Symptoms and Signs of Endometriosis

How would I know if I have endometriosis?

It can be very difficult for any woman, regardless of age, to recognize the symptoms of endometriosis. The disease often goes undiagnosed for years, only to be discovered when a patient experiences infertility or symptoms that have become very severe. The most common symptom of endometriosis is pain in the lower abdomen, the pelvis, or the lower back, mainly during menstrual cycles. However, the amount of pain a woman feels does not depend on how much endometriosis she may have. Some women have no pain, even though their disease affects large areas. Other women with endometriosis have severe pain even though they have only a few small growths.

Stage 4 Endometriosis, Bowel, Endometrioma, Ahesions
This image depicts a patient with endometriosis in the form of a chocolate cyst and endometriosis scar tissue.

What are the "6 Cardinal Symptoms of Endometriosis?"

  1. Dysmenorrhea (painful periods): Cramping usually points to a uterine source while pain and aches point to the peritoneum and ligaments. Endometriosis pain does not disappear in one day. The duration of pain associated with endometriosis usually continues more than two days, and can even persist after the period is over. Pain from endometriosis characteristically does not respond well to analgesics and birth control pills. More than three out of four women with endometriosis have a history of incredibly painful, crampy periods that can be traced back to their adolescence. The event of ovulation (on or around day 14 of the reproductive cycle) is often very painful in patients with endometriosis. As time draws on, there may be non-menstrual pelvic pain in the picture. Since pain is a subjective experience, the nature of its description varies from one individual to the other. Association and overlapping with other symptoms, like bowel movements frequency, gas around and during periods, constipation, diarrhea, and painful bowel movements, are all part of the symptom chain of endometriosis. Therefore, the nature, duration, radiation of painful periods and its association with other symptoms are important in making clinical decisions in ruling out other pelvic disorders.
  2. GI abnormalities: The second cardinal symptom of endometriosis is the gastrointestinal triad of bloatedness, gassiness, and cramps associated with or without diarrhea, and constipation, which is more pronounced around menstruation.
  3. Painful sex (dyspareunia) and painful bowel movements
    Painful sex (dyspareunia) and painful bowel movements are two of the cardinal symptoms of endometriosis. In this image, there is a deep involvement of endometriosis to the posterior cul-de-sac (the area between the back of the uterus and rectum). During sexual intercourse or when one passes a bowel movement, this area of tissue will be irritated and cause pain due to the build-up of endometriosis scar tissue.
    Dyspareunia (painful sex) and painful orgasm: Painful sex, the fourth cardinal symptom, is at times positional and usually involves deep involvement of endometriosis in the rectovaginal septum and pelvic walls. This symptom often leads to intimacy issues, as intercourse starts to become unpleasurable for a woman. If your partner suffers from endometriosis and is experiencing dyspareunia, it is important to be kind, supportive and always keep in mind the endometriosis pain they very well may be going through.
  4. Painful bowel movements: This fifth cardinal symptom may point to the rectovaginal septum and pelvic lateral walls. Endometriosis patients are often misdiagnosed as having IBS when their symptoms are being caused by endometriosis
  5. Neuropathy: The nerves may be directly involved or stimulated mostly by surrounding pathology due to swelling and scarring that changes the retroperitoneum (space in the abdomen behind the peritoneum) as well as direct involvement of the nerves. Symptoms naturally differ —from changes of sensory feelings to pain that radiates to the back, lumbosacral area, inner thigh or along the track of sciatica nerve — according to the varying location of the lesions. Some of these patients find that they cannot comfortably cross their legs and even their walking and gait are affected.   
    As it can be seen here, peripheral system nerves in the uterus and ovaries directly feed into the central nervous system: the body’s brain and spinal cord. In cases of endometriosis, these nerve signals can be damaged leading to nerve pain that causes such symptoms as radiating pain to the leg, back, and inner thigh.
  6. Infertility: Last but not least, the most frequent yet most elusive symptom of endometriosis is infertility, defined as both the difficulty to conceive and difficulty in carrying a pregnancy to term. Due to its silent nature, we sometimes refer to this as “cardinal symptom 0” of Endometriosis. Complex immunobiological factors both at the cellular and antibody levels are involved. Inflammatory toxins that arise because of endometrioma scar tissue do not allow the sperm and egg to mate naturally. Endometriosis visibly causes tubal dysmorphism and ovarian pathology in the form of micro endometriomas and adhesions that serve as barriers to a successful pregnancy. Unable to get pregnant, many patients are unnecessarily treated with in-vitro fertilization treatments without their endometriosis ever being addressed.

