Endometriosis Symptoms

The symptoms of endometriosis tend to vary from one woman to another but the most common sign is pelvic pain and painful periods

symptoms of endometriosis

One of the biggest problems regarding endometriosis is that any signs of this disease in the early stages, appear to be the ‘normal’ bodily changes that take place with the menstrual cycle.

It is only as time goes by that a woman begins to suspect that what is happening, and the discomfort she feels is not normal. The symptoms of her menstrual cycle gradually and steadily becomes worse as the months go by.

List of symptoms of endometriosis and location in the body

Read what other women have said are their most common or difficult symptoms

As the disease develops a woman’s immune system tends to become more and more impaired and this leads to further health problems.

Due to increased research, as well as surveys of patients, it is now becoming clear that women with the disease can be susceptible to other health problems which mostly relate to an impaired immune system. 

No two women will have the same symptoms, and will not suffer the same knock-on health problems, but the most common symptom experienced among sufferers is acute pain.

What you can do to help yourself

For advice on different ways to deal with the pain read the advice HERE of the different natural and medical treatments you can try.

Possible Locations of Endometriosis

possible sites of endometriosis

Having said that, there are odd instances where some women do actually have the disease, but they are nearly free of any symptoms.

These women will only be diagnosed by default, for example when they have surgery for other issues, only then is evidence of endometriosis actually found. That is what makes endometriosis so enigmatic and difficult to diagnose.

The disease does not follow any distinct pattern, which is why it is difficult for the medical profession to know that a woman has it. The symptoms can range from mild to severe, but the level of pain does not always relate to the seriousness of the disease.

The most common signs of Endometriosis are:

  • Pain before and during periods
  • Pain with intercourse
  • General, chronic pelvic discomfort and aches throughout the month
  • Low back-ache
  • Heavy and/or irregular periods
  • Painful bowel movements, especially during menstruation
  • Painful urination during menstruation
  • Fatigue
  • Infertility - estimated for about 40% of women
  • Diarrhoea or constipation
  • General digestive disorders

Other problems which are common can include:

  • Headaches
  • Low grade fevers
  • Depression
  • Hypoglycaemia (low blood sugar)
  • Anxiety
  • Susceptibility to infections, allergies

In the later stages adhesions usually develop in the pelvic cavity, which are caused by untreated cysts, which can ‘glue’ pelvic organs together. These adhesions can seriously interfere with normal functions of organs in the pelvis, causing bowel obstructions, digestive problems, infertility, urinary problems, problems when adhesions are pulled, and mobility issues.

Other health issues that may show  similar signs to endometriosis include:

  • ovarian cysts
  • ectopic pregnancy
  • Pelvic Inflammatory Disease
  • irritable bowel syndrome
  • fibroid tumours
  • colon cancer
  • appendicitis

Symptoms in relation to location in the body

Reproductive Area Endometriosis

There are various areas where endometrial tissue can develop in the pelvic cavity including:

  • Ovaries
  • The outside surface of the uterus
  • Fallopian tubes
  • Ligaments supporting the uterus
  • Internal region between the rectum and the vagina
  • Lining of the pelvic cavity
  • Intestines
  • Bowels
  • Other organs within the abdomen

Pelvic area symptoms

Pelvic pain is one of the most common signs of Endometriosis. It can be excruciating and debilitating for many women. It may be experienced constantly, it may be intermittent or it may be related solely to the menstrual period. Pain can also be provoked by certain activities such as walking, standing too long etc., or it may occur unpredictably.

Occasionally abdominal and pelvic discomfort may be caused by Irritable Bowel Syndrome (IBS). These two diseases are quite common together, so it is advised to take note of the times you experience pelvic discomfort, as it may coincide after meal times.

Lower Back

Lower back ache is another common but poorly recognized symptom that often coincides with menstruation . It is commonly associated with implants in the pouch of Douglas, utero-sacral ligaments, and recto-vaginal septum.


Ovulation symptoms can occur in women who do not have the disease, but this pain will normally be a small twinge. In women with endometriosis, ovulation pain can be rather acute. It usually begins 12-24 hours before ovulation and may last for a few days.

This results from the normal enlargement of the ovary during ovulation which causes stretching of endometrial implants and adhesions lying on the surface of the ovary. It is often described as ‘stabbing’ and it may radiate throughout the pelvic area and into the buttocks and thighs.

