Endometriosis Cramps Explained: Location and Frequency

Patients describe the pain as debilitating

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If you experience unusually painful cramps during your menstrual period, you might wonder if you have endometriosis. Pain is the most common symptom of endometriosis. People might experience different kinds of pain, including:

Some people experience pain only during their menstrual period, while others notice discomfort at other times. Symptoms might be severe or barely noticeable.

This article will explain what endometriosis cramps feel like and how to find relief.

Woman wearing pajamas lying in bed with hot water bottle for cramps

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Endometriosis Cramps Explained

Endometriosis is a condition that happens when tissue that’s similar to the lining of the uterus grows outside of the uterus, in areas of the body where it shouldn’t be. Experts have different theories about what causes endometriosis. Some believe it’s due to an immune system problem or an anatomic variation during development.

Endometrial tissue in the uterus normally thickens every month and is shed during the menstrual period, leaving the body through menstrual blood. But with endometriosis, the tissue that grows outside of the uterus can’t exit the body like tissue in the uterus does.

Because the tissue responds to hormonal stimulation, it can grow and bleed and cause problems. The bleeding can cause inflammation or irritation to the other organs in the abdomen and pelvis. The tissue can also stick together or cause scar tissue to form. This can also cause pain.

The type of pain associated with endometriosis depends on where the misplaced tissue has grown. It can grow in different places in the body. Some common sites include on the uterus, the fallopian tubes, the bladder, and the bowels or rectum, and around or inside the ovaries.

Severity of Pain

The amount of pain a person experiences from endometriosis doesn’t always correlate with the severity of the disease. Some people with very severe endometriosis don’t notice any pain. Others with more mild disease may have extreme symptoms.

Compared to Menstrual Cramps

Typically, menstrual cramps are mild to moderate. Symptoms of endometriosis can vary widely, but they can be much more intense and severe than typical menstrual cramps. Sometimes the pain is so severe that it may make you unable to go to work or school or manage your daily activities.

A person may experience endometriosis pain during their period, but symptoms can occur at other times, too.

Location and Intensity 

Endometriosis pain is commonly felt in the abdomen, lower back, or pelvis. But, where it occurs in the body might depend on where the endometrial tissue is located. People have also reported pain in the lungs, upper body, head, and lower limbs.

In surveys, people with endometriosis describe the pain as:

  • Stabbing
  • Sharp
  • Throbbing
  • Gnawing
  • Intense
  • Cramping

In one study, most of the people with endometriosis reported multiple types of pain, including:

  • Pain during their menstrual period
  • Pain during or after sex
  • Low back pain
  • Pain at ovulation
  • Pelvic pain not associated with sex, urination, ovulation, or menstrual periods
  • Painful urination
  • Rectal pain

Adenomyosis Pain

Adenomyosis is a condition that's similar to endometriosis. However, adenomyosis occurs when tissue that acts like the lining of the uterus grows in the muscular wall of the uterus. You can have both adenomyosis and endometriosis at the same time, or each of these conditions may develop on its own.

Associated Pelvic Floor Pains

Endometriosis may cause scar tissue to develop in the pelvis or a cyst (a fluid-filled sac) to form in an ovary, which can lead to pelvic pain.

In rare cases, endometriosis may affect the sciatic nerve and cause symptoms like tingling, pressure, and radiating back pain that travels down the leg.

Frequency: Cyclical or Chronic

Endometriosis is considered a chronic disease. Some people experience symptoms that are continuous or occur with specific activity (such as sex). Others notice cyclical discomfort, meaning it worsens and improves at different times, often during their menstrual period.

Other Symptoms

Besides pain, endometriosis can cause other symptoms and complications, including:


Certain triggers might worsen symptoms of endometriosis. Hormonal changes during a person's menstrual cycle are a common cause.

Some research has shown certain foods or substances may also trigger symptoms, although the studies conducted are generally subject to bias, and therefore no definitive treatment guidelines can be drawn. The Endometriosis Foundation of America suggests avoiding the following:

  • Processed foods
  • Caffeine
  • Alcohol
  • Soy
  • Dairy
  • Red meat
  • Gluten
  • Sweets and high-fat foods
  • Nonorganic foods

Always consult with a healthcare provider before making significant dietary changes.

