How Do I Know If It’s Endometriosis? Key Symptoms Explained

Endometriosis is a common yet often misunderstood condition that affects around one in ten women of reproductive age. Despite how widespread it is, many women wait years for a diagnosis because the symptoms can be mistaken for “normal period pain.” Knowing the key signs can help you recognise when it’s time to seek specialist advice.

What is Endometriosis?

Endometriosis occurs when tissue similar to the lining of the womb (endometrium) grows outside the uterus. These growths can appear on the ovaries, fallopian tubes, bladder, or bowel. Just like the womb lining, this tissue responds to monthly hormonal changes, thickening and bleeding during the menstrual cycle. However, unlike a period, the blood has nowhere to go, leading to inflammation, scarring, and pain.

Key Symptoms of Endometriosis

While symptoms vary from woman to woman, the following are the most common signs:

1. Severe Period Pain

Period cramps are normal, but if your pain is so intense it interferes with work, school, or daily activities, it could be a sign of endometriosis. Pain that doesn’t improve with over-the-counter medication should always be investigated.

2. Pain During or After Sex

Painful intercourse (dyspareunia) is another classic symptom. It may be sharp, stabbing, or lingering discomfort afterwards. This happens because endometrial tissue can irritate pelvic organs and surrounding nerves.

3. Pelvic or Abdominal Pain Outside of Your Period

Endometriosis pain isn’t limited to menstruation. Some women feel chronic pelvic or abdominal pain at other times of the month, often linked to ovulation or bowel movements.

4. Heavy or Irregular Periods

Periods that last longer than seven days, involve heavy bleeding, or include large clots may point to underlying endometriosis or related conditions such as fibroids.

5. Fertility Problems

Endometriosis is one of the leading causes of infertility. Scarring and adhesions can affect the ovaries and fallopian tubes, making it more difficult for eggs to be released or fertilised.

If you’ve experienced ongoing pelvic pain, heavy periods, or fertility struggles, a private gynaecology consultation and ultrasound can help uncover whether endometriosis could be the cause.

Other Symptoms You Might Notice

Endometriosis can also affect the bladder and bowel, leading to:

• Pain when passing urine or during bowel movements, especially during your period
• Bloating and digestive discomfort (“endo belly”)
• Fatigue or low energy, often linked to heavy bleeding and inflammation

These symptoms can mimic other conditions, which is why endometriosis is often misdiagnosed.

How Endometriosis is Diagnosed

Diagnosis usually begins with a detailed history and examination. Investigations may include:

• Ultrasound scans: While not always definitive, they can identify cysts (endometriomas) linked to endometriosis.
• MRI scans: Provide a clearer picture of deep pelvic disease.
• Laparoscopy: A minimally invasive surgical procedure considered the “gold standard” for diagnosis, allowing both confirmation and treatment.

Early referral to a gynaecologist is key, as waiting too long can worsen symptoms and complications.

Managing Endometriosis

There is no single cure, but treatments can relieve symptoms and improve quality of life. Options include:

• Pain relief medication
• Hormonal treatments such as the pill, coil, or injections
• Surgery to remove endometrial tissue or cysts
• Fertility support if conception is difficult

The right approach depends on your symptoms, age, and whether you are planning a pregnancy.

Final Thoughts

Endometriosis is more than just “bad period pain.” If your symptoms are interfering with your daily life, it’s important not to dismiss them as normal. Recognising the warning signs and seeking specialist advice early can make a huge difference to your long-term health and fertility.

If you’re worried about endometriosis

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