Early Symptoms of Endometriosis

By:    Medically Reviewed: Tom Iarocci, MD   Published: March 27, 2014

How to recognize the signs of endometriosis and find the right treatment.

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More than five million women in the United States have been diagnosed with endometriosis. For those who suffer from this condition, the effects can be life-altering.

The endometrium is the tissue that lines the uterus and is shed every month during menstruation and then is regenerated. Endometriosis, on the other hand, is a condition in which endometrial tissue grows on other organs, including — but not limited to — the ovaries, fallopian tubes and the outer surface of the uterus, vagina or cervix.


The condition may cause painful periods that become progressively worse. But that’s not the only impact.


Symptoms of Endometriosis


“The key symptoms are not very specific, and this can make diagnosis difficult,” says Nanette Santoro, MD, professor of obstetrics and gynecology at the University of Colorado School of Medicine. “And since endometriosis can often affect bowel function, it is sometimes mistaken for intestinal conditions like irritable bowel syndrome or colitis.”


However, crippling menstrual cramps are the hallmark of this condition, and patients often report periods that get more painful over time. Pain that might be attributed to menstrual cramps can occur for many different reasons, so it’s important to be evaluated. Aside from the escalating painful menstrual cramps, symptoms of endometriosis can also include:

  • Pain during sex (especially with penetration) and/or after sex
  • Painful bowel movements or urination during your period
  • Diarrhea, constipation or bloating during your period
  • Lower back pain
  • Pelvic pain (especially after sex)
  • Spotting or bleeding between periods
  • Allergies, migraines or fatigue that gets worse around your period
  • Inability to get pregnant


Relief From Endometriosis


Pain medications and hormones are typically used before considering surgical treatments. “NSAID-type medications can help control monthly pain, but it is best to avoid addictive pain killers since this is usually a long-term condition and addiction is likely,” says Santoro. “By depriving the endometriosis of estrogen, its growth is inhibited.” As a result, treatments such as birth control pills or progestins are often the primary choice for medical intervention.


Surgery may be the best choice for patients whose endometriosis is widespread, isn’t relieved with hormonal treatments or who are dealing with infertility. Laparoscopic surgery is less invasive than other abdominal surgeries and can be used to remove growths and scar tissue; it also allows doctors to access and remove more areas of endometriosis. As a last resort — and only for patients who aren’t trying to get pregnant — a hysterectomy (i.e., surgical removal of the uterus and possibly also the ovaries) can be performed.


Next Steps


If you suffer from any of the symptoms of endometriosis, you should discuss it with your doctor. Too many women suffer painful periods in silence, assuming that cramps (even crippling ones that interfere with your life) are just a normal part of the menstrual cycle. Your doctor can help create a treatment plan to manage your symptoms to help you live better with the condition. 

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  • Santoro N., MD, professor of obstetrics and gynecology at University of Colorado School of Medicine. http://www.ucdenver.edu/academics/colleges/medicalschool/departments/obgyn/Forfacultyandstaff/Facultydirectory/Pages/NanetteSantoroMD.aspx. Interviewed March 2014.
  • Office on Women’s Health, U.S. Department of Health and Human Services. “Endometriosis Fact Sheet.” Updated July 2012. http://womenshealth.gov/publications/our-publications/fact-sheet/endometriosis.html. Accessed March 2014.
  • Endometriosis Research Center (ERC). “Killer Cramps.” http://www.endocenter.org/killercramps.htm. Accessed March 2014.