Sexual Health Reproductive Health Issues Uterine Conditions Endometriosis Endometriosis Guide Endometriosis Guide Symptoms Causes Diagnosis Treatment Coping Symptoms of Endometriosis By Rachel Gurevich, RN Rachel Gurevich, RN Facebook LinkedIn Twitter Rachel Gurevich is a fertility advocate, author, and recipient of The Hope Award for Achievement, from Resolve: The National Infertility Association. Learn about our editorial process Updated on October 21, 2021 Medically reviewed Verywell Health articles are reviewed by board-certified physicians and healthcare professionals. These medical reviewers confirm the content is thorough and accurate, reflecting the latest evidence-based research. Content is reviewed before publication and upon substantial updates. Learn more. by Monique Rainford, MD Medically reviewed by Monique Rainford, MD Monique Rainford, MD, is board-certified in obstetrics-gynecology, and currently serves as an Assistant Clinical Professor at Yale Medicine. She is the former chief of obstetrics-gynecology at Yale Health. Learn about our Medical Expert Board Print Table of Contents View All Table of Contents Painful Menstrual Cramps General Pelvic Pain Painful Sexual Intercourse Heavy Menstrual Periods Infertility Depression and Fatigue Bladder Problems Constipation and/or Diarrhea Family History Frequently Asked Questions Next in Endometriosis Guide Can You Do Anything to Prevent Endometriosis? Endometriosis symptoms vary from woman to woman. Some women will have many symptoms. Others will have no symptoms. Some may experience severe pain with menstruation, making diagnosis slightly easier. Others will only have vague, difficult-to-pinpoint symptoms. They know something is wrong but can't figure out what. To make things even more confusing, the symptoms of endometriosis can also be caused by other conditions and diseases. With that being said, the following are potential risk factors and symptoms of endometriosis. If you're experiencing any of these symptoms, speak to your healthcare provider. Keep in mind that the average time to receive an endometriosis diagnosis is 10 years. If you have described your symptoms to your healthcare provider, only to be told it's "in your head," consider seeing someone else. The only way to diagnose endometriosis is with a laparoscopy. Just reviewing your symptoms or even having an ultrasound isn't enough. Verywell / JR Bee Painful Menstrual Cramps Painful menstrual cramps may be a sign of endometriosis. However, menstrual cramps can be caused by other conditions, too. Mild cramping around the time of your period is quite common. This is especially true for teenagers who have just started menstruating. With that said, cramps caused by endometriosis are more intense. They may cause nausea, vomiting, or diarrhea. Some women with endometriosis are forced to miss work or school during their period—the pain interferes with their daily life. General Pelvic Pain Some women with endometriosis will have pelvic pain throughout their cycles, and not just during menstruation. It’s important to note that the amount of pelvic pain you experience doesn’t necessarily correlate to the severity of the endometriosis. You can have mild endometriosis and suffer from severe pelvic pain or have severe endometriosis and have little or no pelvic pain. Painful Sexual Intercourse Painful intercourse is another potential symptom of endometriosis. Intercourse may be painful only in certain positions, specifically during deep penetration. The pain may also come and go throughout the menstrual cycle. Some women with endometriosis have more pain around the time of ovulation. This can interfere with getting pregnant since you may be less likely to have sex around your most fertile time. Heavy Menstrual Periods Women with endometriosis may have heavier bleeding and longer lasting menstruation. They may have spotting between periods and may also get their periods more frequently. Infertility According to the American Society for Reproductive Medicine, endometriosis may be found in up to 50% of infertile women. As we said above, not every woman with endometriosis will show symptoms such as painful periods. Some women only find out about the endometriosis while being evaluated for infertility. Depression and Fatigue Depression and fatigue can result from endometriosis. They are most likely caused by other symptoms of the disease. For example, you may feel exhausted and depressed from dealing with pain throughout your cycle or period. Infertility and a difficult sex life (from painful intercourse) can lead to depression or anxiety. Bladder Problems Endometriosis can also cause blood in the urine and pain upon urinating. You may experience frequent urination and urgency. In severe cases of endometriosis, endometrial tissue may grow around or even inside the bladder, leading to pain and bleeding. If you experience bleeding when you urinate, contact your healthcare provider. Constipation and/or Diarrhea Some women with endometriosis deal with on-and-off constipation or diarrhea. It may get worse around the time of menstruation. Also, some women will experience pain during bowel movements or when passing gas. In severe cases, endometriosis may develop within the bowel itself. Some women with endometriosis are also diagnosed with IBS. Family History While the cause of endometriosis is not understood, there may be a genetic link to the disease. Some experts say that if you have a mother or sister with endometriosis, your chances of developing the disease is about 7%. Having a first-degree relative with endometriosis may also increase the risk of having a more severe case. Frequently Asked Questions How can you ease endometriosis pain? Pain caused by endometriosis can be eased with home remedies such as warm baths, rest, regular exercise, and a heating pad on the abdomen. Mild pain may be relieved with over-the-counter pain relievers such as Advil (ibuprofen) or Tylenol (acetaminophen), but prescription medications may be needed, as well. What are the stages of endometriosis? There are 4 stages of endometriosis. Stage I indicates minimal disease with very few endometrial implants and no scar tissue, whereas Stage II is considered mild disease in which the number and depth of implants increase and there may be scar tissue. Stage III, or moderate disease, means there are several deep endometrial implants and endometrial cysts in at least one ovary. Stage IV is severe, in which numerous implants and cysts are present and multiple therapies, including multiple surgeries, may be necessary to manage it. Causes and Risk Factors of Endometriosis Was this page helpful? Thanks for your feedback! Sign up for our Health Tip of the Day newsletter, and receive daily tips that will help you live your healthiest life. Sign Up You're in! Thank you, {{form.email}}, for signing up. There was an error. Please try again. What are your concerns? Other Inaccurate Hard to Understand Submit 7 Sources Verywell Health uses only high-quality sources, including peer-reviewed studies, to support the facts within our articles. Read our editorial process to learn more about how we fact-check and keep our content accurate, reliable, and trustworthy. Endometriosis Foundation of America. Endometriosis: Fast Facts Endometriosis Foundation of America. What Is Endometriosis? Causes, Symptoms and Treatments American College of Obstetricians and Gynecologists. Endometriosis Endometriosis Foundation fo America. Endometriosis Symptoms: Infertility Endometriosis Foundation of America. Endometriosis Symptoms American College of Obstetricians and Gynecologists. Endometriosis Johns Hopkins Medicine. Endometriosis. 2021. Additional Reading Endometriosis: A Guide for Patients. American Society of Reproductive Medicine. Endometriosis. A.D.A.M. Healthcare Center.