Steps to Take for Debilitating Cramps 

Painful cramps can interfere with daily activities, but there are some simple lifestyle habits that can lessen the discomfort.


Taking good care of yourself and managing stress levels may help you better deal with pain. You should consume a healthy diet and exercise daily if possible. Additionally, getting enough rest is important for your overall health, especially if you’re dealing with chronic pain.

Heat Therapy

Some people find that heat therapy can help relieve cramping symptoms. You can place a hot water bottle or heating pad on your belly. Or, you can take a warm bath. The heat helps loosen muscles, which may lessen the intensity of cramps.

Over-the-Counter Painkillers

Over-the-counter (OTC) pain relievers, such as Advil or Motrin (ibuprofen), can help keep pain at bay.

Speak to a Healthcare Provider

If your pain is severe or frequent, consult a healthcare provider. They can help you determine if your cramps are due to endometriosis or another condition.

Diagnosing Endometriosis 

A healthcare provider will take your medical history and report of symptoms and conduct a physical examination and pelvic exam. Imaging such as ultrasound, computed tomography (CT) scan, or magnetic resonance imaging (MRI) may be performed.

If endometriosis is suspected, the healthcare provider may perform a laparoscopy procedure. This involves inserting a small camera into the abdomen to look for signs of disease. A biopsy (removing a sample of tissue for analysis in a lab) may be performed.

A Challenging Diagnosis?

Endometriosis is often difficult to diagnose. Research shows it takes 10 years, on average, before a person in the United States will receive a correct diagnosis.

5 Ways to Manage Endometriosis Cramps

Different treatment options are available to help manage the pain of endometriosis cramps. Your healthcare provider can help you determine which types are best for you.

Work-Life Balance

Endometriosis cramps can interfere with daily tasks, including your professional life. According to one study, about 40% of people with endometriosis reported impaired career growth due to their disease, and about half said they experienced a decreased ability to work.

It’s important to maintain a healthy work-life balance, so you can address your symptoms and keep your stress levels in check. 

Support Groups

Talking to others who are experiencing the same disease as you can be therapeutic. Support groups offer a platform for people with endometriosis to connect. Options include both virtual and in-person sessions.


Prescription pain medicines and hormonal therapies are commonly used to help ease symptoms of endometriosis. Some hormonal options are:


Some people with endometriosis are candidates for surgical procedures. A surgeon may take out abnormal tissue using a laparoscope. Another option is a hysterectomy to remove the uterus.  

Treating Fertility Problems

Different medication and treatment options are available to help people with endometriosis increase their chances of becoming pregnant.


People with a chronic pain condition like endometriosis may be prone to experiencing depression or anxiety. Different types of therapy, such as cognitive behavioral therapy (CBT), help address these conditions.


Endometriosis can cause intense, painful cramping that interferes with daily living. Some people also experience infertility, intestinal problems, and fatigue. While there’s no cure, endometriosis sometimes goes away on its own. There are also several treatment options and lifestyle remedies available to help you manage the pain.

If you experience severe and painful cramps during your period, while having sex, or at other times, talk to a healthcare provider. Getting an accurate diagnosis is important, so you can start on treatments to ease your discomfort.

Frequently Asked Questions

  • Is endometriosis painful like labor?

    Though symptoms vary from person to person, some describe their endometriosis cramps as feeling like contractions that come and go and mimic those of labor pains. It's important to note that not all people will experience such intense pain.

  • What should you do if you have endometriosis pain all of the time?

    If you experience constant pain, you should talk to a healthcare provider. Different treatment options, including medicines and surgery, are available to help you deal with the discomfort.

  • How do you know if your endometriosis is returning?

    For some people, endometriosis pain comes and goes, while others experience constant pain. Sometimes, endometriosis improves after menopause. Pain is the most common symptom of endometriosis, so you'll likely know that it's returning if you're feeling pain, especially around the time of your period or during sex.

13 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.
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