What is the complete list of Symptoms for endometriosis?

Not all women will have all of the following symptoms, however, if you are exhibiting any of these symptoms and think you may have endometriosis, please consult with your doctor.

  • Dysmenorrhea — the painful menstrual cramps often classified as "killer cramps" with pain that increases over time

    • Chronic or intermittent pelvic pain

    • endometriosis symptoms: back pain
      Due to dysmenorrhea or neuropathy, endometriosis can often cause back pain.

      Chronic pain in the lower back

    • Spotting or bleeding between menstrual periods

    • Menorrhagia — Heavy bleeding during menstrual cycle

    • Painful menstruation

  • Gastrointestinal pain and discomfort during menstrual cycle

    • Bloating

    • Gassiness

    • Cramps

    • Diarrhea or constipation

    • Constipation or nausea during your menstrual cycle.

  • Dyspareunia — pain during or after sex

    • Painful orgasm

  • Painful bowel movements or painful urination during menstrual periods

    • Rectal pain

    • Blood in urine

    • Urinary frequency, retention or urgency

    • Urinary tract difficulties

  • Neuropathy — nerves affected by advanced cases of the disease and symptoms can include radiating pain to the back, lumbosacral area, inner thigh, legs and along the track of sciatic nerve. Some patients find it difficult to cross their legs, and in some cases, their walking and gait are influenced.

    • endometriosis symptoms: leg pain
      Due to neuropathy, endometriosis
      can often cause leg pain.

      Back pain

    • Leg pain

    • Thigh pain

  • Infertility- the inability to conceive or properly carry a child. This can also include miscarriage or ectopic pregnancy

    • Miscarriage

    • Ectopic pregnancy

  • Fatigue

  • Aching

  • Constant discomfort

What do you do if you have strong signs of endometriosis?

As we may now all be familiar with the classic symptoms of endometriosis, the signs and the findings of endometriosis are dependent on a physician evaluation, in which a patient’s history will be discussed, and a pelvic exam will be conducted. But only you know your body best. If you feel that you have the aforementioned symptoms and that endometriosis may be the probable cause, you do not need to suffer. Consult with Seckin Endometriosis Center today. 

Our office is located on 872 Fifth Avenue New York, NY 10065.
You may call us at (646) 960-3080 or have your case reviewed by clicking here.

Patient Reviews

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  • Grace Larsen

    After years of excessively painful periods, a serious loss of quality of life, and a series of uninformed and uninterested doctors, Dr. Seckin and Dr. Goldstein turned my life around. I was told I woke up from my surgery almost a year ago with a smile on my face, and I haven't stopped since. Before I heard of Dr. Seckin,…

  • Nicole Novakowski

  • Jacqueline Galindo

    Dr Seckin and his team gave me back my life! Tomorrow will be 1 month since my surgery and I feel great. Dr. Seckin, Dr Liu, and Dr Goldstein are not only beyond words talented and amazing Doctors, but they are also genuinely wonderful and caring people. I cannot say enough great things about Holly, Asiye and Kim as well.…

  • Anna Lu

    Dr. Seckin and his staff spared me from years and years of heavy periods and unbearable endometriosis pain. After having surgery with him (my first) I can now function like a regular human. No more eating NSAIDs like candy and calling out sick from work. Thank you, Dr. Seckin!

  • Sheena Wright

    I underwent surgery with Dr. Seckin in 2017 and have felt like a new woman ever since. If you have, or suspect you have endometriosis, Dr. Seckin and his compassionate team of surgeons and staff are a must-see.

  • Angela Aro

    I have struggled with endometriosis and adenomyosis since first starting my period at 13. I was diagnosed at 21 and what followed was a series of unsuccessful surgeries and treatments. My case was very aggressive and involved my urinary tract system and my intestines. After exhausting all of my local doctors I was lucky enough to find Dr. Seckin. We…

  • Emi O

    Seckin and Dr. Goldstein changed my life!

  • Kristin Sands

    Like so many women who have tirelessly sought a correct diagnosis and proper, thorough medical treatment for endometriosis, I found myself 26 years into this unwanted journey without clear answers or help from four previous gynecological doctors and two emergency laparoscopic surgeries. I desperately wanted to avoid the ER again; a CT scan for appendicitis also revealed a likely endometrioma…