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Fertility journal · reviewed by a doctor
20 Symptoms of Endometriosis: Early Signs, Causes, Treatment
The commonest symptoms of endometriosis are period pain that stops normal life, pelvic pain between periods, pain during sex, painful bowel movements or urination during periods, heavy bleeding, bloating, tiredness and difficulty getting pregnant. Some women have no pain at all. Jananam Fertility Centre, Chennai starts with a scan and checks both partners.
Key takeaways
- Period pain that stops you working, studying or sleeping is not normal and is worth checking.
- Endometriosis can also cause pain during sex, bowel or bladder pain with periods, bloating, tiredness and difficulty conceiving.
- A scan comes first; keyhole surgery is no longer needed just to start treating symptoms (ESHRE 2022).
- Many women with endometriosis conceive; when they don't, the plan depends on age, egg reserve, the tubes and the sperm.
The one symptom most women ignore
Period pain that makes you miss work, college or sleep, month after month. Many women are told it is normal, and so were their mothers. It is not. Pain that painkillers barely touch, or that is getting worse each year, is the clearest early sign of endometriosis and the one most worth a scan.
What to check if you are trying to conceive
Along with the scan, we check egg reserve (AMH) and whether the tubes are open, and he has a semen analysis in the same round. Those results decide whether trying naturally, IUI, surgery or IVF makes sense. Endometriosis and fertility.
When to call us
- Period pain stops you working, studying or sleeping, or painkillers barely help.
- Pain during sex, or bowel or bladder pain that flares with periods.
- You have endometriosis and have been trying for 12 months (6 if you are 35 or over), or sooner if you know it is severe.
- A scan has shown an 'endometrioma' or 'chocolate cyst' on an ovary.
- Sudden severe pelvic pain with fever, vomiting or fainting: call 108 or go to the nearest emergency department, then call us on +91 89399 94244.
- Pain is wearing you down: Tele-MANAS, the free national mental health helpline, is on 14416, 24 hours.
Questions couples ask
What are the first symptoms of endometriosis?
Early signs often include painful periods, pelvic pain, fatigue, and digestive problems.
Can endometriosis cause infertility?
Yes. Endometriosis can affect the reproductive organs and reduce fertility in some women.
What are the 20 symptoms of endometriosis?
Symptoms include pelvic pain, heavy bleeding, fatigue, bloating, infertility, painful periods, and digestive issues, among others.
Does endometriosis pain occur only during periods?
No. Some women experience pain throughout the month.
Can endometriosis disappear naturally?
Symptoms may improve after menopause, but the condition usually requires medical management.
At what age does endometriosis usually begin?
It commonly develops during reproductive years and may begin during adolescence.
Can endometriosis cause bloating?
Yes. Severe abdominal bloating, often called “endo belly,” is common.
Is surgery always required for endometriosis?
No. Treatment depends on symptom severity and fertility goals.
Can IVF help women with endometriosis?
Yes. Fertility specialists may recommend IVF for women struggling to conceive.
Which fertility centre can help with endometriosis-related infertility?
Specialised centres like Jananam Fertility Centre provide fertility evaluations and treatment planning for women facing reproductive challenges.
Not the question you had?
The questions people don't ask with their partner sitting beside them, answered by Dr Vani Sundarapandian.
Reviewed by
Dr Vani Sundarapandian
MD, DGO, FRCOG (UK) · Founder, Jananam Fertility Centre
Reviewed by Dr Vani Sundarapandian, MD, DGO, FRCOG (UK), 20 years exclusively in reproductive medicine. The month below is when she last read it.
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Pain that isn't normal? Let's find out why.
Tell us about your periods and how long it has been going on. Janvi, Jananam's companion for fertility treatment, replies straight away.