What are the symptoms of endometriosis?

Bottom lineEndometriosis symptoms center on pain: severe, NSAID-resistant period pain, chronic pelvic pain that can occur between periods, pain during or after sex, and pain with bowel movements or urination, plus heavy or irregular bleeding, significant fatigue, bloating ('endo belly'), bowel and bladder symptoms, and difficulty conceiving. What distinguishes it from ordinary cramps is pain that is progressive, NSAID-resistant, extends beyond the uterus, and occurs between periods.

Endometriosis symptoms vary widely, and their severity doesn't always reflect how much endometriosis is present. Pain is the hallmark.

Pain symptoms

• Severe period pain that disrupts daily life and doesn't fully respond to NSAIDs
• Chronic pelvic pain, sometimes outside your period
• Pain during or after sex (often deep pain)
• Pain with bowel movements or urination, especially during your period
• Lower back and abdominal pain

Other symptoms

• Heavy or irregular periods
• Bleeding between periods
• Fatigue that can be significant
• Bloating ("endo belly")
• Bowel and bladder symptoms - diarrhea, constipation, nausea, especially around periods
• Difficulty getting pregnant

What makes it endometriosis rather than ordinary cramps

• Pain that is progressive (worsening over time)
• Pain that is NSAID-resistant
• Pain extending beyond the uterus (bowel, bladder, deep pelvic, during sex)
• Pain between periods, not just during them

When to see a doctor

Any period pain that disrupts your life, doesn't respond to over-the-counter painkillers, or comes with pain during sex or bowel/bladder symptoms deserves evaluation.

Read period pain vs endometriosis pain and is severe period pain normal.

Femora lets you log pain severity and symptoms over time - exactly what helps a clinician recognize endometriosis.