Over the course of a woman's menstrual cycle, tissue called the endometrium builds up in the uterus and is shed during menstruation. When a women has endometriosis, however, endometrial tissue also grows outside of the uterus, such as in the fallopian tubes, on the ovaries and on the bladder. When menstruation occurs each month, these misplaced endometrial implants cannot be shed from the body. The continual presence of the implants leads to scarring and inflammation.
Pelvic Pain
Pelvic pain is the most common symptom of endometriosis, according to Endometriosis.org. Pain most often occurs before and during periods, during sex and/or during ovulation. According to the National Institute of Child Health and Human Development (NICHD), degree of pain does not necessarily correlate with the severity of the disease. That is, some women have a lot of pain yet very few endometrial implants in the abdomen, while others experience just the opposite. In fact, some women with endometriosis never experience any pain. In addition to pelvic pain, endometriosis may also cause pain in the lower back, according to the New York Times. Back pain may not correspond with menstruation, instead occurring at any time of the month.
Intestinal Difficulties
Endometrial implants can appear anywhere in the pelvis. One common location is on the outer walls of the intestines, according to Endometriosis.org. When this placement occurs, women with endometriosis may experience intestinal problems. Endometriosis-related intestinal symptoms include pain during bowel movements, bloating, nausea, constipation and diarrhea. These symptoms mirror those of irritable bowel syndrome (IBS), leading some women with endometriosis to be misdiagnosed with IBS. It is possible, however, to have both IBS and endometriosis simultaneously.
Abnormal Bleeding
Women with endometriosis often experience abnormal bleeding in some form. Most commonly, bleeding during periods may be heavier than average. In addition, bleeding may occur between periods in cases of endometriosis, says the NICHD.
Infertility
Some women experience no clear symptoms of endometriosis. The first sign of the disease may actually be infertility, defined as the inability to become or remain pregnant after a year of trying. Endometriosis can cause infertility in a number of ways. For example, adhesions formed around the endometrial implants may cause blockages in the fallopian tubes, may cause the ovaries to be incorrectly positioned in the abdomen, or may cause eggs to become trapped in the ovaries. Notably, many women with endometriosis do not experience fertility problems. In those who do, however, laparoscopic surgery to remove the endometrial implants can improve the odds of a successful pregnancy.
