Endometriosis Symptoms

The symptoms of Endometriosis vary from one woman to another but the most common symptom is pelvic pain.

One of the biggest problems regarding Endometriosis is that the 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 symptoms she feels are not normal. The pain of her menstrual cycle gradually and steadily becomes worse and worse as the months go by. This is only the beginning of what will become a gradual decline in a woman’s general health, as well as the health of her reproductive system.

Endometriosis does not follow any distinct pattern, which is why it is difficult for the medical profession to know that a woman has the disease. Some of the symptoms will mimic those of other health problems, including:

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

The most common symptoms of Endometriosis are:

• Pain before and during periods
• Pain with intercourse
• General, chronic pelvic pain throughout the month
• Low back pain
• Heavy and/or irregular periods
• Painful bowel movements, especially during menstruation
• Painful urination during menstruation
• Fatigue
• Infertility
• Diarrhoea or constipation

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

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

As Endometriosis develops a woman’s immune system becomes more and more impaired and this leads to further health problems. Due to increased research, as well as surveys of Endometriosis patients, it is now becoming clear that women with the disease are susceptible to other serious health problems including:

• Chronic Fatigue Syndrome (100 times more common in women with endometriosis)
• ME Hypothyroidism - under-active Thyroid gland (7 times more common in women with endometriosis)
• Fibromyalgia
• Rheumatoid arthritis

It does seem clear that as women with Endometriosis are more receptive to other health problems, then their immune system is the key to their problems.

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

In some instances the pain of Endometriosis can prohibit a woman to partake in every day activities as well as her ability to sustain a career.

Endometriosis symptoms in relation to location of the disease in the body

• 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 pain is one of the most common symptoms of Endometriosis. The pelvic pain of Endometriosis 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 be provoked by certain activities such as walking, standing too long etc., or it may occur unpredictably.

Occasionally abdominal and pelvic pain 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 pain, as it may coincide after meal times.

Lower back pain is another common but poorly recognized symptom that often accompanies period pain. It is commonly associated with endometriosis in the pouch of Douglas, uterosacral ligaments, and rectovaginal septum.

Ovulation pain can occur in women who do not have Endometriosis, but this pain will normally be a small twinge. In women with Endometriosis, ovulation pain can be rather acute. Pain usually begins 12-24 hours before ovulation and may last for a few days. It 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. The pain is often described as ‘stabbing’ and it may radiate throughout the pelvic area and into the buttocks and thighs.

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

• Backache
• Leg pain
• Painful Intercourse

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

(rectosigmoid colon, rectovaginal septum, small bowel, rectum, large bowel, appendix, gallbladder, intestinal tract)

The bowel symptoms of endometriosis are often overlooked or dismissed because many people think endometriosis affects only the reproductive organs. Many bowel symptoms 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 gastrointestinal 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.

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

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

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

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

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

Surgical treatment to remove endometrial implants is sometimes undertaken in the hope of relieving the hip joint pain associated with 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 is a common symptom of Endometriosis. Pain may be felt during intercourse as well as up to 48 hours after sexual activity. It is often associated with endometriosis 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 women suffer with Endometriosis, and is not often recognized as a symptom of Endometriosis.

Fatigue 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. For advice on how to cope with the fatigue of Endometriosis see this useful article on Endometriosis and Fatigue for advice.

Abdominal bloating may be a sign of endometriosis. It is thought to be due to inflammation in the pelvic cavity caused by the endometriosis. 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 pain and discomfort. IBS is very common in women with Endometriosis. For further details of Irritable Bowel Syndrome read this useful article.

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