8 Signs You Could Have Endometriosis

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    Know the Signs of Endometriosis for Diagnosis
    Endometriosis, in which uterine tissue grows outside the uterus, is a common condition that often goes undiagnosed for years. Because two hallmarks of endometriosis, period pain and heavy bleeding, are often considered “normal” by many women, they may not think to talk with their doctor about the problem. Understanding the signs and symptoms of endometriosis can often be the first step to a diagnosis and successful treatment.

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    1. Endometriosis can cause severely painful periods.
    One of the most common symptoms of endometriosis is intense pelvic or abdominal pain during your period, which may feel like a sharp or stabbing sensation. If you have endometriosis, your periods are painful because endometrial tissue swells and bleeds each month, just like the uterine lining. Because it is outside the uterus, the blood and tissue may not be easily shed. The extra pressure can cause pain that is far more uncomfortable than typical menstrual cramps. It is not normal for period pain to disrupt your daily life. If it seems unbearable, let your doctor know.

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    2. Endometriosis can also cause chronic or ongoing pain.
    Though endometriosis is often associated with period pain, you can have discomfort any time of the month. Endometrial tissue can adhere to reproductive organs or spaces in the pelvic cavity, including ligaments or areas between the bladder, uterus, vagina or rectum. The nodules and scar tissue of endometriosis can cause lower back pain or pain anywhere in the pelvic region by pressing on organs. It may get worse around your period, but it may not go away when you are not menstruating.

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    3. Endometriosis can make sexual intercourse painful.
    Pain during sex, called dyspareunia, can have various causes, both physical and psychological. If endometriosis is the cause, you may not feel discomfort upon entry but experience serious pain during deep penetration. That may be because, when endometrial tissue grows behind the vagina or lower uterus, intercourse can pull or stretch the tissue. Asking your partner to be gentle, and stop if you say to, can help you avoid pain during sex. Your doctor can advise you on treatments which can reduce or eliminate the symptoms of endometriosis, including pain during sex.

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    4. Endometriosis often causes excessive menstrual bleeding.
    Menorrhagia, or heavy menstrual bleeding, is not uncommon, but endometriosis can increase blood loss because the tissue sheds and bleeds just like the tissue in your uterine lining. If you soak through tampons or sanitary napkins once an hour, bleed for more than a week, pass large blood clots, or cannot continue your daily activities, it’s possible you have menorrhagia, which could be due to endometriosis. Left untreated, heavy periods can cause fatigue and possible anemia, so see your gynecologist about treatment.

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    5. Endometriosis can make it difficult to get or stay pregnant.
    As many as half the women who have a hard time getting or staying pregnant have endometriosis. The exact relationship between infertility and endometriosis isn’t always clear and there can be many factors affecting fertility. However, when there are endometrial implants (tissue) on the reproductive organs, it can block fertilization. If you are actively trying to have a baby and have not become pregnant within a year, talk with your doctor. Women with endometriosis can get pregnant, and treating the condition can increase your odds of having a baby.

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    6. Endometriosis can make urination or bowel movements painful or difficult.
    If endometrial tissue is growing near your bowel or bladder or within the walls of these organs, it can make bathroom visits problematic. The bowel is more commonly affected than the bladder, but either or both may have endometrial implants. If you see blood in your stool, experience constipation or nausea, or feel an urgent need to urinate—especially, during your period—tell your gynecologist. Your doctor may recommend hormone therapy or surgery to alleviate your symptoms.

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    7. Ovarian cysts can be a form of endometriosis.
    A type of endometriosis can develop on your ovaries and cause cysts called endometriomas, or “chocolate cysts.” They are not cancerous but they can become large and painful. If you have them, you may well have endometriosis elsewhere in your pelvic or abdominal area. Hormone therapy, a common treatment for endometriosis, may shrink them. They can also be surgically removed, but there is debate about how the procedure affects fertility.

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    8. The signs and symptoms of endometriosis can vary from woman to woman.
    Some women with extensive endometriosis have no symptoms, and others who have only a small area of endometrial tissue have a great deal of pain. Because the signs and symptoms are easily confused with other conditions, endometriosis is often misdiagnosed or overlooked. However, it can often be successfully treated with hormone therapy, minimally invasive surgery, or other procedures. If you have signs or symptoms of endometriosis, talk with your healthcare provider.

8 Endometriosis Symptoms and Warning Signs

About The Author

Nancy LeBrun is an Emmy- and Peabody award-winning writer and producer who has been writing about health and wellness for more than five years. She is a member of the Association of Health Care Journalists and the American Society of Journalists and Authors.
  1. Endometriosis Fact Sheet. The American College of Obstetricians and Gynecologists. https://www.acog.org/about_acog/news_room/~/media/newsroom/millionwomanmarchendometriosisfactsheet.pdf
  2. Ovarian endometrioma: guidelines for selection of cases for surgical treatment or expectant management. Cleveland Clinic. https://www.clevelandclinic.org/reproductiveresearchcenter/info/2012/Carnahan-M_Fedor-J-2012.pdf
  3. Endometriomas and fertility. Endometriosis Foundation of America.  https://www.endofound.org/kristin-patzkowsky-md-endometriomas-and-fertility
  4. Endometriosis. Office of Women’s Health. https://www.womenshealth.gov/a-z-topics/endometriosis
  5. Menorrhagia (heavy menstrual bleeding). Mayo Clinic.  https://www.mayoclinic.org/diseases-conditions/menorrhagia/symptoms-causes/syc-20352829








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Medical Reviewer: William C. Lloyd III, MD, FACS
Last Review Date: 2020 Oct 14
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