Generally, the symptoms you experience will depend on where your endometriosis is located and how extensive the growth is; however, there is not always a direct correlation between the extent of the disease and the symptoms. Some women have very little endometriosis but lots of pain and others have severe endometriosis with no pain.
The symptoms are different for every woman. In fact, some women with endometriosis may not experience any symptoms at all, and will never be aware they have the disease. But for other women, the pain associated with endometriosis can lead to fatigue, feelings of depression and isolation, problems with sex and relationships, and difficulty fulfilling work and social commitments.
Pelvic pain can mean many different things.
Daily pelvic pain may be a sign of problems with your bladder, bowels, reproductive organs or pelvic muscles. Many conditions, other than endometriosis, can cause pelvic pain, including internal scarring, chronic appendicitis, irritable bowel syndrome, interstitial cystitis and hernias, as well as endometriosis.
Keep a diary
Write down when and where you have pain or other symptoms of endometriosis. Include details about what factors increase or decrease the symptoms and in what ways they affect your lifestyle. This information can help your health care provider make diagnosis and treatment decisions.
Common symptoms
The most common symptom of endometriosis is pelvic pain. This pain often occurs before or during menstruation, but may also be experienced at other times. Symptoms are not the same for every woman, and depend on the location of the endometriosis.
Severe menstrual cramps
Menstrual cramps caused by endometriosis are different from normal menstrual cramps — they are more severe and may begin earlier in the menstrual cycle and last longer.
Painful intercourse
Endometriosis can cause pain to be felt deep in the abdomen and/or pelvis during or following sex.
Painful urination or bowel movements
With endometriosis, these types of pain may be experienced during menstruation. In cases where the bowel and bladder are severely affected by endometriosis, pain may be felt even between periods.
Lower back, abdominal pain or chronic pelvic pain
Some women may experience abdominal and pelvic pain that is not associated with their menstrual cycles, but which occurs on a daily basis and which has lasted for six months or longer.
Other gastrointestinal upsets such as diarrhea, constipation and nausea
For women with endometriosis, these symptoms may be experienced during menstruation.
Rare symptoms
In very rare cases, the growth of endometriosis is very extensive and the following symptoms might be experienced, usually when you are having your period.
Leg pain or sciatica
This type of pain suggests that the endometriosis is affecting nerves.
Rectal bleeding or blood in the urine
This type of pain suggest that the endometriosis is affecting the bowel or bladder.
Shortness of breath
This symptom suggests that the endometriosis may be affecting the lungs or diaphragm.
Infertility
If you have endometriosis, it may be more difficult to become pregnant. If you have endometriosis and have not conceived after having regular, unprotected sex for a year, you may be experiencing infertility problems associated with endometriosis. But the good news is that many women with endometriosis are able to conceive — it may just take longer.
Endometriosis is only found in five per cent of fertile women — but its prevalence in infertile women ranges from 25 to 50 per cent. Unfortunately, we don’t fully understand what causes endometriosis-associated infertility. In women with extensive endometriosis, scarring can result in blocked Fallopian tubes or ineffective egg release by the ovaries. However, this does not explain infertility in women with minimal or mild endometriosis. It is possible that inflammation, immune response may be at the root of the problem.
Treatment of infertility caused by endometriosis involves either surgical removal of endometriotic tissue (for example, with laparoscopy ) or assisted reproductive technology. Despite lots of research, we don’t fully understand the association between endometriosis and infertility. Sometimes surgery or assisted reproductive technology can help women conceive, but these are not always effective.