9 Symptoms Never to Ignore With Endometriosis

Medically Reviewed By William C. Lloyd III, MD, FACS
  • About 10 to 20% of women of child-bearing age experience endometriosis, a painful condition where cells from the lining of your uterus grow outside the uterus and multiply in places where endometrial tissue does not belong. This condition can lead to infertility and other complications—even, in rare instances, kidney failure. Too often, women put up with debilitating symptoms. Yet, there are treatments that can help—if you don't ignore what your body is telling you. Be aware of these nine endometriosis symptoms.

  • 1
    Extremely painful periods
    Cropped image of Caucasian woman holding pelvis in pain or discomfort

    Does your period leave you doubled over with the heating pad for hours on end, unable to work or engage in other daily activities? Excessive period pain (dysmenorrhea) is common in endometriosis, and shouldn't be ignored—especially if it doesn't go away with medications like ibuprofen or birth control pills, and if it worsens over time. However, not all women with endometriosis have this symptom. Endometriosis is classified in four stages, with stage 4 endometriosis being the most advanced. Yet, some stage 4 women have little to no period pain, while women with less-severe stage 1 endometriosis may find themselves in agony.

  • 2
    Tummy troubles
    Young woman on couch with stomach cramps

    Some women find their periods bring not just bleeding and cramps, but also other nether-region symptoms: diarrhea, constipation, bloating or nausea. Gastrointestinal issues during or near your period can be signs of endometriosis. This is caused by fragments of endometrial tissue setting up shop inside your abdomen or bowel, then swelling and bleeding during menstruation. Symptoms include persistent diarrhea, a feeling of fullness in your tummy, bleeding from the rectum, or seeing blood in your stool.

  • 3
    Heavy periods
    Close-up of woman putting feminine liner or pad in black purse

    Are you changing your tampons or pads every 1 to 2 hours? Heavy bleeding during your period (called menorrhagia) can be a sign of endometriosis. This is because endometrial tissue that has relocated to places like your ovaries or intestines also bleeds during your period, in addition to the normal endometrial tissue shed from the lining of your uterus. Another sign: longer-than-normal periods. If you have endometriosis, your periods may last 7 days or even longer, while typical periods last 3 to 5 days.

  • 4
    Painful sex
    Woman ignoring husband in bed

    Feeling pain during sex (which is called dyspareunia) can be a sign of endometriosis. In fact, women with endometriosis are nine times more likely to have this problem than women without it. Typically, the pain occurs during deeper penetration, rather than during entry, due to the presence of inflamed endometrial tissues in your pelvis outside the uterus. The good news is this endometriosis symptom can be largely relieved following endometrial removal surgery.

  • 5
    Infertility
    Couple holding hands while talking to doctor

    If you have been trying to conceive and not having success, your doctor may check to see if endometriosis is the cause. From one-third to one-half of women with endometriosis have trouble getting pregnant. Endometrial tissue can cover and block your fallopian tubes, among other reproductive complications. It is possible to remove endometrial tissue through laparoscopic surgery—a procedure that can improve your ability to conceive a child. If you have endometriosis during pregnancy, it is unlikely to create problems—and may even reduce symptoms while you are pregnant.

  • 6
    Pain running from your lower back through your legs
    Young business woman at desk with back pain

    In rare cases, endometrial tissue can find its way to your kidneys. Left untreated, this could ultimately lead to kidney failure. It can also cause pain, as endometrial cysts accumulate in the kidneys and area surrounding it. During your period, you may feel pain in your lower back, running down your legs. Other endometriosis kidney symptoms include blood in your urine during your period, difficulty urinating or recurrent urinary tract infections. Because endometriosis of the kidneys is so rare (less than 1% of all endometriosis cases), doctors may misdiagnose the problem as kidney cancer. It is treatable with surgery and medications.

  • 7
    Feeling tired all the time
    stressed young woman removing glasses and rubbing eyes in office in front of laptop

    If you feel deeply exhausted along with other symptoms of endometriosis, bring this up with your healthcare provider. About half of women with endometriosis report frequent fatigue, compared to about 22% of women who don't have it. Doctors suspect one reason for this persistent and common system is that endometriosis engages the immune system. As your immune system tries to fight “diseased” endometrial tissue invading organs in your body, your immune system creates a painful, inflammatory response, which leads to fatigue (just as you feel tired when you have the flu).

  • 8
    Nerve pain in your legs and feet
    Woman Holding Painful Toenail

    With this endometriosis complication, endometrial lesions build around nerves, causing pain in your lower extremities—your legs and feet. This may feel like a constant, sharp and throbbing pain that worsens when you walk or exercise. This pain is neuropathy, and should be reported to your doctor, along with any other endometriosis symptoms. However, sometimes physicians suspect other, more common causes of neuropathy first, such as tendinitis, so you may need to consult with a gynecologist who specializes in endometriosis.

  • 9
    Coughing up blood
    gettyimages-1188576496.jpg

    In rare cases, endometrial tissue can travel to the chest, creating a condition called thoracic endometriosis. The most common symptom is chest pain either right before or during your period. You also may have shoulder pain and shortness of breath, as well as other endometriosis symptoms, such as painful periods. Some women cough up blood during their periods. Others even suffer menstruation-related lung collapse. If you notice chest-related symptoms that come and go with your period, bring this to your doctor's attention.

    When your doctor knows what symptoms you are experiencing and their impact, he or she can develop a treatment plan to help relieve the unpleasant and sometimes dangerous consequences of endometriosis.

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  1. Thoracic Endometriosis. Endometriosis News. https://endometriosisnews.com/thoracic-endometriosis/
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  8. Think You May Have Endometriosis? Signs and Symptoms You Shouldn't Ignore. Endometriosis Foundation of America. https://www.endofound.org/think-you-may-have-endometriosis-signs-and-symptoms-you-shouldnt-ignore
  9. Endometriosis Symptoms: Red Flags or Gray Areas? Cleveland Clinic. https://health.clevelandclinic.org/endometriosis-symptoms-red-flags-or-gray-areas/
  10. Endometriosis. National Health Service Inform. https://www.nhsinform.scot/illnesses-and-conditions/sexual-and-reproductive/endometriosis
  11. Endometriosis Stages. Endometriosis News. https://endometriosisnews.com/endometriosis-stages/

Medical Reviewer: William C. Lloyd III, MD, FACS
Last Review Date: 2020 Sep 2
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