20 Symptoms of Endometriosis: What Your Periods Might Be Telling You

Here are 20 symptoms of endometriosis to know more about your period pain:

1. Painful periods
   Pain in the pelvic area and cramping can begin before a menstrual period and continue for days throughout it. You also might experience lower back and abdominal pain. Another term for painful periods is dysmenorrhea.
2. Heavy bleeding
   Occasionally, you may experience a heavy period or intermenstrual bleeding. Menorrhagia, also called heavy menstrual bleeding (HMB) or heavy uterine bleeding, is common in people with endometriosis. Menorrhagia involves unusually heavy flow or a period that lasts longer than 7 days.
3. Chronic pelvic pain
   You may sometimes experience persistent and intense pelvic pain even when you’re not on your period. This may be because of advanced or resistant disease and scarring
4. Pain during intercourse
   Pain during or after intercourse is a common concern among those with endometriosis. It is also called dyspareunia. You might often feel pain during sex, which is a very personal issue that can be hard to talk about with your gynaecologist. However, it is essential to pay attention to it because it can indicate the severity of the pain and the location of the endometriosis lesions
5. Abnormal periods
   Abnormal periods can involve multiple symptoms that may start before your cycle or with the beginning of your period. The symptoms include painful menstrual cramps (dysmenorrhea) that do not improve with NSAIDs or ibuprofen, heavy bleeding (menorrhagia), nausea, vomiting, diarrhoea, painful bowel movements or urination, chronic pelvic pain, leg pain (neuropathy), headaches or migraines, and fatigue. If you experience any of these symptoms consistently during your periods or follow a cyclical pattern throughout the month, you should notify your gynaecologist
6. Vaginal bleeding between periods (spotting)
   Vaginal bleeding refers to any bleeding that is unusual for you and your period. Endometriosis could be the cause of bleeding between or during your periods. The most common symptoms of endometriosis include irregular or heavy menstrual bleeding or spotting between periods, because the overgrowth of the uterine lining responds to your hormones.  It is recommended that you see your doctor.
7. Pain with urination
   If you have misplaced tissue from your bladder or bowel, you might experience painful urination. When these tissues shed and become trapped, it can cause pain during urination, urinary incontinence, bloating, and urinary retention. Doctors refer to this as bladder endometriosis. Although rare, when it occurs, it can be painful. Bladder endometriosis results in inflammation and discomfort in the bladder. While these symptoms are uncommon for endometriosis affecting the urinary tract system, if you experience persistent painful urination, we recommend consulting your gynaecologist.
8. Pain with bowel movements
   When tissue that normally lines your uterus begins to grow on your intestines, it is known as bowel endometriosis. This condition can cause significant pain, including severe abdominal discomfort, bloating, and changes in bowel habits. If you experience symptoms of bowel endometriosis, such as painful bowel movements, cramping in the intestines or rectal pain, especially during menstrual periods, and bloody stools, seek prompt medical attention. These signs are most likely to appear before or during your period. 
9. Ovarian cysts
   Most ovarian cysts are normal and will heal on their own, but cysts related to endometriosis (endometriomas) are another classic sign of endometriosis. They can be managed conservatively with medications such as birth control pills, patches, or vaginal rings to regulate hormonal fluctuations. If they grow large and painful, they may require surgical removal.
10. Pain or bleeding in other areas
    If you experience body pain, such as in the chest, along with shortness of breath and coughing up blood, it could be a symptom of endometriosis. Usually, endometriosis patches develop in the lower abdomen and pelvic area. However, if they occur in or around the lungs, they can be life-threatening. Complications may cause bleeding or a collapsed lung. Some individuals may not show any symptoms. Lung involvement in endometriosis is rare. However, if you experience shortness of breath, chest pain, shoulder pain, or cough during menstruation, see a doctor immediately.
11. Infertility
    Endometriosis occurs in approximately 25% to 50% of women with infertility, and it causes scarring as well as damage and inflammation of the fallopian tubes, resulting in infertility. Studies also indicate that endometriosis impacts the quality of the egg and lowers the quantity of eggs in the body..
12. Family history of endometriosis or painful periods
    Medical experts often see a link between family history and an increased risk of developing the condition later. If someone in your biological family — like your mother, grandmother, or sister — has endometriosis, talk to your healthcare provider about your risk .
13. Acne and hormonal imbalance
     Endometriosis may not directly cause acne; however, research suggests that it is associated with severe acne in teenagers. Both endometriosis and acne can be affected by hormonal imbalances, especially involving oestrogen and androgens. The hormonal fluctuations associated with endometriosis can potentially contribute to the development or worsening of acne in some women. If you notice blackheads, whiteheads, and small cyst-like pimples or bumps under the skin that appear temporarily before and after your periods, consult your healthcare provider.
14. Extreme tiredness (fatigue)
    If you experience extreme tiredness and weakness, accompanied by low energy levels and increased fatigue around your menstrual cycle, consult your doctor. Endometriosis fatigue can also include symptoms such as muscle or joint aches and pains, headaches, and insomnia., dizziness, or nausea. If the fatigue is severe, you might often take long naps and feel faint when standing up or moving quickly.
15. Brain fog
    The pain from endometriosis might change your brain in ways that affect your mood, motivation, or thinking, even if you don’t have chronic pain. It’s also called the endometriosis brain..
16. Trouble sleeping
    Endometriosis symptoms can make it hard to fall asleep. You might wake up more often or sleep for shorter periods. Poor sleep can exacerbate pelvic pain or negatively impact your mood. Depression or anxiety can lead to more sleep problems..
17. Depression or anxiety
    Endometriosis can impact your mental health and lower your quality of life compared to those without the condition. Hormonal changes during your menstrual cycle can worsen existing mental health issues. It may influence existing disorders such as anxiety, depression, bipolar disorder, substance use disorders, attention deficit hyperactivity disorder (ADHD), or sexual dysfunction.  The 2-year risk of chronic opioid use was observed as 4.4% in women with endometriosis. The relative risk of chronic opioid use among women with endometriosis compared to those without was higher. Even if you don’t develop a mental health condition, endometriosis symptoms can still negatively affect your quality of life.
18. Migraines or headaches
    Endometriosis and migraines are two conditions worsened by the menstrual cycle. Frequent migraines or headaches during periods are likely caused by your body’s reaction to endometrial-like tissue, genetics, or hormonal imbalance. Pure menstrual migraine makes life more difficult when headaches and other symptoms occur only during menses. Menstrual-related migraine happens when headaches and other symptoms appear both during menses and at different times in the month. If this continues, consult your doctor.
19. Allergies
    Women with endometriosis are much more likely to have allergies. Additionally, 88% of women with endometriosis and either fibromyalgia or chronic fatigue syndrome also have allergies. If your allergies worsen during your periods along with severe pain and cramps, consult your healthcare provider. 
20. Hypersensitivity to pain
    Women experience varying levels of non-specific pain, from mild to severe cramps. If you experience intense symptoms of endometriosis, including painful sex and painful bowel movements, it might be linked to deep endometriosis. This could indicate that your chronic pelvic pain caused by endometriosis is connected to central sensitization syndrome, which can lead to a decreased overall quality of life and a higher risk of anxiety and depression. Central sensitization is also associated with patients having low pain thresholds due to hypersensitivity to pain stimuli..