20 Signs and symptoms of Endometriosis

20 Signs and Symptoms of Endometriosis

Endometriosis is a chronic, sometimes debilitating condition. Endometriosis means tissue similar to the lining of the uterus (the endometrium) grows outside the uterus. It affects 1 in 10 women between 15-50 and other genders. While there is no cure for endometriosis, understanding the common signs and symptoms can help you get an earlier diagnosis and manage your symptoms more effectively.

Here we discuss 20 symptoms of endometriosis.

Painful Periods 

The most common symptom of endometriosis is pain during or around periods ranging from mild to extreme. This pain may start before or after your period begins. It may be localized in the pelvic region or spread to other parts of your body. The pain may also become worse over time if endometriosis is left untreated. 

Pain During Intercourse 

Intercourse may be uncomfortable or even painful with endometriosis. This type of pain is called dyspareunia and occurs because of endometriosis mass in the pelvis and around the vagina or the adhesions of endometriosis in the pelvis. Adhesions form when scar tissue binds organs together, causing them to stick together instead of sliding against each other as they usually do during intercourse. 

Heavy Bleeding 

Women with endometriosis often experience heavy bleeding during their periods. Heavy bleeding means they must change their pads or tampons more frequently than normal—as often as every hour—or pass large blood clots during their menstrual cycle. Some women also experience spotting throughout their cycles and bleeding between cycles due to endometriosis-related changes in hormones. This heavy bleeding or spotting can be a sign of adenomyosis, which is very common in endometriosis patients.

Fertility Issues 

Endometriosis can cause fertility issues for some women. Infertility can result from inflammation, adhesion, or mass effect of endometriosis lesions on reproductive organs such as ovaries, fallopian tubes, and the uterus. Infertility due to endometriosis can cause a range of emotions, including anger, sadness, and frustration.


Fatigue is a lack of energy and motivation. It is one of the most common signs of endometriosis.

Do you have endometriosis? Contact an endometriosis specialist:

Dr. Andrea Vidali, Endometriosis Specialist, Reproductive Endocrinologist

Dr. Steve Vasilev, Endometriosis Specialist, Integrative Medicine specialist


It might start before a period and last several days. Patients describe it as stabbing, searing, debilitating pain.

Read more: Understanding and Finding Relief from Endometriosis Cramps


Bloating is a complaint in 82.8% of patients with endometriosis. Inflammation, bacterial, immunologic, and hormonal changes might be the likely reasons.


Vomiting might result from endometriosis’s mass effect and hormones on the gastrointestinal tract. It could also be secondary to severe pain and discomfort.


Severe pain and cramps can lead to nausea. Also, with heavy bleeding, you may feel lightheaded or dizzy during your periods which can lead to nausea.


Generally, constipation means the passage of small amounts of hard, dry stool, usually fewer than three times a week.

Chronic constipation in women with endometriosis varies from 12% to 85%. Constipation can result from multiple causes. These causes for constipation include inflammation, scar tissue, damage to pelvic autonomic nerves, pelvic floor muscle dysfunctions, and hypertonic (too much muscle tone) pelvic floor muscles. 


Diarrhea means loose, watery stools that occur more frequently than usual. Endometriosis diarrhea is most likely related to high patient anxiety and hormonal imbalances such as increased prostaglandins.

Read more: Endometriosis and Diarrhea: What You Need to Know

Rectal bleeding

Deep infiltrating endometriosis of the colon can cause cyclic or midcycle rectal bleeding.

Pain with bowel movement

Deep infiltrating endometriosis of the colon can cause a painful bowel movement. Moreover, lesions behind the rectum or anus can cause the same painful bowel movement. 

Rectal fullness

Deep infiltrating endometriosis of the colon can cause the feeling of rectal fullness. Similarly, lesions behind the rectum or anus can cause rectal fullness.

Blood in urine

Deep endometriosis lesions in the bladder and ureter can cause bloody urine during the period or off cycle.

Pain with urination

It is also known as “dysuria.” Deep infiltrating endometriosis of the bladder can cause pain with urination (dysuria).

Excessive urination

It is also known as “frequency.” Deep infiltrating endometriosis of the bladder can cause excessive urination, AKA frequency.

Flank pain

Endometriosis lesions impacting kidneys and ureters can lead to pain in the flank. Also, other pelvic sidewall lesions can have similar flank pain.

Back pain

Low back pain can be present due to the direct impact of endometriosis lesions on lumbosacral bones or nerve roots. Some other explanations of this pain include referral pain of visceral pelvic pain, hypersensitization, and adhesion in the pelvic area that impacts low back joints.

Leg pain

Leg pain occurs due to nerve inflammation or hypersensitization. Nerve inflammation happens due to endometriosis covering nerves such as the sciatic nerve. Another reason for nerve inflammation is the presence of endometriosis in distant places, such as ovaries and pelvic side walls, that compress and inflame nerves.

Ovarian mass 

Endometriosis of ovaries can result in endometrioma. An ovarian endometrioma is a cyst that contains endometriosis tissue and a thick, brown, tar-like fluid. Some may call it a “chocolate cyst.” It can grow to 10-15 cm and present with a mass in the abdomen.

Postcoital bleeding

Bleeding after sex, known as postcoital bleeding, can result from endometriosis lesions in the uterine cervix. With penetration, the endometriosis tissue on the cervix becomes irritated and wounded and starts bleeding.

Read more: What were your uncommon symptoms of endometriosis?

Read more: Does Endometriosis Go Away After Menopause?

There are many other signs and symptoms associated with endometriosis, including shortness of breath, headaches, depression, and anxiety. Suppose you experience any individual or combination of these symptoms regularly. In that case, you must seek medical advice from your doctor so that they can properly diagnose and treat your condition accordingly. An early diagnosis can help you manage your symptoms more effectively, so don’t hesitate to speak with your doctor if you think you suffer from this condition!

Read more:

How to Get an Endometriosis Diagnosis

How to Find an Endometriosis Specialist for Diagnosis, Treatment, & Surgery

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i get severe Sharp pain on my left lower side of my abdomen and can’t bend durin g my period what medication would help?

Hannan Ahmad

Endometriosis, cloaked in layers of physical pain and emotional turmoil, punctuates the profound intricacies of women’s health. Through its vast spectrum of symptoms, from debilitating pelvic pain to the nuance of postcoital bleeding, we’re reminded of the resilience of those enduring this condition. The confluence of pain, whether radiating to the back or echoing in the legs, couples with more elusive symptoms like fatigue, underlining the relentless nature of endometriosis. The emphasis on understanding not just the physiological, but the emotional and psychological ramifications of this condition, underscores the imperative to champion early diagnosis and compassionate care. Each symptom, be it overt or covert, is a testament to the silent battles waged daily by countless individuals.

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