Most women who have endometriosis, in fact, do not have symptoms. Of those who do experience symptoms, the common symptoms are pain (usually pelvic) and infertility. Endometriosis symptoms can be different and severity depends on the woman and the timing of the menstrual cycle.
Absence of symptoms
Endometriosis may not produce any specific symptoms, and the women may not be aware of the condition. In fact, most women with endometriosis do not have any specific symptoms of the condition. Sometimes endometriosis can be discovered only because of infertility.
Endometriosis symptoms – Pelvic pain
The most common symptom noted by women with endometriosis is pelvic pain that is worse just before menstruation, which then improves at the end of the menstrual period. Women often describe the pain as a constant, aching pain that is deep and often spreads to both sides of the pelvic region, the lower back, abdomen, and buttocks. Pelvic pain usually occurs during or just before menstruation and lessens after menstruation.
Pelvic pain in women with endometriosis depends partly on where the implants of endometriosis are located.
- Deeper implants and implants in areas with many pain-sensing nerves may be more likely to produce pain;
- The implants may also produce substances that circulate in the bloodstream and cause pain;
- Pain can result when endometriosis implants form scars. There is no relationship between severity of pain and how widespread the endometriosis is (the “stage” of endometriosis).
Endometriosis symptoms – Menstrual pain and/or Menstrual Cramps
Endometriosis symptoms – pain
Pain during menstruation (called “dysmenorrhea”) is very common symptom of endometriosis. The age at which endometriosis develops varies considerably. Some adolescent women note painful menstruation when their periods first begin. This condition is later diagnosed as endometriosis, while other women are in their 20s, 30s, or older before endometriosis is diagnosed.
The menstrual pain intensity can change from month to month, and vary greatly among women. Some women experience progressive worsening of menstrual cramps, while others can have resolution of pain without treatment.
Endometriosis symptoms – Dyspareunia
Pain during sexual intercourse called “dyspareunia” which could be the main disturbing symptom of endometriosis. Some women could experience painful sexual intercourse (dyspareunia) or cramping during intercourse, and or/pain during bowel movements and/or urination. Even pelvic examination by a doctor can be painful.
Endometriosis symptoms – Infertility
Infertility is a common symptom of endometriosis. The exact mechanism by which endometriosis causes infertility is not clear – it may involve physical blocking of the Fallopian tubes due to implants or scarring, or hormonal factors related to the presence of the endometriosis implants. The reasons for a decrease in fertility are not completely understood, but might be due to both anatomic and hormonal factors.
In most cases during laparoscopic examinations (performed for infertility evaluations) endometrial implants can be found on or under the ovaries, behind the uterus, on the tissues that hold the uterus in place and/or on the bowels or bladder.
The presence of endometriosis may involve masses of tissue or scarring (adhesions) within the pelvis that may distort normal anatomical structures, such as Fallopian tubes, which transport the eggs from the ovaries. Alternatively, endometriosis may affect fertility through the production of hormones and other substances that have a negative effect on ovulation, fertilization of the egg, and/or implantation of the embryo.
Endometriosis symptoms – Severe abdominal pain
An area of endometriosis on the ovary that has become enlarged is referred to as endometrioma. When the center of this fills with blood, it is known as a chocolate cyst, referring to the appearance of the tissue. Chocolate cysts can become very painful, mimicking the symptoms of other ovarian problems.
Endometriosis symptoms – Rare symptoms
Other symptoms related to endometriosis include:
- brown vaginal discharge and/or brown spotting before and after period,
- diarrhea and/or constipation,
- low back pain,
- irregular or heavy menstrual bleeding,
- blood in the urine,
- chest pain,
- coughing blood (due to endometriosis in the lungs),
- headache and/or seizures due to endometriosis in the brain.
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