Endometriosis impacts around one in 10 women and people who menstruate in the UK.  This makes it surprising that the cause remains unknown  and that it is difficult to diagnose . Read on to find out more about the signs and symptoms of endometriosis, as well as some of the theoretical causes. 

What are the first signs of endometriosis?

If you think you might have endometriosis, you can find some of the most common symptoms below:  

• Painful periods
• Heavy periods
• Pain that spreads acoss the levis, lower back and even your legs
• Pain that occurs during sexual intercourse
• Bleeding or spotting in between your periods

The severity and frequency of pain differs from woman to woman. Some women might only experience pain during their period, whereas others may experience it at other points in their cycle or all the time. In some cases, this pain can also arise when you have sex or go to the toilet. Some people may not even have any symptoms at all. 

The symptoms of endometriosis can sometimes be confused with those of other health conditions. Should you have some of the symptoms above, it’s recommended that you seek further advice and diagnosis from a medical professional to confirm the condition. 

What does endometriosis pain feel like?

The pain associated with endometriosis can differ from person to person. Some describe a “sharp jabbing pain”  whereas others say it’s like period pain . It’s important to note, however, that period pain is a different condition which has a different cause. 

Every month as part of the  menstrual cycle, the endometrial layer within the uterus thickens to prepare for a fertilised egg.  When an egg isn’t fertilised, the lining is released as a period.  

Period pain is generally the result of the uterus contracting in order to shed this lining  and is thought to affect nine in 10 women in the UK aged 16 to 40 (according to Wellbeing of Women, 2023).  

In contrast, the pain associated with endometriosis is usually caused by endometrial cells growing in places besides the uterus. The cells act the same as they would do in the womb, thickening at a certain time of the month ready to be released. The problem is they cannot be released – they have nowhere to go and therefore become trapped, resulting in pain and swelling. These endometrial cells can be found in the organs within the reproductive system, like the fallopian tubes or ovaries, but even outside these areas, in the bladder or bowel.  In extreme cases the cells can fuse these organs together.  

What does endometriosis pain feel like?

The pain associated with endometriosis can differ from person to person. Some describe a “sharp jabbing pain”  whereas others say it’s like period pain . It’s important to note, however, that period pain is a different condition which has a different cause. 

Every month as part of the  menstrual cycle, the endometrial layer within the uterus thickens to prepare for a fertilised egg.  When an egg isn’t fertilised, the lining is released as a period.  

Period pain is generally the result of the uterus contracting in order to shed this lining  and is thought to affect nine in 10 women in the UK aged 16 to 40 (according to Wellbeing of Women, 2023).  

In contrast, the pain associated with endometriosis is usually caused by endometrial cells growing in places besides the uterus. The cells act the same as they would do in the womb, thickening at a certain time of the month ready to be released. The problem is they cannot be released – they have nowhere to go and therefore become trapped, resulting in pain and swelling. These endometrial cells can be found in the organs within the reproductive system, like the fallopian tubes or ovaries, but even outside these areas, in the bladder or bowel.  In extreme cases the cells can fuse these organs together.  

What are the other signs of endometriosis?

There are more signs of endometriosis besides pain. These might include: 

• Fertility problems/issues when trying to conceive
• Bleeding from the rectum
• Bowel blockage, caused by endometrial cells in the intestines
• Bloating
• Tiredness and/or exhaustion.

What causes endometriosis?

There is no known cause of endometriosis, however there are a number of unproved theories and potential explanations that may help us to understand why it affects some women.  

The theories include: 

• Genetics
• An ineffective immune system
• Transported cells via the bloodstream.  

It’s speculated that endometriosis can be passed down through the generations, particularly as African-Caribbean women are less likely to have the condition and it’s more common in Asian women.  The condition also seems to run in families, suggesting that genes are a factor.  

Another theory is that in some women, the immune system isn’t strong enough to fight off endometriosis. It’s still undecided, however, whether the immune system is weaker because of the condition or the condition is present because of the weaker immune system. 

Endometriosis may also be carried around the body via the bloodstream. While this hasn’t been proven, it might explain why endometrial cells are found in unusual places, like the eyes (though this is rare). 

Today, these theories are nothing more than that - theories. None of them are regarded as a sole accepted cause of endometriosis as none of them provide a full explanation for the condition - which is why many researchers believe it might be caused by a combination of various factors. 

Part of what makes it so difficult to ascertain the exact cause of endometriosis is that it is so difficult to diagnose. To get a proper diagnosis, surgical measures may need to be taken, including a laparoscopy, but even then, studies and research projects would require appropriate control groups, and the symptoms aren’t always the same in every woman.   

If you suspect that you might be suffering with endometriosis, you should seek medical advice from a healthcare professional who will advise you on any treatments for the condition should this be needed. 

Sources

https://www.endometriosis-uk.org/fionnulas-story 
https://www.nhsinform.scot/healthy-living/womens-health/girls-and-young-women-puberty-to-around-25/periods-and-menstrual-health/endometriosis/ 
https://mft.nhs.uk/app/uploads/sites/4/2018/04/11-65-Endometriosis-Sept-19.pdf  
https://www.endometriosis-uk.org/laurens-story 
https://www.endometriosis-uk.org/i-could-not-explain-what-i-was-feeling-pain-would-go-hours 
https://www.endometriosis-uk.org/symptoms 
https://www.endometriosis-uk.org/fionnulas-story  
https://www.nhs.uk/conditions/endometriosis/  
https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5737931/  

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