The tricky thing about endometriosis is it has a vast array of symptom presentation! However, at PRM our providers are on the “front lines of Endo” because we treat the pelvic floor nerves and muscles and focus on symptoms associated with intercourse, bladder, and bowel as well as any pain or discomfort from the belly button to the mid-thigh. This covers a lot of the top 20 most common symptoms of endometriosis!

What is endometriosis?

Endometriosis is a disease in which tissue, similar to the lining of the uterus, grows outside of the uterus. While the cause of endometriosis is unknown, the impact on patients’ health can be severe. The pH balance of the tissues can be disrupted, and the muscles and nerves can be put into disarray. Neurotransmitters begin stimulating an inflammatory cascade that can cause chronic pain.

What we know:

  • Endometrial lesions are typically found in the pelvis, but they can occur at other locations, including the bowel and diaphragm.
  • Endometriosis is common – with 1 in 9 women suffering from this disease – and it can cause several serious comorbidities, as well as chronic pain and infertility.

What are the biggest signs of endometriosis?

Symptoms range from minor to severely debilitating and patients’ primary symptoms are often chronic pelvic pain. However, that can vary and our providers have seen it all! The most common symptoms of endometriosis I see are GI complaints such as abdominal bloating, abdominal pain, constipation, and pain/discomfort with bowel movements.

Classically, all the below symptoms are worse when patients are on their menstrual cycle. However, if it persists for a long time, they may become constant and not cyclical. This all being said, please see what I believe are the most 20 common symptoms of Endo not in any particular order:

  1. Severe Menstrual Cramps- that cause you to miss school, work, social events
  2. Pain with Menstruation
  3. Pain with Intercourse
  4. Sacral and Low Back Pain with Periods
  5. Heavy Bleeding during menstruation
  6. Abdominal Bloating
  7. Abdominal Pain
  8. Rectal Pain
  9. Constipation
  10. Pain or Discomfort with Bowel Movements
  11. Blood in Stool During Menstrual cycle
  12. Vaginal Pain – “Hot poker in Vagina”
  13. Vulvar Pain
  14. Superficial Entrance Pain with Intercourse
  15. Soreness or Pelvic Pain Flare Post Intercourse
  16. Bladder Pain
  17. Burning with Urination
  18. Urinary Urgency or Frequency
  19. Infertility
  20. Pelvic Pain Worse with Prolonged Sitting/Biking

How can I check if I have endometriosis?

It’s true that pain is one of the most common symptoms of endometriosis, and many of the symptoms above are pain driven; however, it’s important to note that the level of pain is not a good indicator of the extent of the condition or a way to check if you have endometriosis. When it comes to certain symptoms I like to encourage patients to ask questions about their symptoms – they know their bodies best!

One important question to ask about bloody stool is: does it happen during the menstrual cycle only? This can happen in Endo. Our patients are often given the diagnosis of IBS as the GI work was “normal” and the symptoms correlate.

Of course, pain with intercourse is also extremely common. Typically pain with intercourse is on deep penetration, and we like to ask about certain positions that may cause pain and those that do not.

Endometriosis patients can also have superficial pain or entrance pain, and sometimes have what we call Vulvodynia or pain in the Vulvar area. This is from inflammation and irritation of the pelvic nerves from the Endo and myofascial restrictions. Sometimes patients state they have a “pelvic pain flare” after intercourse. This is most likely because the inflamed pelvic nerves and muscles are used to have intercourse and since they are irritated from the Endo they cause muscles spasms and nerve pain symptoms.

Bladder symptoms again are also super common. We hear a lot “it felt like I had a UTI that never when away”. Endo patients can also have Bladder Pain Syndrome/Interstitial Cystitis so it’s common for them to have pain with bladder filling, urinary urgency, frequency, and nocturia. Nocturia is where they get up to urinate frequently during the night.

We can help if you think you might have endometriosis

Unfortunately, we know that 75% of women with endometriosis have experienced a misdiagnosis. At Pelvic Rehabilitation Medicine, we want to change the standard of care for women suffering with endometriosis. We believe that endo patients deserve options when it comes to their treatment – we believe they deserve to heal from their pain.

We are pelvic pain specialists who offer a whole-body approach to endo. We provide a functional, restorative approach to persistent pelvic pain that has proven to help decrease pain and restore function. We design a treatment plan tailored to your individual needs. Our goal is to help you enjoy an active, pain free lifestyle. 

Do you think you might have endometriosis? Take our common symptoms quiz and assess your own symptoms to learn more.