By Geradine Ohonba
Health Editor/Columnist
Endometriosis is a chronic and often painful condition in which tissue similar to the lining of the uterus grows outside the uterine cavity. Affecting an estimated 1 in 10 women of reproductive age worldwide, endometriosis is more than just “bad period cramps.” It’s a complex medical condition that can significantly impact a woman’s physical, emotional, and reproductive health. Yet, despite its prevalence, endometriosis often goes undiagnosed or misdiagnosed for years. Understanding and recognizing the signs early can lead to timely treatment and better quality of life.
1. Painful Periods (Dysmenorrhea)
One of the most common and early symptoms of endometriosis is severe menstrual pain that goes beyond normal cramping. While many women experience discomfort during their periods, endometriosis-related pain tends to be intense, persistent, and often begins before menstruation starts and continues after it ends. The pain may radiate to the lower back and legs, and over-the-counter pain relievers may offer little to no relief. This type of chronic pelvic pain can disrupt daily activities and should not be dismissed as “just part of being a woman.”
2. Chronic Pelvic Pain
Chronic pelvic pain is another hallmark sign of endometriosis. Unlike menstrual cramps that come and go, this pain can be ongoing throughout the month. It may feel like a dull ache, sharp stabbing pain, or pressure deep in the pelvis. Women often describe it as debilitating, especially during ovulation or sexual activity. The pain may worsen over time and can significantly interfere with work, relationships, and overall well-being.
3. Pain During or After Sex (Dyspareunia)
Painful intercourse is a commonly overlooked symptom of endometriosis. This pain is usually felt deep within the pelvis during penetration and may persist for hours afterward. It is often caused by endometrial tissue growing behind the uterus or near the cervix, which becomes irritated during sexual activity. Unfortunately, many women suffer in silence due to embarrassment or the assumption that this pain is normal. Open communication with healthcare providers is essential for identifying and addressing this symptom.
4. Painful Bowel Movements or Urination
Endometriosis can affect the bowel and bladder, particularly if the endometrial tissue grows on or near the rectum, colon, or bladder. As a result, some women experience pain during bowel movements or urination, especially during menstruation. In some cases, there may also be constipation, diarrhea, bloating, or nausea. These gastrointestinal symptoms can easily be mistaken for irritable bowel syndrome (IBS), delaying proper diagnosis and treatment.
5. Heavy or Irregular Periods
Many women with endometriosis report experiencing menorrhagia—unusually heavy menstrual bleeding. This may include soaking through pads or tampons every hour, passing large blood clots, or bleeding for more than seven days. Some also experience spotting or bleeding between periods. Although variations in menstrual flow are common, consistently heavy or unpredictable bleeding may indicate an underlying issue like endometriosis.
6. Infertility or Difficulty Conceiving
A significant percentage of women with endometriosis—up to 40%—experience fertility challenges. The condition can cause inflammation, scarring, and adhesions that distort the reproductive organs, making it more difficult for eggs to travel through the fallopian tubes or for embryos to implant successfully. While not all women with endometriosis are infertile, difficulty getting pregnant can be an important clue that warrants further evaluation by a specialist.
7. Fatigue and Emotional Strain
Endometriosis doesn’t only cause physical pain; it can also lead to chronic fatigue, depression, and anxiety. Living with ongoing pain, uncertainty, and missed opportunities (from work to social events) takes a toll. The emotional burden of the disease—especially when symptoms are minimized or misunderstood—can be overwhelming. Sleep disruption due to pain may also contribute to ongoing exhaustion, creating a cycle that impacts both mental and physical health.
When to See a Doctor
If you are experiencing one or more of these symptoms, especially if they interfere with your daily life, it’s important to seek medical attention. Unfortunately, many women with endometriosis are dismissed or told their pain is “normal.” Being your own advocate, keeping a symptom diary, and asking for a referral to a gynecologist or endometriosis specialist can make all the difference. Early detection and appropriate management—ranging from pain relief to hormonal therapy and surgery—can greatly improve outcomes.
Endometriosis is a serious, often misunderstood condition that affects millions of women around the world. Recognizing the signs early—such as painful periods, chronic pelvic pain, and infertility—can help shorten the time to diagnosis and lead to more effective care. No woman should have to endure years of unexplained pain. By raising awareness and promoting early detection, we take a crucial step toward improving the lives of those living with endometriosis.
