The Painful Symptoms of Endometriosis Every Woman Should Be Able to Recognize

This article was medically reviewed by Carolyn Swenson, MD, an assistant professor of obstetrics and gynecology and member of the Prevention Medical Review Board, on July 26, 2019.

As women, we’ve almost all experienced cramping around our periods at some point or another. But according to the Office on Women’s Health, for more than 11 percent of women ages 15 to 44 (aka reproductive ages), there’s one big culprit behind those pelvic aches: endometriosis.

“Endometriosis is a condition where the inner tissue lining of the uterus grows outside of the uterus and causes an inflammatory response,” says Jennifer Conti, MD, clinical assistant professor of obstetrics and gynecology at Stanford University.

Translation: Instead of the lining of your uterus coming out the cervix and into the vagina during your period, imagine it “backing up” into your fallopian tubes and going out the ends of them, leading the tissue to plant itself on various pelvic organs, including your intestines. “It can take up residence there, and act just like the lining of the uterus, but bleeding into the abdominal cavity—not out the uterus and out of the body,” says Mary Jane Minkin, MD, clinical professor of obstetrics, gynecology, and reproductive sciences at Yale New Haven Hospital. “You can imagine that can be pretty painful.”

This process in particular—where the lining flows in the wrong direction during menstrual periods through the fallopian tubes—is called retrograde menstruation, and it’s thought to be the possible trigger of endometriosis, says Rebecca Brightman, MD, a New York-based gynecologist and educational partner for SpeakENDO.

While the exact cause of the condition is unknown, the most common risk factor of endometriosis is a positive family history of it, says Dr. Conti. “If your mom or sister has endometriosis, then you’re much more likely to experience it, as well,” she says. And even though endometriosis can occur in any woman of reproductive age, it’s more common in women in their 30s, which is likely related to the years of having periods, says Dr. Minkin.

For most women with the condition, it’s not the easiest to live with. “Endometriosis is responsible for many days of missed school, missed work, and interference with general quality of life, including sexual dysfunction and subsequent relationship issues,” says Alyssa Dweck, MD, a New York-based gynecologist and author of The Complete A to Z for Your V.

Another hard truth? Endometriosis can often takes years (and multiple practitioners) to formally diagnose, says Dr. Dweck. That’s why it’s so important for women to be able to spot the symptoms early and start treating them. Unfortunately, the signs will vary from woman to woman—and some women may not experience any symptoms at all—but the following red flags warrant a chat with your OB/GYN.