The main reproductive signs are:

  • Chronic or intermittent pelvic discomfort
  • Ectopic (tubal) pregnancy
  • Dysmenorrhea (painful menstruation is not normal!)
  • Infertility
  • Miscarriage(s)
  • Painful ovulation

Uterosacral/Presacral Nerve Endometriosis

  • Backache
  • Leg pain
  • Painful Intercourse

Cul-de-sac ("Pouch of Douglas") Endometriosis

  • Dyspareunia (pain during intercourse)
  • Gastrointestinal symptoms
  • Pain after intercourse

Gastro-intestinal symptoms

(recto-sigmoid colon, recto-vaginal septum, small bowel, rectum, large bowel, appendix, gallbladder, intestinal tract)

Endometriosis of the bowel is often overlooked or dismissed because many people think that the disease affects only the reproductive organs.

Many bowel problems are caused by irritation to the bowel from endometrial implants lying on adjacent areas such as the Pouch of Douglas and the back of the uterus, but some are due to endometrial deposits lying on the outside of the bowel wall.

The gastro-intestinal disorder which is most common with endometriosis is Irritable Bowel Syndrome which can cause many of the bowel symptoms mentioned above. Candida has also been found to be prevalent in women with Endometriosis, and this too can cause many distressing digestive upsets and discomfort.

The main Gastro-intestinal signs are:

  • Nausea
  • Diarrhoea
  • Blood in stool
  • Bloating
  • Vomiting
  • Rectal pain
  • Rectal bleeding
  • Tailbone pain
  • Abdominal cramping
  • Constipation
  • Sharp gas pains
  • Painful bowel movements

For more information on Intestinal endometriosis

read this informative article HERE

Other Locations of Endometriosis

Urinary Tract (bladder, kidneys, urethras, and urethra)

Urinary tract symptoms are usually the result of endometriosis lying on the outside of the bladder or irritation from endometrial implants lying on the front of the uterus.

The main signs of urinary tract endometriosis are:

  • Blood in urine
  • Painful or burning urination
  • Hypertension
  • Tenderness around the kidneys
  • Flank pain radiating toward the groin
  • Urinary frequency, retention, or urgency

Pleural (lung & chest cavity) Endometriosis

Very occasionally the disease can travel to the lungs, which will give rise to strange symptoms, and are usually related to the menstrual cycle.

  • Coughing up of blood or bloody sputum, particularly coinciding with menses
  • Accumulation of air or gas in the chest cavity
  • Constricting chest and/or shoulder pain
  • Collection of blood and/or pulmonary nodule in chest cavity (revealed under testing)
  • Shortness of breath

Sciatic Endometriosis/ Hip pains

Hip pain or discomfort that radiates from the buttock and down the leg is common in women where it has affected the sciatic nerve. Also, endometriosis in the groin area can feel like hip pain.

On occasion adhesions can restrict the hip ligaments, causing distress and limping. Hip joint pains that worsens in a cyclical fashion in line with the menstrual cycle will usually be caused by endometriosis.

Surgical treatment to remove implants is sometimes undertaken in the hope of relieving the hip joint problem associated with the disease.

Skin Endometriosis

Painful nodules, often visible to the naked eye, at the skin's surface. Can bleed during menses and/or appear blue upon inspection.

Dyspareunia (painful sexual intercourse)

Dyspareunia is a common problem with this disease. Pain may be felt during intercourse as well as up to 48 hours after sexual activity. It is often associated with implants in the pouch of Douglas or adhesions in the pelvic cavity.


Fatigue and Endometriosis seem to go hand in hand. No-one knows what causes the acute fatigue that women suffer, and is not often recognized as a symptom.

This can be one of the most debilitating aspects of the disease, and most women with endometriosis experience fatigue around the time of their period and some experience it throughout the month. The fatigue may be related to the constant pain and/or medication, or it could be the bodies reaction to the disease at a deeper level.

Abdominal Bloating

Abdominal bloating is another problem suffered by many women. It is thought to be due to inflammation in the pelvic cavity caused by the endometriosis  implants.

As mentioned above, Irritable Bowel Syndrome (IBS) can cause pelvic pain, and can also cause severe abdominal bloating. With IBS, the bloating is usually caused by intestinal gasses which expand and distend the abdomen and can cause severe discomfort.


Adhesions are a very common symptom of endometriosis which can be caused by the development of the disease in the abdomen, and can also be caused by surgery. A further detailed description of adhesions is found HERE


Most women will develop cysts with endometriosis and they can cause a lot of pain during various times of the month especially during ovaulation. They will also cause pain when they rupture. Learn more about endometriosis cysts HERE

Monitoring your symptoms

Keeping a daily diary of your symptoms will help you keep track of changes in your symptoms and the various issues that can be affecting your health.  The best way to do this is by compiling a visual chart of symptoms. More advice can be found HERE

Share your experiences of endometriosis symptoms!

Share with others the symptoms you suffer ... and read what other women have to say are their most common symptoms

› Endometriosis Symptoms

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