What are the symptoms of endometriosis?

Dr. Mehmet Oz, MD
Cardiologist (Heart Specialist)
The most common symptoms of endometriosis are pelvic pain (severe cramping in the lower back and abdomen that usually coincide with menstrual cramps); sharp pelvic pain during sex; painful bowel movements; exceptionally heavy periods or bleeding between periods; and even infertility. If you have 2 out of the 3 symptoms it’s probably worth speaking with your doctor.

Because of excess bleeding and swelling in unusual places within the pelvic cavity, endometriosis can cause some serious symptoms. These symptoms include painful periods due to swelling in places where you don't usually suffer from swelling. You can also have pain outside of your menstrual cycle, while using the bathroom, during ovulation and during intercourse. Endometriosis leads to excess bleeding during periods and, many times, infertility because of scar tissue blocking your reproductive organs. This being said, endometriosis can also present no symptoms at all and only be discovered when investigating infertility. It may also be suspected if a doctor finds signs like large cysts during a regular doctor's visit.

This answer is based upon source information from the National Women's Health Information Center.

Dr. Jessica A. Shepherd, MD
OBGYN (Obstetrician & Gynecologist)

Endometriosis is a chronic disorder that affects the pelvic organs; symptoms include painful menstruation, painful urination and bowel movements, cysts and pelvic pain. Watch OBGYN Jessica Shepherd, MD, explain the symptoms of this common condition.

Endometriosis is a condition that is common and often overlooked. Spotting or bleeding at times other than your period is sometimes a sign of endometriosis. The presence of the endometrium (the lining of the womb) outside the uterus is associated with painful menses but also infertility.

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Pain is the main symptom of endometriosis. This can include painful periods, pain in the lower abdomen before and during menstruation, pain with sexual intercourse, pain with bowel movements and cramps for a week or two before and during menstruation. There also may be no symptoms at all.

Treatment options depend on age, severity of symptoms, and whether a woman wants children or not.

The main symptoms of endometriosis are the following:

  • pain before and during periods
  • pain with sex
  • infertility
  • fatigue
  • painful urination during periods
  • painful bowel movements during periods
  • diarrhea, constipation and nausea
Dr. Kevin W. Windom, MD
OBGYN (Obstetrician & Gynecologist)

The most common symptoms are pelvic pain, pain with sex, pain with menses, pain with bowel movements (especially on your period), infertility, painful urination and no bladder infection can be diagnosed, and back pain.

The most common symptoms of endometriosis are painful menstrual periods and/or chronic pelvic pain.

Others symptom include the following:

  • diarrhea and painful bowel movements, especially during menstruation
  • intestinal pain
  • painful intercourse
  • abdominal tenderness
  • backache
  • severe menstrual cramps
  • excessive menstrual bleeding
  • painful urination
  • pain in the pelvic region with exercise
  • painful pelvic examinations
  • infertility

It is important to understand that other conditions aside from endometriosis can cause any or all of these symptoms and other causes may need to be ruled out. These include, but are not limited to, interstitial cystitis, irritable bowel syndrome, inflammatory bowel disease, pelvic adhesions (scar tissue), ovarian masses, uterine abnormalities, fibromyalgia, malabsorption syndromes and, very rarely, malignancies.

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The symptoms of endometriosis are usually dependent upon the areas within the pelvis that are involved. For example, if endometrial tissue has embedded on the bladder, women may experience pain with urination and the urge to urinate more often. Common symptoms include painful periods or irregular bleeding, pelvic pain, low back pain, pain with intercourse, bloating, nausea and vomiting. These symptoms tend to start just before a woman starts her menstrual cycle and stop as the cycle concludes.

Dr. Madeleine M. Castellanos, MD
Psychiatrist (Therapist)

The way that endometriosis usually comes to people's attention is that it causes very painful periods for many women. This is because during a woman's menstrual cycle, the uterus has periodic muscle contractions to expel the old tissue. When there is scar tissue from endometriosis attached to the uterus, these contractions cause pulling and tugging that adds to the pain of cramps. The nature of the pain is also different from the aching of menstrual cramps in that it can be very sharp and stabbing pain, but this varies from woman to woman.

The other way that endometriosis may come to be diagnosed is when a woman experiences pain on deep penetration during sexual intercourse. This definition of 'deep' really refers to deep enough to push on the cervix, which is only 3-4 inches of penetration. Since the scar tissue also may attach to the outside of the vagina, once the vagina starts to be stretched from penetration, any scar tissue located there would once again tug and pull. Women may find that it happens only in certain positions, or certain depths of penetration, depending on how the endometriosis is affecting her. Some women even start to avoid sex or are apprehensive about it because the pain. But with treatment, both painful sex and painful periods can be much improved.

Women with endometriosis often, but not always, have one or more of the following symptoms:

  • dysmenorrhea (painful cramps during menstruation)
  • dyspareunia (painful intercourse)
  • dysfunctional uterine bleeding, including heavy periods or unusual spotting

In about 30 percent of women, there are no symptoms except infertility.

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Important: This content reflects information from various individuals and organizations and may offer alternative or opposing points of view. It should not be used for medical advice, diagnosis or treatment. As always, you should consult with your healthcare provider about your specific health needs.