DO I HAVE ENDOMETRIOSIS?
Only a doctor can give you a definitive diagnosis – but here, you can learn more about endometriosis and what signs to pay attention to.
What is endometriosis?
Endometriosis occurs when tissue that resembles the lining of the uterus grows outside the uterus – in places where it doesn’t belong. It reacts to hormonal changes in the same way as the uterine lining: it thickens during your cycle and tries to bleed during menstruation.
But outside the uterus, the blood has nowhere to go. The body doesn’t recognize this type of bleeding as normal – and tries to respond. This can cause irritation and inflammation, which over time may lead to scar tissue and adhesions between organs.
You can think of it as a creeping vine growing between your organs. If it’s pulled in one place, the tendrils tug elsewhere – which can cause pain during movement, menstruation, bowel movements, or sex.
Different types of endometriosis
Endometriosis can show up in different ways – both in terms of depth and location.
In some, the tissue is found on the peritoneum, the thin layer that lines the abdominal cavity. In others, it may be on the ovaries and sometimes form dark cysts (called endometriomas).
In another group, the tissue grows deeper into the surrounding structures – this is called “deeply infiltrating endometriosis.” It can be located behind the vagina or between the vagina and rectum, where it may cause bowel-related symptoms like pain during bowel movements, constipation, or a feeling of pressure in the pelvis.
Symptoms
Endometriosis can cause symptoms that severely affect your everyday life. The exact symptoms vary depending on where the tissue is located.
Pain is the most common symptom – and it can show up in many ways:
- Severe menstrual pain – both before and during your period
- Pain around ovulation
- Pain during or after sex – especially with deep penetration
- Ongoing pain in the lower back, pelvis, or abdomen
- Pain during bowel movements – especially while menstruating
- Pain while urinating, if the bladder is affected
Tight pelvic floor
Many people with endometriosis develop a tight or overactive pelvic floor – often as a reaction to ongoing pain. This in itself can cause pain during sex, bowel movements, touch, or even at rest. Some describe it as a constant tension or inner pressure in the pelvic region.
Other symptoms may include:
- Heavy or irregular bleeding
- Spotting between periods
- Fatigue and exhaustion
- Digestive issues: diarrhea, constipation, bloating, and nausea – especially around menstruation
- Bowel symptoms: pain, pressure, or a need to hold back during bowel movements
- Bladder symptoms: frequent urination, pain when emptying the bladder, or discomfort with pressure over the bladder
- Feeling worn down or overstimulated – physically and mentally. Many describe it as being in constant alert mode inside their own body
- Difficulty getting pregnant
Symptoms may come and go or vary in intensity – but even if they’re not constant, they still matter and deserve attention.
Talk to your doctor
Some doctors recognize endometriosis right away – others don’t. Unfortunately, many people experience having their pain dismissed as “just bad period cramps.”
If you don’t feel heard, ask your doctor if they have experience with endometriosis. Be as specific as you can when describing your symptoms – and explain how they affect your daily life, not just your cycle.
How is endometriosis diagnosed?
There’s no single test that can definitively confirm endometriosis. Your doctor will ask about your symptoms and decide if further tests are needed.
- Pelvic exam: The doctor may feel for cysts, nodules, or tender areas. Small changes can be hard to detect – but your pain is still real.
- Scans: An ultrasound may detect cysts on the ovaries. In some cases, an MRI can help assess deeper endometriosis.
- Laparoscopy (keyhole surgery): This is the most precise method. The doctor looks directly into the abdominal cavity. Sometimes, visual inspection is enough; other times, a tissue sample (biopsy) is taken to confirm the diagnosis.
- Hormonal treatment as a trial: If your symptoms point to endometriosis, your doctor may suggest trying birth control pills or other hormonal medication. If this eases your pain, it may support the suspicion of hormone-sensitive endometriosis-like tissue. This isn’t a final diagnosis – but it can be an important part of the process.
It’s unfortunately common for endometriosis to take time to diagnose. But that doesn’t mean your symptoms aren’t real.
If you need to read more in English: Learn more at Endometriosis UK.