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Endometriosis Symptoms: Pain, Bleeding & More
Endometriosis symptoms include severe menstrual pain, chronic pelvic pain, and infertility. Learn which signs may indicate endometriosis and when to seek medical advice.
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Endometriosis symptoms include severe menstrual pain, chronic pelvic pain, and infertility. Learn which signs may indicate endometriosis and when to seek medical advice.
What is Endometriosis?
Endometriosis is a chronic gynecological condition in which tissue similar to the lining of the uterus (endometrium) grows outside the uterus. This tissue responds to the hormonal cycle and can cause inflammation, scarring, and significant pain. Approximately one in ten women of reproductive age is affected worldwide.
Common Symptoms of Endometriosis
The symptoms of endometriosis vary widely from person to person. In some cases, the condition may initially cause no noticeable complaints. The most common symptoms include:
Pain
- Dysmenorrhea: Severe, cramping menstrual pain that goes beyond normal and disrupts daily life.
- Chronic pelvic pain: Persistent or recurring lower abdominal pain, independent of menstruation.
- Dyspareunia: Pain during sexual intercourse, especially with deep penetration.
- Dyschezia: Painful bowel movements, particularly during menstruation.
- Dysuria: Pain or burning sensation when urinating, especially around the time of the period.
Bleeding Irregularities
- Heavy menstrual bleeding (menorrhagia): Abnormally heavy or prolonged periods.
- Spotting or irregular bleeding between periods.
- Blood in urine or stool during menstruation (when the bladder or bowel is affected).
Other Symptoms
- Infertility: Endometriosis is one of the leading causes of female infertility.
- Fatigue and exhaustion: Chronic tiredness driven by the condition and ongoing pain burden.
- Bloating, nausea, or digestive issues, especially around the time of menstruation.
- Back pain that may radiate into the legs or groin.
When to Seek Medical Advice
If menstrual pain is so severe that it limits daily activities, work, or social life, medical advice should be sought promptly. Recurring pelvic pain, pain during intercourse, or difficulty conceiving are also strong reasons to consult a gynecologist. Since the diagnosis of endometriosis takes an average of several years, early medical evaluation is especially important.
Diagnosis
Endometriosis is typically diagnosed through a combination of gynecological examination, ultrasound (sonography), and in many cases a laparoscopy (keyhole surgery), during which tissue samples can be taken and examined under a microscope. Imaging techniques such as MRI may also be used to assess the extent of the condition.
Treatment
There is currently no cure for endometriosis, but symptoms can be effectively managed. Treatment options include:
- Pain relief medication: Non-steroidal anti-inflammatory drugs (NSAIDs) such as ibuprofen to reduce pain.
- Hormonal therapies: Progestogens, the contraceptive pill, GnRH analogues, or a hormonal IUD to suppress the growth of endometrial tissue.
- Surgical treatment: Surgical removal of endometriosis lesions, typically performed by laparoscopy.
- Physiotherapy and complementary approaches: To support pain management and improve quality of life.
References
- World Health Organization (WHO) - Endometriosis Fact Sheet (2023). Available at: https://www.who.int/news-room/fact-sheets/detail/endometriosis
- Zondervan, K.T. et al. - Endometriosis. New England Journal of Medicine, 382(13), 1244-1256 (2020).
- European Society of Human Reproduction and Embryology (ESHRE) - Guideline on Endometriosis (2022). Available at: https://www.eshre.eu/Guidelines-and-Legal/Guidelines/Endometriosis-guideline
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