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Could Your Pain Mean You Have Endometriosis?

Could Your Pain Mean You Have Endometriosis?

This article is for women who are having pain in their abdomen (belly) or pelvic area during or in between their periods, or during or after sex, or their care partners or anyone who wants to learn more about endometriosis. The goal of this patient education activity is to educate patients on the importance of engaging with their doctor and healthcare team about their pain and how to recognize endometriosis.

You will learn about:

  • What endometriosis is

  • What causes endometriosis and who's at risk for getting it

  • How you or your doctor can recognize endometriosis

  • How endometriosis is diagnosed and what tests your doctor may do

  • How to lower your chances of endometriosis

  • Questions to ask your doctor

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What Is Endometriosis?

Endometriosis is a condition that can happen in women when the tissue that normally lines the inside of your uterus or womb -- called the endometrium -- grows outside of your uterus, where it doesn't belong. This tissue can grow on your ovaries, fallopian tubes, the outside of your uterus, and on other organs inside your pelvic area and abdomen (belly).

Endometriosis growths are benign (not cancerous), but they can still cause problems, such as pain.

Source: Blausen.com staff (2014). "Medical gallery of Blausen Medical 2014". WikiJournal of Medicine 1 (2). DOI:10.15347/wjm/2014.010

What Causes Endometriosis?

No one knows for sure what causes endometriosis, but some possible causes are:

  • Genetics. Because endometriosis runs in families, it can be inherited (passed on genetically)

  • Menstrual blood flow problems, called retrograde menstruation. During your period, blood may flow back through the fallopian tubes into your pelvic area, instead of out your body. Endometrial cells in the blood can then stick to organs and grow

  • Immune system problems. Your body may not recognize and destroy endometrial tissue that's growing outside your uterus

  • Hormones, such as estrogen, may cause endometriosis in some people

  • Surgery in your abdomen, such as a hysterectomy or C-section, may cause endometrial tissue to move

Who's at Risk for Endometriosis?

Endometriosis is a fairly common health problem in women, and can happen in anyone with a uterus. It can happen in women at any age, and may make it harder to get pregnant.

You might have a greater chance of endometriosis if you:

  • Have never given birth

  • Started getting your period at a younger age

  • Started going through menopause at an older age

  • Have periods that last longer than 7 days

  • Get your period every 27 days or less

  • Have a family member with endometriosis

  • Have a health problem that blocks the normal flow of blood from your uterus during your period

Pain Is the #1 Symptom of Endometriosis

Pain in your abdomen (belly) or pelvic area is the most common symptom of endometriosis. Cramps during your period can be tough, but if you have endometriosis, the pain can be so intense it disrupts your daily activities.

Pain might start before your period and can last for several days. It can feel sharp and stabbing. Pain can also happen before, during, or after your period at any time of the month.

Endometriosis pain can also happen during or after sex and last for up to 2 days. It can feel stabbing or sharp, or like a deep ache.

This type of pain should not be thought of as "normal" or just period cramps, so be sure to talk to your doctor about it.

Other Pain and Symptoms

Other types of pain you may have with endometriosis can include:

  • Chronic (long-term) lower back pain

  • Leg or hip pain as weakness or numbness, or sharp pain that gets worse when you walk

  • Painful bowel movements or urinating, especially during your period

Additional symptoms include:

  • Bleeding or spotting between periods

  • Very heavy bleeding during periods

  • Infertility (not being able to get pregnant)

  • Stomach or digestive problems such as diarrhea, constipation, bloating, indigestion, or nausea, especially during your period

  • Fatigue, especially around your period


Some people with endometriosis don't have any symptoms. But it's important to know that many different conditions can cause pain, so if you're having pain or any other symptoms, talk to your doctor.

How to Know if You Have Endometriosis

Your doctor may do tests or procedures to find out if you have endometriosis, such as:

  • Pelvic exam to feel your uterus

  • Ultrasound or magnetic resonance imaging (MRI) to get pictures of your organs and pelvic area

  • Laparoscopy, a surgical procedure that lets the doctor check for endometriosis tissue

  • Biopsy, where a small piece of tissue is removed and examined

Tips to Help With Your Endometriosis

You can't prevent endometriosis, but you can help manage your symptoms and lower your chances by:

  • Talking to your doctor right away if you have pain or other symptoms

  • Exercising regularly to maintain a healthy weight

  • Eating a diet that's high in fruits and vegetables

  • Avoiding large amounts of alcohol (no more than 1 drink per day)

  • Managing your stress

There is no cure for endometriosis, but it is treatable -- talk to your doctor about your treatment options.

Questions to Ask Your Doctor

When you tell your doctor about your symptoms, be specific. Don't leave out symptoms and don't downplay your pain. Keeping a journal of your symptoms and when they started and what they felt like can be helpful.

Questions to ask your doctor can include:

  • Can endometriosis be causing my pain?

  • Am I at risk for endometriosis?

  • What symptoms of endometriosis should I look for?

  • Are there any tests I should have?

  • What medicines or treatments are available and what are their side effects?

  • Are there lifestyle changes I should make?

  • What type of diet should I be eating and what exercise should I do?

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You have successfully completed the program: Could Your Pain Mean You Have Endometriosis?

View Additional Materials

View Additional Materials on this topic that you may find useful

Endometriosis Association Website

Endometriosis: What Are Your Treatment Options?

Authors and Disclosures


Susan L. Smith, MN, PhD

Senior Medical Education Strategic Director, Medscape, LLC

Disclosure: Susan L. Smith, MN, PhD, has disclosed no relevant financial relationships.


Anita A. Galdieri, PharmD, RPh

Senior Scientific Content Manager, Medscape, LLC

Disclosure: Anita A. Galdieri, PharmD, RPh, has disclosed no relevant financial relationships.


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