Symptoms Of Endometriosis You Shouldn't Ignore

Endometriosis is a chronic gynecological condition. According to Johns Hopkins Medicine, endometriosis occurs when tissue similar to the lining of the uterus grows outside the uterus. This diseased tissue is most often found on the outside of the uterus, the ovaries, the fallopian tubes, the bowels, or the bladder (per MedlinePlus). However, endometriosis tissue can grow anywhere in the body. In rare cases, it's even been found in the lungs.

This errant tissue behaves just like the tissue that lines the uterus. Each month when a person's menstrual cycle occurs, the diseased tissue follows the same pattern as the lining of the uterus. First it builds up, getting thicker and thicker to prepare for the implantation of a fertilized egg. When a fertilized egg doesn't implant, the tissue starts to break down.

When this process happens to the endometrium that lines the uterus, the broken-down lining expels itself from the body in the form of menstrual blood. The endometrium-like tissue outside the uterus cannot expel itself from the body. So  when it starts to break down, the tissue bleeds, which leads to swelling, inflammation, tissue damage, and eventually scarring. This can lead to intensely painful and difficult periods.

Despite what people with uteri are often told, periods should not be intensely painful or difficult. If they are, endometriosis can be the cause. Here are some symptoms of endometriosis that you should never write off as "just a bad period."

According to the Cleveland Clinic, menstrual bleeding is classified as heavy when it lasts for more than seven days or when you lose an excessive amount of blood during menstruation. People with heavy menstrual bleeding often have to change their tampon or pad several times a day, sometimes every single hour. Sometimes people who experience heavy menstrual bleeding will expel blood clots, which can be the size of a quarter or even larger. Some people with heavy menstrual bleeding will lose so much blood that they develop secondary symptoms like chronic fatigue, shortness of breath, and anemia.

Many people dismiss heavy menstrual bleeding as a "bad period" because they believe that heavy bleeding is just part of having a menstrual cycle. But it's not! If you have to wear a tampon and a pad at the same time and excuse yourself to change them, that's not normal menstruation. If you regularly pack a second pair of underwear and pants because you think you might bleed through your clothes, that's not normal menstruation. If you're skipping out on life because of your menstrual bleeding, that's definitely not normal.

Several conditions can cause heavy menstrual bleeding, and endometriosis is one of them, according to the Mayo Clinic. So if your heavy menstrual bleeding is interfering with your life for multiple days out of each month, it's time to talk to your doctor.

Another telltale sign of endometriosis is pain during sex. According to Everyday Health, the type of pain experienced during sex by people with endometriosis varies from person to person. While one person might experience a dull, aching pain during sex, another may experience sharp, stabbing pain. Some people only experience pain with deep vaginal penetration, while others experience pain with vaginal penetration of any kind. For some people, the pain even persists after sex is done, sometimes for days.

The misplaced, endometrium-like tissue characteristic of endometriosis often grows on the uterus, the ligaments surrounding the uterus, the cervix, and the vagina. This tissue often damages the surrounding healthy tissue (via Johns Hopkins Medicine). During sex, this damaged tissue is moved and stretched by penetration, which irritates it, leading to pain.

Any kind of persistent pain during vaginal penetration, even if it's mild, should be discussed with a gynecologist or primary care physician as soon as possible. It's not normal to experience pain during penetration. Pain during sex isn't always a sign of endometriosis. However, it's often one of the earliest signs of the disease.

When you think about symptoms of gynecological illnesses, the first symptoms that come to mind probably don't have anything to do with your gastrointestinal or urinary tracts. However, painful bowel movements and painful urination can definitely be symptoms of endometriosis, according to Endometriosis.net.

Some people with endometriosis experience pain with urination, almost like an urinary tract infection, but without an infection. Some people also describe uncomfortable pressure when they urinate. Other people have trouble passing bowel movements. They experience uncomfortable pressure and pain in their anus and rectum even when they're not constipated and passing a relatively soft stool. Some people have painful bowel movements but not painful urination, while others experience both. The symptoms usually occur around the time of menstruation.

Doctors and researchers that specialize in endometriosis aren't entirely sure why the disease causes bladder and bowel pain. One potential reason is that diseased tissue can grow directly on the bladder and bowel, which creates lesions on these organs. Another possibility is that scar tissue from the lesions can build up in the pelvic cavity and prevent the organs from functioning as they should. Yet another theory is that the persistent inflammation caused by the lesions and scar tissue can impact the function of both the bowel and the bladder. Regardless of the reason, bladder and bowel pain that can't be explained by other pathologies may well be a sign of endometriosis.

Chronic problems with urination that won't go away and can't be explained by other diseases can also be a sign of endometriosis. According to Verywell Health, there are two explanations: bladder endometriosis and interstitial cystitis (IC), also known as painful bladder syndrome.

