Endometriosis Symptoms and Signs

As a Vulva Doctor Will Tell you: “Endometriosis affects up to 10% of women between the ages of 15 and 44. It most often occurs on or around reproductive organs in the pelvis or abdomen. Endometriosis affects hundreds of thousands of women every year. Cramps are never pleasant, but for women with endometriosis, they’re unbearable” [1]

The Low-Down

Endometriosis refers to a condition in which endometrial tissue grows outside the uterus. In order to prepare for egg fertilisation, every time a woman has menstrual cycle arrives, their body has to grow a new endometrium. (The latter refers to the tissue which lines the uterus (womb) – the pear-shaped organ which houses a fetus) [1].

Endometrial tissue can grow in the following areas:
• The fallopian tubes
• The ovaries
• The ligaments surrounding the uterus
• The pelvic cavity lining
• The exterior surface of the uterus
• The gap between the uterus and the bladder or rectum
Moreover, in rarer instances, endometrial tissue can grow on and around the:
• Cervix
• Bladder
• Rectum
• Intestines
• Abdomen (stomach)
• Vulva or vagina [1]

Did You Know?

“Endometrial tissue growing in these areas does not shed during a menstrual cycle like healthy endometrial tissue inside the uterus does. The build-up of abnormal tissue outside the uterus can lead to inflammation, scarring and painful cysts. It can also lead to a build-up of fibrous tissues between the reproductive organs” (this causes them to ‘stick’ together) [1]

So What Endometriosis Symptoms Should I Look Out For?

As Vulva Consultants note, the two key signs of endometriosis, are infertility and pain. Moreover, when patients undergo an examination by a Vulva Pain Doctor, their pain from endometriosis normally presents as:
•Painful menstrual cramps which may extend to the lower back or stomach (abdomen)
•Painful sex, or post-sex
Moreover, other symptoms comprise:
•Constipation or diarrhoea at the time of a menstrual period
•Irregular or heavy periods
•Low energy or fatigue
•Bleeding or spotting during the time between menstrual periods
•Pain when: having a bowel movement or urinating at the time of a menstrual period [1]

During an online or in-person consultation, a Vulva Specialist will explain that every patient’s endometriosis experience is different. For example, some endometriosis patients could exhibit a few of the aforementioned symptoms, every symptoms, or none of them. Moreover, it is important to point out that experiencing severe pain or other symptoms, does not automatically mean that the endometriosis very severe [1].

So What Causes Endometriosis?

Potential causes of endometriosis, include:
• Lymph or blood system transportation (endometrial tissues are transported to other regions of the body via the lymphatic or blood systems)
• Direct transplantation: endometrial cells could bind to the abdomen walls or other areas of the body after a patient has undergone surgery
• Genetics: there appears to be a genetic link to endometriosis
• Reverse menstruation: endometrial tissue enters the abdomen and fallopian tubes instead of being passed from the body at the time of menstruation
• Transformation: Other body cells could become endometrial cells, and begin to grow outside the endometrium [1]

Getting an Accurate Endometriosis Diagnosis

• A Vulva Doctor could determine that endometriosis is highly likely based on each patient’s physical examination and medical history. They may diagnose endometriosis by:
• Laparoscopy or
• A biopsy
Moreover, Pain Doctors often use imaging studies to look for signs of endometriosis. These comprise:
• Ultrasound
• MRI [1]

Once an accurate diagnosis has been made, the Vulva Specialist will then draw up a Personalised Treatment Plan.


[1]. John Hopkins Medical (2024). “Endometriosis.”