Endometriosis is a disease caused by endometrial tissue — the tissue lining the uterus — developing outside of the uterus. This can occur under the ovaries, on the fallopian tubes (the tubes connecting the ovaries to the uterus), behind the uterus, on the tissues that hold the uterus in place, and on the bowels or bladder.

The primary symptoms of endometriosis are pain and infertility.

Pain associated with endometriosis

Pain is the most common symptoms of endometriosis. In addition to generalized abdominal pain, patients may also experience:

  • Painful, even debilitating, menstrual cramps
  • Pain during or after intercourse
  • Pain in the intestine or lower abdomen
  • Painful bowel movements or painful urination during menstruation

The precise cause of endometriosis-associated pain is not well understood, and the severity of the pain a patient experiences does not seem to correlate with the size or location of endometrial lesions. It is possible that the pain may be caused by some lesions containing nerve cells, or scar tissue pulling on internal organs. For some women, endometriosis causes severe pain around the menstruation cycle, which may be caused by changes in hormone levels during this cycle. Some patients report a lessening in endometriosis pain following pregnancy and after menopause.

Endometriosis-related infertility

Infertility is also a very common symptom of endometriosis, and it is estimated that about 50 percent of all cases of problems with fertility are due to endometriosis. This is because endometrial lesions, depending on location, may block the ovaries or fallopian tubes and prevent the release of an egg into the uterus. The inflammation that is caused by endometrial lesions can also change the environment of the uterus, making fertilization more difficult because fewer sperm cells survive to potentially fertilize an egg.

Other symptoms of endometriosis

Women with endometriosis may have very heavy menstrual bleeds and some report premenstrual spotting or bleeding between periods. Extreme tiredness or fatigue is also often reported by patients.


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