Symptoms

Some women with endometriosis do not have symptoms. Other women have symptoms that range from mild to severe.

Endometriosis symptoms are often most severe just before and during the menstrual cycle and get better as the menstrual period is ending. But for some women, pain is ongoing and does not improve during the menstrual cycle.³ Ongoing pain is especially common in teens with endometriosis.

Symptoms may include:

• Pain, which can be:
  • Pelvic pain.
  • Severe menstrual cramps.
  • Low backache 1 or 2 days before the start of the menstrual period (or earlier), becoming less during the period.
  • Pain during sexual intercourse.
  • Rectal pain.
  • Pain during bowel movements.
• Infertility, which may be the only sign that you have endometriosis. Between 20% and 40% of women who are infertile have endometriosis.¹
• Abnormal bleeding. This can include:
  • Blood in the urine or stool.
  • Some vaginal bleeding before the start of the menstrual period (premenstrual spotting).
  • Vaginal bleeding after intercourse.

Endometrial growths (implants) that are large are not necessarily more painful. Instead, pain and bleeding are closely linked to an implant's location or how deeply it has grown.

Several other conditions, such as painful periods, adenomyosis, or noncancerous growths in the uterus called uterine fibroids, can cause symptoms that are similar to endometriosis.