Endometriosis is a condition that can affect women, as well as girls who are old enough to have begun menstruation. If you have endometriosis, it means that tissue similar to the lining of the endometrium grows outside the uterus, in areas like the ovaries, abdomen, and bowel. The tissue that grows outside the uterus in endometriosis is not equivalent to endometrial tissue.

This tissue still responds to your menstrual cycle no matter where it’s located, but because it’s not in your uterus, it can cause problems each month. It can’t leave by way of your period, so it gets trapped and can cause issues like inflammation, irritation, and even scar tissue.

Endometriosis is often misdiagnosed, with symptoms that can vary from person to person. Pain is a common sign but may not accurately show the severity of the condition. Some people have a lot of pain even with mild endometriosis, and for others the opposite is true. Conditions such as ovarian cysts or irritable bowel syndrome (IBS) have similar symptoms, which is why endometriosis can be mistaken for other issues.

Are you having unexplained symptoms like pelvic pain, heavy periods, and discomfort? Take a moment to explore whether these symptoms might be related to endometriosis.

Pelvic pain that coincides with menstruation is the main symptom of endometriosis. Menstrual cramps are common even for women without endometriosis, but pain from this condition is usually much worse.

You may be experiencing different types of pain, which can be confusing. You might feel sharp pain, bad cramps, or chronic lower back and pelvic aches. You may have pain associated with sexual activity, both during and after. Sometimes your pain may seem completely unrelated to your reproductive organs, like when you have a bowel movement or urinate.

Ask your doctor how to know if your pain could be from endometriosis or when you should seek additional medical evaluation.

If you’re having trouble getting pregnant, it could be endometriosis. Not everyone who has this condition is unable to get pregnant, but there are women who do suffer infertility as a result.

Sometimes the growths from endometrial tissue can block your fallopian tubes or enter your ovaries, and cysts can form from trapped blood. Scar tissue and adhesions can also interfere with your ability to get pregnant.

Your doctor may be able to prescribe medication that can put you in a temporary state of menopause. This prevents pregnancy but also stalls the growth of endometrial lesions. That means when you stop taking the medication and resume menstruation, you have a higher chance of becoming pregnant. Women diagnosed with endometriosis are usually encouraged not to wait to have their children.

Endometriosis can cause bloating, diarrhea, constipation, and nausea if the lesions are located in your bowel wall. You can even experience bowel obstruction if you have an adhesion or large enough lesion.

The symptoms of endometriosis in the bowel are similar to those of IBS. If you notice a change in symptom intensity connected to your menstrual cycle, then there’s a good chance the culprit is endometriosis.

Excess fatigue is a symptom of endometriosis. If you have this symptom, tell your doctor. A simple blood test can check for other treatable conditions that make your fatigue worse, such as:

  • anemia, which refers to low iron that causes poor
    oxygen circulation in your blood
  • hypoglycemia, which occurs when your resting
    blood sugar is too low
  • hypothyroidism, which means inadequate hormone
    production by your thyroid gland

All of these conditions can cause fatigue on their own and make fatigue worse if you have endometriosis. The good news is that they’re treatable, which can help you feel better.

In addition to heavy periods, you might experience spotting or bleeding between periods. Unusual bleeding is a symptom of endometriosis, and if you have it, you should let your doctor know. The abnormal tissue from endometriosis and resulting cysts and lesions can affect the hormones that regulate your menstrual flow. The result of this hormonal disruption can be abnormal bleeding.

Discuss any unusual bleeding with your doctor. Although it’s not a common symptom, endometriosis can cause blood in stool and urine.

In rare cases, endometriosis penetrates the inside of the bladder and results in blood in your urine.

Rectal lesions that bleed cause blood to appear in your stool. This symptom can also be a sign of colorectal cancer, so if you see blood when you pass stool, make an appointment with your doctor to ensure that the cause is in fact endometriosis and not cancer.

Pain can have many different causes, so it’s important to talk to your doctor if you’re experiencing recurring pain on a regular basis, in any part of your body.

In some cases, endometriosis can cause pain in unexpected areas. A rare presentation known as thoracic endometriosis syndrome sees endometrial tissue in the lungs, which can result in chest pain and even a collapsed lung when you’re menstruating.

What feels like appendicitis but without the fever could actually be endometriosis of the appendix, or appendiceal endometriosis.

Even leg pain that gets worse before your period begins could be the result of endometrial tissue that has traveled through your body.

Your doctor will ask for information about your menstrual cycles, as well as the type of symptoms you’ve been having. Keep a journal of the pain you experience, with details such as its location, severity, and duration. Also, log your periods: Record the start dates and how many days are heavy and light. Make note of any spotting you observe when you’re not menstruating.

There are apps you can get on your smartphone to track your period and enter notes.

An effective way to diagnose endometriosis is with a minor surgical procedure called laparoscopy. During this procedure, your doctor can see the affected area and take a tissue sample to view under a microscope.

Your options for an accurate diagnosis are among the many topics to discuss with your doctor if you’ve been struggling to identify the cause of your symptoms.

Q: What are the advantages of seeing a healthcare professional who has experience treating endometriosis?


A: Endometriosis can be difficult to diagnose because the symptoms can mimic a variety of other diseases.

A healthcare professional with experience treating endometriosis is more likely to recognize the different presentations and symptoms and diagnose the condition more quickly and effectively.

The symptoms of endometriosis can also be very vague. Less experienced professionals may be more likely to dismiss your symptoms. Despite its sometimes nondistinctive presentation, endometriosis can be severe and negatively impact your quality of life. It’s important to work with a healthcare professional who will take your symptoms seriously.

There are also several different treatments for endometriosis. Choosing the right option for you depends on your specific symptoms, risk factors, lifestyle, and health goals. For example, someone who is actively trying to conceive will manage endometriosis differently than a person who is not interested in getting pregnant.

Sometimes you need to try a few different treatments before you find one that works for you. A healthcare professional with extensive experience managing endometriosis can recommend a customized treatment plan to fit your needs and goals.

Sanaz Ghazal, MD, FACOG, an ABMS board certified reproductive endocrinology and infertility specialist and OB/GYN, co-founder and medical director of RISE Fertility in CaliforniaAnswers represent the opinions of our medical experts. All content is strictly informational and should not be considered medical advice.
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Endometriosis can impact your well-being. But once you have a proper diagnosis, you can start therapies designed to treat your specific condition. If your symptoms are from endometriosis, treatments such as hormone therapy, heating pads, and exercise may help.

See your doctor to ask about your options for diagnosis so that you can start proper treatment and take steps to improve your quality of life.