7 Symptoms of Endometriosis You Should Never Ignore

It's easy to mistake symptoms like nausea for something less serious.

  • There are several symptoms of endometriosis—such as nausea; painful, heavy, and long periods; and painful bowel movements and urination—that it's best not to ignore.
  • The condition is long-lasting, has no cure, and does more damage the longer you have it.
  • Many treatments are available to help manage symptoms.
  • If you think you may have endometriosis, see a healthcare provider as soon as possible to catch the condition early.

Most people who menstruate cope with heavy periods, killer menstrual cramps, and painful sex once in a while. But for up to 10% of females of childbearing age, these symptoms signal something more serious: endometriosis.

Endometriosis is a condition in which endometrial tissue—which is made up of cells similar to the tissue lining the inside of the uterus—moves outside the uterus and sticks to other pelvic organs. Those can include the fallopian tubes, bladder, or bowels. Every month during the menstrual cycle, this tissue becomes inflamed and swollen. It can cause intense pain and sometimes infertility.

It can be managed with treatment, but there's no cure.

"Endometriosis is a war zone," Tamer Seckin, MD, founder and medical director of the Endometriosis Foundation of America (EFA) and author of "The Doctor Will See You Now: Recognizing and Treating Endometriosis," told Health. "If it's not treated, it's a wound that never heals throughout the reproductive life of a woman."

Endometriosis Symptoms

Healthcare providers frequently mistake endometriosis for other conditions that can cause pelvic pain, such as irritable bowel syndrome, pelvic inflammatory disease, or even PMS. Although many people with endometriosis experience severe, debilitating symptoms, some have none.

There are also currently no tools to predict the people or populations most likely to get the condition.

However, the U.S. Department of Health and Human Services' Office of Women's Health indicates the following people may be somewhat more likely to experience endometriosis and its symptoms:

  • Anyone who has menstrual periods (but more common in the 30s and 40s)
  • Never had children
  • Menstrual periods that last more than seven days
  • Short menstrual cycles (27 days or fewer)
  • A family member (parent, aunt, sibling) with endometriosis
  • A health problem that blocks the normal flow of menstrual blood from your body during your period

Get Help With Symptoms Early

Getting the best care and outcomes means catching the condition early, perhaps as soon as you begin to suspect you have it. Its symptoms mimic other conditions, which can delay proper treatment.

The longer endometriosis goes untreated, the more likely you will have scarring or other complications. If you're experiencing the following signs of endometriosis—severe or not—make an appointment with an endometriosis specialist.

Period-Related Symptoms

Some endometriosis symptoms pop up when your period is due or has started. The most common symptoms are painful, prolonged, and heavy periods.

Painful Periods

Gut-wrenching cramping that doesn't go away after popping a couple of non-steroidal anti-inflammatory drugs (NSAIDs) like Advil or Motrin is one of the hallmark signs of endometriosis.

Dr. Seckin said that the abdominal pains could begin a few days before your period and last beyond the first few days of your flow. Dr. Seckin added the pain could be so debilitating that it takes you away from daily activity.

Heavy Periods

With endometriosis, unrelenting pain isn't the only thing your menstrual cycle brings. Excessive bleeding is another common endometriosis symptom. You may soak through your tampon or pad every hour or two throughout your period.

You may also see clumps of blood, said Dr. Seckin.

Long Periods

A typical period lasts between three and five days. It's normal to have a period that lasts as long as seven days, but if yours lasts longer, it may be a symptom of endometriosis.

Pain-Related Symptoms

Your pain may be telling you something. Here are some painful symptoms that mean you might want to be checked for endometriosis.

Painful Sex

When endometrial tissue travels outside the uterus, it can stick to different organs and freeze them in place. The lack of flexibility can make sex very painful.

"In early cases, intercourse just before your period is painful," said Dr. Seckin. "In advanced cases, sex is painful all the time." Arousal and orgasms both hurt—even during masturbation, said Dr. Seckin.

Painful Bowel Movements and Urination

Endometrial tissue can adhere to the bowels, making something as simple as going to the bathroom a wince-inducing experience. Bowel endometriosis symptoms can vary from patient to patient and may include constipation, diarrhea, intestinal cramping, nausea, rectal pain, and rectal bleeding.

Other Symptoms

Other key symptoms come without pain, but may involve some discomfort.

Nausea and Fatigue

Imagine your worst bout of PMS ever—you probably had a few days of feeling unusually tired, a little achy, and maybe even a little queasy. Now, amplify that a hundredfold, and you will better understand what it's like to deal with endometriosis symptoms around your period.

Endometriosis can cause persistent nausea, vomiting, and exhaustion that's worse around that time of the month.


Some studies estimate that 30 to 40% of females with endometriosis experience fertility issues. However, other studies question this but suggest that females under 35 with endometriosis were twice as likely to be infertile.

Either way, you're more likely to have fertility issues if you have the condition. Many people who menstruate don't even realize they have endometriosis until they seek fertility treatment.

When To See a Healthcare Provider

Finding an endometriosis specialist is crucial to getting a proper diagnosis and treatment. Specialists can also rule out endometriosis if your symptoms are due to another health issue.

Because the symptoms mimic many other conditions, getting the proper treatment can take a long time. The earlier you are in the stages of endometriosis, the better your prognosis is.

You could start by reviewing your symptoms with an OB/GYN or another trusted healthcare provider so that they can help you with recommendations, referrals, and follow-up care. Don't be afraid to get a second opinion if you don't feel your concerns aren't thoroughly addressed. 

Possible Treatments for Endometriosis

If you do have endometriosis, you'll have several treatment options.

They may include:

  • Medications such as contraceptives, NSAIDs, or painkillers
  • Combined oral contraceptives, progestins, or other medicines to regulate hormone levels
  • Surgery to remove lesions, adhesions, or scar tissue
  • Infertility treatments
  • Complementary and alternative methods (such as physical therapy, meditation, acupuncture, diet changes, and other interventions)
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7 Sources
Health.com 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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