Endometriosis : 5 Common Signs and When to See a Doctor

Endometriosis : 5 Common Signs and When to See a Doctor

Endometriosis is a chronic condition that affects millions of women worldwide, yet it remains one of the most misunderstood and underdiagnosed areas of women’s health.

By the time a patient receives a formal diagnosis, they have often suffered for nearly a decade.

Understanding the signs, causes, and treatment options is the first step toward reclaiming your quality of life.

What is Endometriosis?

Endometriosis occurs when tissue similar to the lining of the uterus (the endometrium) grows in other parts of the body. Most commonly, this tissue is found on the ovaries, fallopian tubes, and the lining of the pelvis.

Unlike the lining of the uterus, which leaves the body during a period, this ectopic tissue has no way to escape. It continues to thicken, break down, and bleed with every hormonal cycle, leading to inflammation, internal scarring (adhesions), and significant pain.

5 Common Signs of Endometriosis

If you experience these symptoms, it is important to track them and discuss them with your doctor.

1. Dysmenorrhea (Painful Periods)

This is not “normal” cramping. Endometriosis pain is often severe, begins several days before the period, and may worsen over time. If your period pain prevents you from going to work or school, it requires investigation.

2. Chronic Pelvic Pain

Many women experience non-menstrual pelvic pain that feels like a heavy, dragging sensation. This pain can radiate to the lower back and down the legs.

3. Dyspareunia (Pain During Intercourse)

Pain during or after sex is a common but often “taboo” symptom of endometriosis. This is typically caused by the stretching of scarred or inflamed pelvic tissues.

4. Bowel and Bladder Issues

Because the tissue can grow near the intestines or bladder, you may experience painful bowel movements, diarrhea, constipation, or a frequent urge to urinate—particularly during your period.

• Note: This often leads to a misdiagnosis of Irritable Bowel Syndrome (IBS).

5. Infertility

For some women, the first sign of endometriosis is difficulty conceiving. Between 30% and 50% of women with endometriosis struggle with fertility, as the condition can cause blockages or inflammation that affects the egg and sperm.

When to See a Doctor

You should book an appointment with your GP if:

• Your period pain is not relieved by over-the-counter painkillers.

• You are missing school or work due to pelvic pain.

• You experience pain during sex or when using the bathroom.

• You have been trying to conceive for over a year without success.

Top Tip: Keep a “pain diary” for two months before your appointment. Documenting when the pain happens in relation to your cycle helps your doctor spot patterns and can reduce the average 7–8 year delay in diagnosis.

Causes and Risk Factors

While the exact cause is unknown, the most common theory is Retrograde Menstruation, where menstrual blood containing endometrial cells flows backward through the fallopian tubes and into the pelvic cavity.

Risk factors include:

• Family History: Having a mother or sister with the condition.

• Early Menarche: Starting your period before age 11.

• Short Cycles: Having periods more frequently (cycles less than 27 days).

• Nulliparity: Never having given birth.

Diagnosis: The “Gold Standard”

Diagnosis often begins with a pelvic exam, ultrasound, or MRI. However, smaller endometriosis lesions are frequently invisible on these scans.

• Laparoscopy: This is the only way to definitively diagnose endometriosis. A surgeon performs a minor procedure using a small camera to look inside the pelvis and take a tissue sample (biopsy).

Treatment Options

While there is currently no cure, endometriosis can be managed through a combination of approaches:

Summary

Endometriosis is a complex, whole-body disease. Remember: Severe period pain is not normal. Early intervention can prevent the progression of the disease and protect your future fertility.