Symptoms of endometriosis can vary and some individuals experience symptoms that others may not.

The most common symptom of endometriosis is chronic pelvic pain, which may feel similar to menstrual cramps. The pain often correlates to the menstrual cycle, however, a person with endometriosis may also experience pain at other times.

Endometriosis is described as a chronic illness as it lasts a long time, sometimes for the rest of the affected persons life. When describing an illness, the term chronic refers to how long a person has it, not to how serious a condition is.

The symptoms of endometriosis can vary in intensity. For some individuals, the pain of endometriosis can be so severe and debilitating that it impacts on their life and they may not be able to carry out normal day to day activities.

Common symptoms

The most common symptoms of endometriosis are
  • Pain in the lower abdomen, pelvis or lower back
  • Changes to your periods such as spotting before your period is due
  • Pain before, during or after your period
  • Painful, heavy or irregular periods
  • Painful menstrual cramps
  • Pain during or after sex
  • Abdominal bloating
  • Painful or problematic bowel movements, including diarrhoea or constipation
  • Pain on passing urine
  • Extreme fatigue
  • Nausea

Another symptom of endometriosis can be infertility. It is estimated that 30-40% of women with endometriosis are sub-fertile (being less than normally fertile though still capable of effecting fertilisation). Infertility is not always caused by endometriosis - it can be due to many other factors.

Classifying endometriosis

Endometriosis is often classified as mild, moderate or severe, or as stage I-IV.
  • Mild or Stage I endometriosis - small patches, surface lesions or inflammation on or around organs in the pelvic cavity.
  • Moderate or Stage II-III endometriosis - sometimes more widespread and starting to infiltrate pelvic organs, peritoneum (pelvic side walls) or other structures. Sometimes there is also scarring and adhesions.
  • Severe or Stage IV endometriosis - infiltrative and affecting many pelvic organs and ovaries, often with distortion of the anatomy and adhesions.
These stages provide a useful guideline, however, they also have limitations. For instance, the amount of endometriosis does not always correspond to the amount of pain and discomfort. A small amount of endometriosis can be more painful than severe endometriosis. It depends, largely, on where the endometriosis is actually growing inside the body.

* All of the symptoms above may have other causes. It is important to seek medical advice to clarify the cause of any symptoms you may experience. If your symptoms change after diagnosis, it is important to discuss these changes with a medical practitioner. It is easy to attribute all your problems to endometriosis, but it may not always be the cause of your symptoms. The symptoms of endometriosis can also indicate many other conditions and because endometriosis manifests itself in a variety of ways, diagnosis can be difficult.