Endometriosis symptoms

The classic endometriosis symptoms include:

• Pelvic pain
• Painful periods that interfere with everyday life
• Heavy menstrual bleeding
• Pain during or after sex
• Painful bowel movements/when having a poo
• Pain when urinating/peeing
• Difficulty getting pregnant – up to 70% of those with endometriosis will be able to get pregnant naturally
• Fatigue, with one or more of the above symptoms

Symptoms vary from person to person, some may have severe and debilitating symptoms, others may have no symptoms at all. Symptoms are not always related to the location, amount or the type of endometriosis. It’s also important to know that endometriosis symptoms can also be symptoms of other health conditions. We recommend that you speak to a doctor if your symptoms are interfering with day-to-day life.

All of the symptoms above may have other causes and may not necessarily be endometriosis. It is important to seek medical advice to clarify the cause of any symptoms. If your symptoms change after diagnosis, discuss these changes with your doctor. If your symptoms are interfering with your day-to-day life, speak to your doctor.

Many people with endometriosis also experience significant bloating around the time of a period. Bloating is common in those without endometriosis too, and bloating that does not go away can be a symptom of other health conditions.

Endometriosis can significantly impact mental health and wellbeing. With treatment, many of these issues can be addressed and symptoms made more manageable. Sometimes it can take time to find a treatment that works for you - keep speaking to your doctor.

Understanding Periods: What is Normal?

Periods are different for everyone. While a typical menstrual cycle happens about once a month (every 28 days), anything between 21 and 35 days is considered normal.

• When periods first start: It is very common for periods to be irregular and more painful as your body adjusts to changing hormones. They usually settle into a regular routine after a couple of years.
• Duration and flow: Periods generally last between 2 to 7 days. Bleeding is usually heaviest during the first 2 days, where the blood is bright red. On lighter days, it may appear pink or brown.
• Blood loss: Most people lose between 20 to 90 ml of blood per period, though some may bleed more heavily. On heavy days, you will likely need to change your period products (pads, tampons, menstrual cups, or period pants) every 3 to 4 hours.

Period Pain

Period pain is very common - about three out of four people who have periods experience it.

Why Does It Happen?

Most period pain is caused by natural contractions in the uterus (womb).

• Prostaglandins: These are chemical signals released by the uterine lining that cause the muscle walls of the womb to squeeze tight. This temporarily reduces the blood supply to the womb, leading to discomfort and cramping.

Pain Relief

Mild pain which can be managed with over-the-counter painkillers, such as ibuprofen or paracetamol is normally experienced with periods. 

Unlike typical period pain, endometriosis occurs when cells similar to the ones in the lining of the womb (uterus) are found elsewhere in the body. These cells can grow and change in response to hormones in the menstrual cycle, causing inflammation, pain, and scar tissue. Endometriosis tissue also produces higher levels of prostaglandins, which can intensify muscle cramping and pain. If period pain is affecting your daily life, then it’s important to discuss this with your healthcare practitioner.

PMS (Premenstrual Syndrome)

Changes in hormone levels in the days leading up to your period can cause a mix of physical and emotional symptoms known as PMS (or PMT - premenstrual tension). Not everyone who has periods experiences PMS.

Common Symptoms

• Mood swings
• Breast tenderness
• Bloating
• Skin changes (such as spots)
• Lower sex drive
• Headaches

PMS symptoms usually improve when your period starts and disappear a few days later.

When to Seek Medical Advice

While many symptoms are a normal part of the menstrual cycle, it is important to talk to a doctor, school nurse, or healthcare practitioner if you experience any of the following:

• Periods lasting longer than 7 days
• Heavy bleeding (e.g., regularly leaking through products or passing large blood clots) 
• Period pain or bleeding that prevents you from carrying out normal daily activities, such as going to school, working, or socialising
• Period pain that continues after or in between periods
• PMS symptoms that are severe, ongoing, and impact your daily life.