The signs and symptoms to look out for
Endometriosis symptoms can sometimes improve by themselves, but they can also progress over time. The symptoms can vary and range from mild to severe, and they can be constant or intermittent in nature.
Pain symptoms tend to worsen during menstruation, ovulation, and sexual intercourse.​ It often starts in the lead up to menstruation, (around 2-5 days before). Although some people, especially those with severe endometriosis, may experience pain and symptoms outside of menstruation or even continuously (known as on-going / chronic pain).
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Those with endometriosis may also experience pain, discomfort, and sometimes bleeding during pelvic exams, or any other type of physical exam involving a doctor manually investigating their pelvis.
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Ambassador and Gynaecologist, Dr Anita Mitra (@gynaegeek) explains how best to keep a record of your symptoms.
Keeping a symptom diary
Keeping a symptom diary can not only help you think about your symptoms and how often they occur, but it can also help towards getting the care and support you need and help make a diagnosis.
It can also be useful when having conversations with health care professionals about your treatment choices and what treatments help you, as well as supporting you through your treatment plans.
Occasionally, a symptom diary will help you understand other symptoms that you may not have previously considered could be related to endometriosis, or other changes throughout your menstrual cycle.
It can also help to record not only the symptoms you experience, but also the impact they have on your day to day life and how they made you feel at the time.
It is often these knock-on effects that are harder to recall after they have happened, but they can be incredibly helpful in understanding the impact of the condition and monitoring any changes after treatments are started.
The common symptoms
Some people may experience one or two symptoms, whereas others may experience a combination of them.
The following symptoms are often associated with endometriosis (the list is not exhaustive) and includes:
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Pelvic pain (Pain in your lower tummy)
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This pain is usually felt in the lower abdomen and lower back, but it can also radiate to the rectum, hips and legs. The intensity of this discomfort can reach such levels that even small tasks like sitting and walking can become challenging, particularly during your period.
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Period pain that stops you doing your normal activities
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This pain can vary in its intensity, some individuals may find themselves bedridden, unable to attend school or work, impacting their daily lives, whilst others may find it improves or becomes manageable after taking pain relief, and they are able to continue with normal activities. Even if this is the case, pain is not a ‘normal’ symptom, and it should not be suffered in silence.
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Additionally, there is a chance of experiencing abdominal pain, which can manifest as cramping, a burning sensation, or a varying intensity of a dull ache.
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Pain during or after sex
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The pain can vary in intensity, sometimes feeling sharp, other times dull, and in some cases, it may be accompanied by light bleeding. For some, it can be triggered by orgasm, leading to deep discomfort that may last for hours.
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The severity of the pain can also depend on your position during sexual activity. Often, this pain is felt deep internally, but endometriosis can also cause other sensations, such as involuntary muscle spasms in the vagina (vaginismus). This can result in discomfort or pain in the lower vagina or vulva, even during gentle touch or when inserting a finger or tampon.
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Fatigue (extreme tiredness)
Lethargy, lack of energy, exhaustion, and the general feeling of being ‘run-down’.
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Pain when passing urine or stools
Painful bladder and bowel movements may suggest signs of endometriosis. In some cases, individuals may feel a heightened urgency or increased frequency to pass urine, along with experiencing pain in the lower back and kidney area, which can often resemble UTI-like symptoms.
Changes in bowel habits may also include difficulties in passing stools or the presence of blood in urine or stools may suggest signs of endometriosis.
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Fertility problems
Endometriosis can lead to difficulties conceiving.
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Other common symptoms may include gastrointestinal symptoms such as nausea and vomiting, bloating, constipation or diarrhoea, acid reflux, dizziness, headaches and migraines.
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Feelings of isolation, heightened anxiety and depression are often felt by people with endometriosis.
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Endometriosis is a long-term condition which can have a big impact on your life, affecting both your mental and physical health. If you are experiencing pain that is stopping you from carrying out your usual day-to-day activities, if you have noticed changes around your menstrual cycle or if you’re feeling low in mood or anxious, it is important to tell your doctor as early as possible.