A major symptom of endometriosis is recurring pelvic pain. The pain can be mild to severe cramping that occurs on both sides of the pelvis, to the lower back and rectal area and even down the legs. The amount of pain a woman feels is not necessarily related to the extent or stage (1 through 4) of endometriosis. Some women will have little or no pain despite having extensive endometriosis affecting large areas or having endometriosis with scarring. On the other hand, women may have severe pain even though they have only a few small areas of endometriosis. However, pain does typically worsen with severity. Symptoms of endometriosic-related pain may include :
- dysmenorrhea – painful, sometimes disabling cramps; pain may get worse over time (progressive pain), also lower back pains linked to the pelvis
- chronic pelvic pain – typically accompanied by lower back pain or abdominal pain
- dyspareunia – painful sex
- dyschezia – painful bowel movements
- dysuria – urinary urgency, frequency, and sometimes painful voiding
Many women with infertility have endometriosis. As endometriosis can lead to anatomical distorsions and adhesions (the fibrous bands that form between tissues and organs following recovery from an injury), the causality may be easy to understand; however, the link between infertility and endometriosis remains enigmatic when the extent of endometriosis is limited. It has been suggested that endometriotic lesions release factors which are detrimental to gametes or embryos, or, alternatively, endometriosis may more likely develop in women who fail to conceive for other reasons and thus be a secondary phenomenon; for this reason it is preferable to speak of endometriosis-associated infertility in such cases.
Other symptoms may be present, including:
- nausea, vomiting, fainting, dizzy spells, vertigo or diarrhea—particularly just prior to or during the period or after
- frequent or constant menses flow
- chronic fatigue
- heavy or long uncontrollable menstrual periods with small or large blood clots
- some women may also suffer mood swings
- extreme pain in legs and thighs
- back pain
- mild to extreme pain during intercourse
- extreme pain from frequent ovarian cysts
- pain from adhesions which may bind an ovary to the side of the pelvic wall, or they may extend between the bladder and the bowel,uterus, etc
- extreme pain with or without the presence of menses
- mild to severe constipation
- premenstrual spotting
- mild to severe fever
In addition, women who are diagnosed with endometriosis may have gastrointestinal symptoms that mimic irritable bowel syndrome
Patients who rupture an endometriotic cyst may present with an acute abdomen as a medical emergency.
Occasionally pain may also occur in other regions. Cysts can occur in the bladder (although rare) and cause pain and even bleeding during urination. Endometriosis can invade the intestine and cause painful bowel movements or diarrhea.
In addition to pain during menstruation, the pain of endometriosis can occur at other times of the month and doesn't have to be just on the date on menses. There can be pain with ovulation, pain associated with adhesions, pain caused by inflammation in the pelvic cavity, pain during bowel movements and urination, during general bodily movement i.e. exercise, pain from standing or walking, and pain with intercourse. But the most desperate pain is usually with menstruation and many women dread having their periods. Also the pain can start a week before menses, during and even a week after menses, or it can be constant. There is no known cure for endometriosis.
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