It's easy to miss the symptoms of endometriosis. They might simply be written off as just part of having a period. That's at least partly why so many women have endometriosis but don't know it. Some women have no symptoms, while other women experience severe symptoms. Treatment can ease the symptoms, but first you need a diagnosis. That's why it's important to talk with your doctor if you have pain or other unusual symptoms. Don’t ignore these warning signs: Pain Pain is the most common symptom. Endometriosis can cause pain in several ways. Some women experience very severe menstrual cramps—these cramps are so severe that medication doesn't help. They make it difficult to get through daily activities. Other women have pain in the lower back or pain in their pelvis. Pain may even spread to the legs or abdominal area. Endometriosis may also cause pain during or after sex. Women usually feel pain around the time of their periods, but some women experience pain all the time. Long and Heavy Periods Endometriosis causes periods to be unusually long. Periods lasting longer than seven days are a warning sign of endometriosis. So are very heavy periods. This means periods with bleeding so heavy that you soak through a pad or tampon every hour or two throughout most of your period. Infertility If you’re struggling to get pregnant, endometriosis may be to blame. Sometimes infertility is the first sign of endometriosis. Treatments, including surgery to remove the endometrial tissue, may help women with endometriosis become pregnant. Digestive Problems Endometriosis can cause issues with digestion. Constipation, diarrhea, bloating, vomiting and nausea are all warning signs of possible endometriosis. These symptoms tend to be worse during your period, but may happen at any time. Bleeding Between Periods Spotting or any level of bleeding when it’s not time for your period can be a warning sign of endometriosis. There are many possible causes of bleeding between periods. Talk with your doctor about what could be to blame. Bladder and Bowel Problems Some women with endometriosis have trouble with urination and bowel movements. Endometriosis can cause painful urination. It can also make you feel like you need to urinate more often. Sometimes there may be blood in the urine. Some women find that they have pain during bowel movements if the endometrial tissue affects the bowels. Also be aware that endometriosis is sometimes misdiagnosed as irritable bowel syndrome, ovarian cysts, pelvic inflammatory disease, and other conditions. These symptoms, either alone or in combination, warrant a visit to your doctor. Your Ob/Gyn will need a detailed account of your symptoms. Then, you’ll have a physical exam and possibly some imaging tests to determine if you have endometrial tissue.