

Hysteroscopy

A hysteroscope is a thin tube with a light and camera that’s inserted into your vagina to enter your uterus. This instrument sends images to a nearby computer screen mapping out any lesions or cysts. Your clinician may recommend a hysteroscopy to help evaluate abnormal bleeding and, if necessary, remove polyps.

Laparoscopy

A laparoscope is a thin tube with a light and camera that’s inserted into small incisions in your abdomen. The scope surveys the abdominal and pelvic cavities for smaller lesions and cysts.

This procedure is considered the gold standard for endometriosis diagnosis. The scope can be used to obtain a tissue sample, which will be sent to a specialist to confirm the diagnosis. The tool can also remove tumors and cut away scar tissue.

Hysterectomy

If you aren’t concerned about becoming pregnant in the future, your clinician may suggest a hysterectomy.

Removing your uterus and surrounding endometrial tissue may help control endometriosis and its symptoms. Your clinician may leave your ovaries intact, if possible, to avoid triggering menopause.

If you do wish to become pregnant in the future, your clinician may remove your ovaries but leave your uterus to support in vitro fertilization.

How long does endometriosis bleeding last?

When endometriosis is present, menstruation may last longer than the average 4–7 day time frame.

On the other hand, endometriosis may cause your overall menstrual cycle to shorten, meaning menstruation will occur sooner than once every 28 days.

Each body is different, and symptoms can vary from person to person, month to month.

Where do endometriosis blood and tissue go?

As the lining sheds and bleeds in places it’s not supposed to be present, it can cause pain and inflammation as it comes in contact with other surrounding organs.

Over time, this tissue starts to build up, causing benign cysts and scar tissue.

Endometrial tissue can also travel through the blood and lymphatic system, which is how it can be found in places like the knee or thumb.

Can endometriosis cause bleeding after menopause?

Estrogen is considered to be one of the catalysts of endometriosis. Your estrogen levels naturally taper off after menopause, reducing your risk of developing the condition or experiencing its symptoms.

Although endometriosis after menopause is rare, it isn’t impossible.

If you suspect you have endometriosis but don’t have an official diagnosis, make an appointment with a doctor or other healthcare professional to talk about your concerns.

They may ask you to keep a log of any symptoms you’re experiencing, where you are in your menstrual cycle when symptoms occur, and other information that could be useful for diagnosis.

Endometriosis symptoms can range from nonexistent to severe. When symptoms do occur, they may include:

Symptoms may be occasional, constant, or even cyclical. Cyclical symptoms typically worsen before and during menstruation and improve once your period ends.

If you already have an endometriosis diagnosis and notice atypical bleeding or other unusual symptoms, you should also make an appointment with a doctor or other healthcare professional.

They may want to conduct a pelvic exam or other diagnostic tests to better understand the change in symptoms and rule out other underlying causes. Your clinician can also adjust your care plan to better manage your current symptoms.

Endometriosis can cause heavy menstrual bleeding, spotting between periods, and pelvic pain. There are several treatment options to help manage bleeding and other symptoms of endometriosis.

Catasha Gordon is a sexuality educator from Spencer, Oklahoma. She’s the owner and founder of Expression Over Repression, a company built around sexual expression and knowledge. You can typically find her creating sex education materials or building some kinky hardware in a fresh set of coffin nails. She enjoys catfish (tail on), gardening, eating off her husband’s plate, and Beyoncé. Follow her everywhere.