Endometriosis is a chronic gynecological condition in which tissue similar to the lining of the uterus, known as the endometrium, grows outside the uterus. These growths are most commonly found on the ovaries, fallopian tubes, and pelvic lining, but in more severe cases, they can appear on the bladder, intestines, and even beyond the pelvic region. Although this tissue is not cancerous, it behaves similarly to the endometrial lining, thickening, breaking down, and bleeding with each menstrual cycle. Since this tissue has no way to exit the body, it can cause inflammation, pain, adhesions, and scarring.
Recognizing the symptoms of endometriosis is essential for early diagnosis and effective management. Unfortunately, symptoms are often dismissed or misattributed to other conditions, resulting in delayed diagnosis for many women.
Common Symptoms of Endometriosis
Endometriosis symptoms can vary widely between individuals and are not always proportional to the extent of the disease. The most common symptoms include:
- Pelvic pain – Often severe during menstruation (dysmenorrhea), this is the most recognized symptom.
- Pain during or after sexual intercourse (dyspareunia) – Typically felt deep within the pelvis.
- Pain with bowel movements or urination – Most noticeable during menstrual periods.
- Heavy menstrual bleeding (menorrhagia) – Includes prolonged periods or bleeding between cycles.
- Infertility – Difficulty conceiving may be the first sign for some women with endometriosis.
- Chronic fatigue – Persistent exhaustion not relieved by rest.
- Gastrointestinal symptoms – Such as bloating, diarrhea, constipation, and nausea, particularly during menstruation.
These symptoms often overlap with other conditions such as irritable bowel syndrome (IBS), ovarian cysts, or pelvic inflammatory disease, making accurate diagnosis more challenging.
How Endometriosis Is Diagnosed
Diagnosing endometriosis requires a careful and multi-step approach. Many women may experience symptoms for years before receiving a definitive diagnosis. The diagnostic process typically includes:
- Medical history and symptom review – A healthcare provider will assess menstrual patterns, pain history, and any family history of endometriosis.
- Pelvic examination – A manual exam may reveal cysts or tender nodules behind the uterus or near the pelvic wall.
- Imaging tests – Ultrasound and magnetic resonance imaging (MRI) can help detect larger lesions or ovarian cysts (endometriomas), though they may miss smaller or deeper implants.
- Laparoscopy – This minimally invasive surgical procedure is the most accurate way to diagnose endometriosis. A small camera is inserted into the abdomen to look for endometrial tissue outside the uterus. If lesions are found, a biopsy may be performed, and in many cases, the lesions can be removed during the same procedure.
Timely recognition of symptoms and appropriate medical evaluation can lead to earlier intervention, helping to manage pain, preserve fertility, and improve quality of life for those living with endometriosis.
