Symptoms of Endometriosis

Symptoms of endometriosis

What is endometriosis?

Endometriosis is a condition where areas of tissue (lesions) that are similar to the endometrium of the uterus grow in places other than the uterus. They can occur anywhere in the body – the bowel, bladder and throughout the pelvis, for example. The most common sites are around the uterus and ovaries and on the fallopian tubes. 

Endometriosis affects as many as 1 in 10 women of reproductive age.

what causes endometriosis?

Endometriosis can be considered an estrogen-dependent inflammatory and immune disease, although the root cause is still not really known as research into endometriosis has been woefully lacking. 

Estrogen-dependent means that it is influenced but not caused by hormones. Some researchers think that endometrial tissue is laid down before birth and is then activated by hormones at puberty.

Newer research is suggesting endometriosis may be a microbial disease and that addressing the gut microbiome may be able to help reduce symptoms.  

What we do know is that endometriosis is a whole body inflammatory disease, not necessarily just a hormone or period issue. The immune system plays a big part in it by producing inflammatory cytokines that inflame the endometrial tissue and promote growth. Therefore immune dysfunction likely plays a big part too. 

Read more about the 5 causes of endometriosis.

What are the common symptoms of endometriosis?


The main symptom of endometriosis is pain, which is often severe and isn’t relieved by painkillers – and that’s the big difference between this and ‘normal’ period pain. It can last many days and can be burning, stabbing, searing and can make you sick.

The pain can occur in the uterus during your period but also in other places and at other times. Pain can occur in the bladder and legs and throughout the pelvis. You can have pain all the time – but also some women with endometriosis get no pain at all.

Pain is also very common in endometriosis while passing bowel motions or during sexual intercourse. 

Endometriosis can often be mistaken for other conditions that cause pain and even abdominal cramping such as ovarian cysts or pelvic inflammatory disease, and even IBS. 

Heavy periods

Another main symptom of endometriosis is suffering from heavy periods. Heavy bleeding is common in endometriosis during your period, but can also occur between periods also. 

You can track your flow easily using a menstrual cup, but it’s also possible to get an idea of how heavy your flow is from how many tampons or pads you use in a month. 

It’s considered normal to use 6–10 tampons or pads each period. If you’re soaking more than 16 regular tampons or pads, or if you bleed for more than 8 days, you likely have an excessively heavy flow. A heavy flow can also be due to unopposed estrogen, perimenopause, thyroid imbalance, high histamine and more, therefore if you are suffering from heavy periods it is important to investigate the underlying root cause. 

Read more about high or unopposed estrogen.

Other symptoms of endometriosis include:

  • Bladder issues – urgency, frequency, pain – similar to a UTI.
  • Bowel problems – constipation and/or diarrhoea.
  • Bloating – symptoms like bloating and constipation can often be mistaken as IBS. 
  • Nausea and vomiting – this is commonly associated with the pain of endometriosis. 
  • Headaches.
  • Fatigue.
  • Low-grade fever.
  • Bleeding between periods.
  • Infertility and recurrent miscarriage.

What to do if you have symptoms of endometriosis

If you have some signs and symptoms of endometriosis, the first step is to see your GP. 

In preparation for your appointment, Endometriosis UK has a helpful pain and symptoms diary you can use to note down your symptoms and the severity of them which you can then give to your doctor.

Testing your hormones at FUTURE WOMAN can also help you to understand if high estrogen, low progesterone, poor estrogen metabolism or inflammation inside the body is exacerbating your symptoms. We usually recommend the Advanced Hormone Test for clients struggling with endometriosis as it offers a comprehensive overview of your reproductive hormones, adrenal hormones and other contributing factors like nutrient deficiencies, inflammation markers and neurotransmitter balance.

Compare our FUTURE WOMAN hormone tests.

Key takeaways:

  • Endometriosis is an estrogen dependent inflammatory and immune disease, although the root cause is still not really known. 
  • Common signs and symptoms of endometriosis include pain which can often be severe. 
  • Other common signs and symptoms of endometriosis include heavy bleeding or heavy periods. 
  • Other signs and symptoms of endometriosis include bladder issues, constipation and/or diarrhea, bloating, nausea and vomiting – this is commonly associated with the pain of endometriosis, headaches, fatigue, low-grade fever, bleeding between periods and infertility and recurrent miscarriage. 
  • If you have some of these signs and symptoms the first step is to visit your GP. 


Huchon, C., Aubry, G., Ploteau, S., & Fauconnier, A. (2018). Signes spécifiques cliniques évocateurs de l’endométriose (hors adénomyose) et questionnaires de symptômes, de douleur et qualité de vie, RPC Endométriose CNGOF-HAS [Specific clinical signs suggestive of endometriosis (excluding adenomyosis) and questionnaires of symptoms, pain and quality of life: CNGOF-HAS Endometriosis Guidelines]. Gynecologie, obstetrique, fertilite & senologie, 46(3), 168–176.

Farquhar C. (2007). Endometriosis. BMJ (Clinical research ed.), 334(7587), 249–253.

National Guideline Alliance (UK). Endometriosis: diagnosis and management. London: National Institute for Health and Care Excellence (NICE); 2017 Sep. (NICE Guideline, No. 73.) 6, Signs and symptoms of endometriosis (monitoring and referral) Available from:

Parasar, P., Ozcan, P., & Terry, K. L. (2017). Endometriosis: Epidemiology, Diagnosis and Clinical Management. Current obstetrics and gynecology reports, 6(1), 34–41.

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