Bladder endometriosis occurs when diseased tissue implants itself on the outside of the bladder or the ureters. This tissue tries to shed each cycle, causing lesions and scar tissue to build up on the bladder and/or ureters, inhibiting their proper function. Bladder endometriosis can cause uncomfortable symptoms like painful urination, bladder pain, pelvic pain, lower back pain, needing to urinate all the time, an urgent need to urinate, and even blood in the urine.

Another cause of urinary tract issues that often coincides with endometriosis is interstitial cystitis or painful bladder syndrome. Though endometriosis doesn't cause IC, the conditions often occur together. Experts believe that as many as 66% of people with endometriosis have interstitial cystitis. IC is a diagnosis for a collection of symptoms. The hallmark symptoms are constant pain and pressure in the urinary tract, accompanied by other urinary symptoms like painful, frequent, or urgent urination. Again, not all people with IC have endometriosis, but those who do should be evaluated for the disease.

Chronic urinary tract problems can be caused by a wide variety of conditions other than endometriosis. But if other conditions have been ruled out, it's worth being evaluated for endometriosis.

According to The Femedic, back and leg pain is a common symptom for people with endometriosis. Since the endometrium-like tissue associated with endometriosis can grow nearly anywhere in your body, it's not uncommon for it to grow on the ligaments and nerves around the low back. This causes damage to these ligaments and nerves, leading to inflammation which causes chronic back pain.

Chronic back pain from endometriosis often feels like an ache or a sharp pain deep within your back. Some people with endometriosis experience this pain only around their period. Others experience back and leg pain all the time. According to Healthline, the disease tissue can also grow on and around the sciatic nerve, which can lead to pain that shoots or radiates down your leg. This pain is often described as sharp and stabbing or dull and throbbing, and it can switch back and forth between the two sensations.

Back and leg pain caused by endometriosis doesn't respond to typical treatments like stretching, changing position, or chiropractic adjustment. For some, over-the-counter pain medications like Ibuprofen and Aspirin provide relief. However, many people with endometriosis find that these remedies don't touch their pain. Other common home remedies include heating pads and hot baths. If you have chronic back and/or leg pain that hasn't been explained by another condition along with any of the other symptoms of endometriosis, definitely talk to your doctor.

One study on fatigue and endometriosis published in the medical journal Human Reproduction found that a majority of people with endometriosis struggle with severe and chronic fatigue. The study also concluded that women with endometriosis are twice as likely to experience fatigue than women without endometriosis. Additionally, the study revealed that severe and chronic fatigue is one of the common symptoms of endometriosis that has the biggest impact on quality of life.

Another study that assessed the impact of fatigue in women with endometriosis found that fatigue had a significant impact on their quality of life. More than two-thirds of the participants said that their fatigue was "extremely bothersome" or "quite bothersome." They reported that fatigue regularly limited their ability to complete day-to-day tasks, succeed at work, and maintain strong relationships. They also stated that fatigue had a major impact on their emotions and overall mood.

The study included interviews with each of the subjects, during which they described their experience of fatigue. The women said that they often felt "exhausted, drained, tired, lethargic, worn out, and/or weak," and that they were often too tired to complete basic self-care activities like showering, washing their hair, and brushing their teeth. Additionally, the participants stated that they often canceled plans or avoided social situations because of fatigue, and that fatigue prevented them from exercising. So if you're tired and drained all the time and it's impacting your daily life, it could be a sign of endometriosis.

Endometriosis cannot be definitively diagnosed without laparoscopic surgery, per the National Institute of Health. Though diagnostic tests like ultrasounds and MRIs can provide your doctor with information that suggests endometriosis, they cannot definitively diagnose endometriosis. 

If you have several of the symptoms of endometriosis, your doctor may unofficially diagnose you with endometriosis and start treatment like hormonal birth control or hormone therapy, per the Office on Women's Health. If you get significant relief from these treatments, then you most likely have endometriosis, and your doctor will continue to treat your symptoms with a combination of hormone therapy, birth control, and/or pain medications. If your symptoms are severe and these methods do not provide relief, your doctor will likely recommend laparoscopic surgery. Your doctor will make several small incisions in your abdomen and insert a special instrument to visualize the inside of your abdomen. This will allow them to see where the endometrium-like tissue has grown and formed lesions and adhesions. During the same procedure, they can remove the diseased tissue, lesions, and adhesions. They will also do biopsies to confirm the endometriosis diagnosis. Once the endometrium-like tissue is removed, many people find great relief from their symptoms. However, the tissue can regrow, causing symptoms to recur. Some people need multiple surgeries for endometriosis.

If you have any of these signs or symptoms of endometriosis, do not ignore them! Schedule an appointment with your gynecologist ASAP to see what they think.