Endometriosis
Top Endometriosis Specialist Florida: Your Path to Pain-Free Living
Endometriosis affects approximately 10% of women in Florida, impacting their daily lives and overall well-being. This chronic condition, characterized by the growth of uterine-like tissue
March 17, 2025
The symptoms of endometriosis can be summarized as:
1. Pelvic pain
2. Dysmenorrhea – painful menstruation
3. Dysuria – painful, uncomfortable, or difficult urination
4. Dyspareunia – pain during sexual intercourse
5. Dyschezia – painful or difficult bowel movements
6. Difficulty getting pregnant (infertility)
Except for infertility, all the other symptoms are related to pain during a physiological activity.
At the onset of symptoms, pain is usually associated with menstruation and improves during the rest of the cycle.
In patients with a delayed diagnosis, symptoms may persist throughout the menstrual cycle, worsening during menstruation.
There is no single symptom that indicates intestinal involvement in endometriosis.
Many patients may be asymptomatic, even with significant intestinal lesions.
The main symptoms of endometriosis occur due to the presence of ectopic endometrial tissue, which responds to menstrual cycle hormones just like the endometrium inside the uterus. Here’s why each symptom happens:
1. Chronic pelvic pain – Chronic inflammation caused by endometriosis leads to nerve irritation and the formation of adhesions between pelvic organs, resulting in persistent pain.
2. Dysmenorrhea (painful menstruation) – During menstruation, ectopic endometrial tissue also bleeds, triggering inflammation and the release of pro-inflammatory substances like prostaglandins, which increase uterine contractions and intensify pain.
3. Dysuria (painful urination) – When endometriosis affects the bladder or nearby areas, it can cause local inflammation and bladder spasms, leading to pain, urinary urgency, or even blood in the urine.
4. Dyspareunia (pain during sexual intercourse) – Adhesions and the inflammatory process make structures like the uterus, ovaries, and uterosacral ligaments more rigid and painful with movement, especially during deep penetration.
5. Dyschezia (painful bowel movements) – Endometriosis infiltration in the rectum or sigmoid colon can cause inflammation, fibrosis, and narrowing of the intestinal lumen, making bowel movements painful, especially during menstruation.
6. Infertility – Endometriosis can affect fertility in several ways, including causing chronic inflammation, altering egg quality, impairing tubal function, and leading to adhesions that make it difficult for the fallopian tubes to capture the egg.
In summary, the symptoms are directly related to inflammation, ectopic bleeding, and adhesions caused by endometriosis, interfering with the normal function of pelvic organs.
To add to Dr. Bellelis’ response, as a physical therapist we see this full list he has described, as well as many other chronic overlapping conditions.
Low back pain, TMJ dysfunction and extreme fatigue are all concurrent conditions we are managing in our office along with the more traditional abdominal and pelvic symptoms.
While we know this is not just a disease related to menstruation, there are many other signs and symptoms that come up during this time. There may be nausea and vomiting associated with menstruation. It is not uncommon for there to be lost days of school and/or work due to the severity of the pain or other symptoms.
Other concurrent conditions that are common include anxiety and depression. When you take all of the abdominal, pelvic and total mind/body systems that are affected, there is a need to address our central nervous system in order to heal. Our central nervous system is what is relaying and processing all of these different inputs and because there is essentially so much it is needing to sort through, the signals it receives start to amplify each new sensation. Think of it as a speaker with the sound turning louder and louder with each new input. So if one had just one or two inputs, they may be able to manage them, but with each additional input, the dial gets turned up and harder to ignore. This is why an interdisciplinary team of providers – ones that are communicating with each other and individualizing care to the patient – is essential for those with endometriosis to begin to heal. Assessing the endometriosis lesions, but also the system-wide effects on our nervous system and pain processing, are the key to recovery.