Endometriosis Symptoms

Endometriosis is now recognised as one of the most painful conditions in the world and the pain can be so debilitating that it affects every aspect of women’s lives. For a number of women, the pain can be so bad that even opiates will not touch it.

The stage and severity of the disease do not necessarily indicate the level of pain this disease can cause. Unfortunately, many doctors still dismiss the pain and symptoms with comments like ‘Some women just have more pain than others. Doesn’t mean anything is wrong’!

‘Before I went on birth control, mine were so bad it would feel like I was dying. I’d be screaming into a pillow, writhing on the floor trying to find a position that hurt just slightly less, vomiting, and fainting.’

One of the main problems regarding endometriosis and getting a diagnosis is that any signs of this disease in the early stages, may appear to be the ‘normal’ bodily changes that take place with the menstrual cycle. This is when doctors declare - It's just a bad period !!!

It is only as time goes by that a woman begins to suspect that what is happening, and the pain she feels is not normal. The symptoms of her menstrual cycle gradually and steadily becomes worse as time goes by.

Having said that, there are instances where some women do actually have endometriosis, but they are mainly free of any symptoms. These women will only be diagnosed by default when they have surgery for other gynaecological issues. Only then is evidence of endometriosis actually found. That is what makes endometriosis so enigmatic and difficult to diagnose along with the fact that women's symptoms of pain are so often dismissed.

The disease does not follow any distinct pattern, which is why it is often difficult for  doctors to know that a woman has the disease. The symptoms can range from mild to severe, but the level of pain does not always relate to the seriousness of the disease.

The following is a breakdown of all the possible symptoms and locations of endometriosis

This is a long list . . .  but the more informed you are - the more chance you have of finding out the possible cause of your symptoms to help you obtain a diagnosis.

The most common symptoms of Endometriosis include:

Other problems which are common can include:

In the later stages adhesions usually develop in the pelvic cavity, which are caused by untreated cysts, which can ‘glue’ pelvic organs together. These adhesions can seriously interfere with normal functions of organs in the pelvis, causing bowel obstructions, digestive problems, infertility, urinary problems, problems when adhesions are pulled, and mobility issues.

Other health issues that may show similar signs to endometriosis include:

Symptoms in relation to location in the body

Reproductive Area Endometriosis

There are various areas where endometrial tissue can develop in the pelvic cavity including:

Pelvic area symptoms

Pelvic pain is one of the most common signs of Endometriosis. It can be excruciating and debilitating for many women. It may be experienced constantly, it may be intermittent or it may be related solely to the menstrual period. Pain can also be provoked by certain activities such as walking, standing too long etc., or it may occur unpredictably.

Occasionally abdominal and pelvic discomfort may be caused by Irritable Bowel Syndrome (IBS). These two diseases are quite common together, so it is advised to take note of the times you experience pelvic discomfort, as it may coincide after meal times.

Lower Back symptoms

Lower back ache is another common but poorly recognised symptom that often coincides with menstruation . It is commonly associated with implants in the pouch of Douglas, utero-sacral ligaments, and recto-vaginal septum.

Ovulation symptoms

Ovulation symptoms can occur in women who do not have the disease, but this pain will normally be a small twinge. In women with endometriosis, ovulation pain can be rather acute. It usually begins 12-24 hours before ovulation and may last for a few days.

This results from the normal enlargement of the ovary during ovulation which causes stretching of endometrial implants and adhesion's lying on the surface of the ovary. It is often described as ‘stabbing’ and it may radiate throughout the pelvic area and into the buttocks and thighs.

The main reproductive signs are:

Uterosacral/Presacral Nerve Endometriosis

Located on the uterosacral ligaments, which are bands of connective tissue in the lower back part of the pelvis

Cul-de-sac ("Pouch of Douglas") Endometriosis

Located directly between the back wall of the uterus and the rectum

Gastro-intestinal symptoms

(recto-sigmoid colon, recto-vaginal septum, small bowel, rectum, large bowel, appendix, gallbladder, intestinal tract) 

Many bowel problems are caused by irritation to the bowel from endometrial implants lying on adjacent areas such as the Pouch of Douglas and the back of the uterus, but some are due to endometrial deposits lying on the outside of the bowel wall. 

The gastro-intestinal disorder which is most common with endometriosis is Irritable Bowel Syndrome which can cause many of the bowel symptoms mentioned above. Candida has also been found to be prevalent in women with Endometriosis, and this too can cause many distressing digestive upsets and discomfort.

The main Gastro-intestinal signs include:

Other Locations of Endometriosis

Urinary Tract (bladder, kidneys, urethras, and urethra)

Urinary tract symptoms are usually the result of endometriosis lying on the outside of the bladder or irritation from endometrial implants lying on the front of the uterus.

