Endometriosis is a chronic condition in which tissue similar to the endometrium or inside lining of the uterus grows outside of the uterus on organs such as ovaries, fallopian tubes, bowel, exterior uterine walls, kidneys, bladder, or even lungs.
Endometrial lesions are thought to be caused by overproduction of prostaglandins and estrogen, which leads to chronic inflammation. The most common symptom of endometriosis is pelvic pain, but some women experience no symptoms at all.
Although endometriosis can occur in any woman after her first menstrual period, the condition is most common in women in their reproductive years, primarily in their twenties and thirties.
With endometriosis, symptoms are chronic, a key detail in diagnosing the condition properly. A person with endometriosis may experience the following:
Painful menstrual periods
Heavy menstrual periods
Spotting or bleeding between menstrual periods
Pain during or after sex
Pain in the pelvis or lower abdomen
Infertility
Painful bowel movements or urination, especially during menstrual periods
Fatigue, diarrhea, constipation, nausea, or bloating, especially during menstruation
Neuropathy due to swelling and scar tissue
Menstrual period pain may range from mild to debilitating and may worsen over time. Although pain may feel worse during menstruation, pain can occur at any point during one’s monthly cycle.
Cases where a woman doesn’t feel any pain or experience any other symptoms are referred to as silent endometriosis. About 20 to 25 percent of women with endometriosis are asymptomatic. In such cases, the most common way some women discover they have endometriosis is when they seek help for unexplained infertility.
Pain associated with endometriosis can vary widely from person to person. Some women don’t experience painful symptoms at all, while others experience severe pelvic pain or pressure.
Tamer Seckin, MD, founder of the Endometriosis Foundation of America and author of The Doctor Will See You Now: Recognizing and Treating Endometriosis, describes the range of endometriosis pain in the following ways:
You may experience cramping and intense pain with menstruation. Think throbbing contractions or sudden, sharp, stabbing pains that may leave you breathless. It may start before menstruation begins and not let up for several days afterward.
You may feel a dull, throbbing pain around the time of ovulation.
GI distress is also common, including bloating, gas, and cramps, sometimes accompanied by diarrhea and constipation. Symptoms are worse around menstruation.
Pain during sexual activity can feel like sandpaper, along with sharp pains that radiate toward the abdomen.
You may have painful bowel movements or urination due to irritated tissue.
Neuropathy may cause sciatica, a sharp, burning, radiating pain down your leg, inner thigh, or back, that can make walking or even crossing your legs uncomfortable.
The degree of pain doesn’t necessarily dictate the severity of endometriosis. You can have a very early case and feel pain much worse than another woman whose disease is much more advanced. The level of pain experienced with endometriosis depends more so on:
Location If lesions are in an area rich in nerve endings, the pain will be more intense.
Swelling Lesions swell and bleed much like the uterine lining does during a menstrual cycle. Since the area has limited room and no way to expel the blood, this swelling and bleeding causes pain.
Scarring Scarring of surrounding tissue caused by lesions can also increase pain levels by causing organs to stick together.
Endometriosis can cause pain, and sometimes very severe discomfort, during or after sexual penetration or orgasm. It can be difficult to seek treatment for this sensitive problem.
Painful sex, coupled with the anticipatory fear of that pain, can also be a big turnoff.
Unfortunately, many women are too embarrassed to talk with their physician about the pain associated with sexual intercourse. Some may think nothing can be done and try to ignore it or live with it. Others are told that their pain is psychological or somehow less than real.
However, women with endometriosis don’t have to live with pain that interferes with intimacy or sexual relationships. Treatments are available, and sex doesn’t have to hurt.
Since many people think of endometriosis as only a gynecological issue, bowel endometriosis can be tricky to detect.
Bowel endometriosis, sometimes misdiagnosed as irritable bowel syndrome (IBS), occurs when lesions grow on the peritoneum (the membrane lining the inside of the abdomen and covering the abdominal organs), the rectum, the intestines, and other deeper bowel levels. Bowel endometriosis causes intense pain specifically during the menstrual cycle.
Endometriosis can easily be confused with other conditions due to its varying signs and symptoms, so it’s important to see your gynecologist to obtain an accurate diagnosis. For instance, beyond endometriosis, pelvic pain could also be related to these conditions:
Adenomyosis, in which endometrial tissue infiltrates the wall of the uterus instead of getting outside the uterus
On average, it takes between 4 and 11 years from the onset of symptoms for women to receive a correct diagnosis of endometriosis, so address any symptoms you may be experiencing promptly. Although endometriosis remains incurable, there are treatments that can help manage accompanying pain and other symptoms. For some women, endometriosis symptoms go away on their own once they’ve reached menopause.
The most common symptom of endometriosis is chronic pelvic pain, although some women don’t experience any symptoms at all.
Additional signs and symptoms of endometriosis include painful and heavy menstrual periods, spotting or bleeding between menstrual periods, pain during sex, infertility, pain and gastrointestinal distress during menstrual periods, and neuropathy.
Pain associated with endometriosis can vary widely from person to person, and pain levels aren’t necessarily an accurate reflection of the severity of the condition.
Endometriosis can easily be confused with other conditions due to its varying signs and symptoms, so it’s important to see your gynecologist to obtain an accurate diagnosis.
