Symptoms - Endometriosis

Endometriosis is a condition where tissue similar to the lining of the womb starts to grow in other places.

Tissue may grow in your:

• ovaries
• pelvic cavity
• tummy lining (peritoneum)
• bladder
• bowel and ureters (tubes from kidney to bladder)

Endometriosis can affect women of any age, although it is less likely in women after menopause. It is also less likely in girls in the early years after their first period.

It is a long-term condition that can impact people on different levels. Some women can continue to lead a normal life. But for others, endometriosis can have a significant impact on their quality of life. There are treatments available that can help.

Symptoms of endometriosis

The symptoms of endometriosis can vary. Some women will have very noticeable symptoms, while others may not have any noticeable symptoms.

The most common symptoms of endometriosis are:

• pain in your lower tummy or back (pelvic pain) in the days before your period starts and pain that usually gets worse during your period. The pain is worse than 'normal' period cramps and can be hard to control with basic pain medication
• period pain that stops you from doing normal activities or causes you to miss social events
• pelvic pain that also happens at other times of the month when you are not menstruating (such as midway through your cycle)
• heavy bleeding during your period - you might use a lot of pads or tampons, or you may bleed through your clothes
• pain during or after sex
• pain when peeing or pooing that is worse during the time of your period
• feeling sick, constipated, having diarrhoea, or blood in your urine during your period
• difficulty getting pregnant

Living with these symptoms may lead to you feeling down or depressed.

There are other less common symptoms, such as cyclical shoulder pain, that may be a sign of endometriosis.

Complications of endometriosis

Women with endometriosis can sometimes experience a number of complications.

Fertility problems

Endometriosis can cause fertility problems. The reason is not fully known, but is thought to be because of damage to the fallopian tubes or ovaries, or the inflammation caused by the disease in the pelvis.

Not all women with endometriosis will have fertility problems and some will be able to get pregnant without treatment.

The medication (painkillers) often used to help the symptoms of endometriosis will not improve fertility. Surgery to remove visible patches of endometriosis tissue can sometimes help. But there is no guarantee this will help you get pregnant.

If you're having difficulty getting pregnant after diagnosis and treatment of endometriosis, fertility treatments may be an option, such as IVF.

Women with moderate to severe endometriosis can have a lower chance of getting pregnant with IVF. This is because of the effect that endometriosis has on egg quality and embryo implantation.

If you are struggling to get pregnant, get help early if you ever had treatment for endometriosis.

Adhesions and ovarian cysts

Some women will develop:

• adhesions – 'sticky' areas of endometriosis tissue that can join organs together
• ovarian cysts – fluid-filled cysts in the ovaries that can sometimes become large and painful

These can both happen if the endometriosis tissue is in or near the ovaries. The presence of cysts with endometriosis (chocolate cysts) can be detected using ultrasound. This is advanced disease.

Cysts can be treated with surgery, but may come back in the future.