The main signs of urinary tract endometriosis are:

Pleural (lung & chest cavity) Endometriosis

Very occasionally the disease can travel to the lungs, which will give rise to strange symptoms, and are usually related to the menstrual cycle.

Sciatic Endometriosis/ Hip pains

Hip pain or discomfort that radiates from the buttock and down the leg is common in women where it has affected the sciatic nerve. Also, endometriosis in the groin area can feel like hip pain.

On occasion adhesion's can restrict the hip ligaments, causing distress and limping. Hip joint pains that worsens in a cyclical fashion in line with the menstrual cycle will usually be caused by endometriosis.

Surgical treatment to remove implants is sometimes undertaken in the hope of relieving the hip joint problem associated with the disease.

Skin Endometriosis

Painful nodules, often visible to the naked eye, at the skin's surface. Can bleed during menses and/or appear blue upon inspection.

Dyspareunia (painful sexual intercourse)

Dyspareunia is a very common problem with this disease. Pain may be felt during intercourse as well as up to 48 hours after sexual activity - for some women the pain can last even longer. It is often associated with implants in the pouch of Douglas or adhesion's in the pelvic cavity. For help with dealing with painful sex read this article HERE

Fatigue

Fatigue and Endometriosis seem to go hand in hand. The fatigue can have various causes, and many diseases can cause daily fatigue.  The fatigue with endometriosis is commonly associated with the body trying to cope with inflammation.

This can be one of the most debilitating aspects of the disease, and most women with endometriosis experience fatigue around the time of their period and some experience it throughout the month. 

Abdominal Bloating

Abdominal bloating is another severe symptoms suffered by many which is referred to as endo belly. It is thought to be due to inflammation in the pelvic cavity caused by the endometriosis  implants.  Find out more about endo belly and how you can help reduce the pain and inflammation  HERE

As mentioned above Irritable Bowel Syndrome (IBS) can cause pelvic pain, and can also cause severe abdominal bloating. With IBS, the bloating is usually caused by intestinal gasses which expand and distend the abdomen and can cause severe discomfort.

Adhesions

The development of adhesions caused by endometriosis is one of the most damaging effects of this disease. Adhesions in endometriosis are caused by chronic local inflammation and the body's natural healing response. Adhesions are not typically classed as a symptom of endometriosis but rather an effect caused by the disease. But it is worth mentioning here as adhesions can cause a lot of damage leading the severe symptoms.

Adhesions are bands of fibrous scar tissue caused by inflammation from endometriosis lesions, which can make pelvic organs stick together. They may not cause symptoms for everyone, but they can lead to symptoms like chronic pelvic pain, painful sex, and bowel issues are common for many women. Adhesion can also limit movement and restrict bowel movements.

It is also important to note that adhesions can be caused by previous surgery. This can include abdominal endometriosis surgery, infections, laparoscopy and laparotomy.

Cause of Adhesions

Lesion Bleeding: Trapped blood and fluid from misplaced tissue irritate the internal lining of the pelvis.

Chronic Inflammation: The immune system reacts to the abnormal growths, setting off continuous healing signals.

Surgical Trauma: Past operations to excise or treat endometriosis can also trigger scar tissue formation as a normal part of post-surgical healing.

Advanced Disease: Severe, deep infiltrating endometriosis creates larger raw and inflamed surfaces that easily stick to nearby organs like the bowel, bladder, or ovaries.

Other Health Issues

The symptoms of endometriosis can also be confused with other health issues, especially gut health problems. Endometriosis can cause symptoms similar to IBS (irritable bowel syndrome). Additionally, it is common for women with endometriosis to have other gut health problems like Leaky Gut or SIBO (Small Intestinal Bacteria Overgrowth) which can be serious as this can cause problems with absorbing vital nutrients.

To conclude

If you have any of these symptoms or suspect you may have endometriosis you need to get a diagnosis as soon as possible. The longer that this disease is left untreated the more damage it can do. If your symptoms are not being taken seriously by your health care provider, then you need to seek a second opinion. 

I know many women have their health problems dismissed and are often gaslit by the medical profession. You will need to be forthright (and thick skinned) to navigate your way to obtaining a diagnosis and getting the treatment you need.

Endometriosis is a serious disease and not something you should be trying to cope with on your own. Some women do give up seeking medical help, because of the bad attitudes and negative treatment. Fight for your corner and don’t give up!

Reference:

https://www.mayoclinic.org/diseases-conditions/endometriosis/symptoms-causes/syc-20354656

https://en.wikipedia.org/wiki/Endometriosis

https://www.webmd.com/women/endometriosis/understanding-endometriosis-symptoms

 

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Carolyn Levett  BA, NT Nutritional Therapist -

Promoting health and well-being through nutrition, diet and lifestyle changes

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