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Symptoms and causes

Endometriosis affects everyone differently. The severity of symptoms is often related to the location of endometriosis, rather than the extent of the disease.
It’s common for women to experience a slow and steady progression of symptoms. Learn more about endometriosis symptoms, causes and complications.

Topics on this page

Symptoms

Pain

Pain is a common symptom of this condition.

Endometriosis can cause different types of pain.

For example:

  • painful periods
  • pain during or after sex
  • abdominal, lower back and pelvic pain
  • pain during ovulation, including pain in your thighs or legs
  • pain when doing a wee or poo
  • pain that gets worse over time
  • pain that stops you from doing things you usually do.

Other symptoms

Some women with endometriosis experience other symptoms, including:

  • bladder and bowel problems (e.g. the need to wee frequently, constipation or diarrhoea)
  • bloating around the time of your period
  • tiredness, especially around the time of your period
  • vaginal discomfort
  • mood conditions (e.g. anxiety and depression)
  • asthma.

Symptoms during the menopause transition

Most women with endometriosis have the same experience at menopause as other women. Menopause symptoms can range from no symptoms to severe symptoms.

But some women with endometriosis may experience increased pelvic pain in the lead-up to menopause. Your doctor can help you manage these symptoms if they develop – or return – at this stage of life. While uncommon, endometriosis can return with the use of menopausal hormone therapy (MHT).

Learn more about treatment options for endometriosis during the menopause transition.

In most cases, endometriosis symptoms will improve after menopause.

When to get help

Talk to your doctor if your symptoms stop you from doing regular activities.

For example, if:

  • you miss work, school or recreational activities
  • medicines used for period pain don't help
  • you need to stay in bed due to pain
  • your symptoms are getting worse
  • you feel upset by your symptoms
  • you feel anxious or depressed about the pain.

Causes

The exact cause of endometriosis is unknown, but some factors may increase the likelihood of developing the condition.

Backwards (retrograde) menstruation

When you have a period, blood flows out of your vagina. But it can also flow backwards along your fallopian tubes into your pelvis. In 90% of women, the blood, which contains endometrial cells, is absorbed or broken down. But in some women, endometrial tissue grows outside the uterus, which can cause a range of symptoms.

Family history

Women who have a close relative (e.g. mother or sister) with endometriosis are seven to 10 times more likely to develop the condition.

Your immune system

If your immune system doesn’t stop the growth of endometrial tissue outside your uterus, you can develop endometriosis.

Can you prevent endometriosis?

Endometriosis can’t be prevented, but your chances of developing the condition may decrease if:

  • you have irregular periods
  • you breastfeed
  • you have progestin-only hormone therapy .

The risk of endometriosis developing may also decrease with each pregnancy. This may be due to an increase in the progesterone hormone during pregnancy.

Complications

Endometriosis can affect different systems in the body. While pelvic pain is the most common symptom, women with endometriosis have a higher risk of other pain conditions, such as migraines and arthritis . Back, bladder and bowel pain, and associated conditions, are also common in women with endometriosis.

Women with this condition also have an increased risk of diseases such as uterine fibroids and adenomyosis.

Uterine fibroids are non-cancerous tumours that grow into the wall of the uterus.

Adenomyosis is a condition where tissue that normally lines the uterus grows into the muscle wall of the uterus.

Research shows that women with endometriosis have an increased risk of:

  • cancerous tumours in organs such as the thyroid gland, ovary and breast
  • autoimmune diseases
  • early natural menopause
  • heart disease.

Download our fact sheets or visit resources for more information, including translated fact sheets.

This web page is designed to be informative and educational. It is not intended to provide specific medical advice or replace advice from your health practitioner. The information above is based on current medical knowledge, evidence and practice as at January 2023.

This con­tent has been reviewed by a group of med­ical sub­ject mat­ter experts, in accor­dance with Jean Hailes pol­i­cy.

© Jean Hailes Foun­da­tion. All rights reserved. This pub­li­ca­tion may not be repro­duced in whole or in part by any means with­out writ­ten per­mis­sion of the copy­right own­er. Con­tact: licensing@​jeanhailes.​org.​au

1
Smorgick N, Marsh CA, As-Sanie S, Smith YR, Quint EH. Prevalence of pain syndromes, mood conditions, and asthma in adolescents and young women with endometriosis. J Pediatr Adolesc Gynecol. 2013;26(3):171-175. doi:10.1016/j.jpag.2012.12.006
2
Alio L, Angioni S, Arena S, et al. Endometriosis: seeking optimal management in women approaching menopause. Climacteric. 2019;22(4):329-338. doi:10.1080/13697137.2018.1549213
3
Matalliotakis M, Goulielmos GN, Zervou MI, Matalliotaki C, Koumantakis G, Matalliotakis. The Familial Risk of Endometriosis among the Female Relatives of Patients with Endometriosis in Greece. Journal of Endometriosis and Pelvic Pain Disorders. 2017;9(3):184-187. doi:10.5301/jeppd.5000290
4
Candiani GB, Danesino V, Gastaldi A, Parazzini F, Ferraroni M. Reproductive and menstrual factors and risk of peritoneal and ovarian endometriosis. Fertil Steril. 1991;56(2):230-234
5
Youseflu S, Savabi-Esfahani M, Asgahari-Jafarabadi M, Maleki A. The protective effect of breastfeeding and ingesting human breast milk on subsequent risk of endometriosis in mother and child: a systematic review and meta-analysis. Breastfeeding Medicine 2002;17(10):805-816
6
Casper RF. Progestin-only pills may be a better first-line treatment for endometriosis than combined estrogen-progestin contraceptive pills. Fertil Steril. 2017;107(3):533-536. doi:10.1016/j.fertnstert.2017.01.003
7
Candiani GB, Danesino V, Gastaldi A, Parazzini F, Ferraroni M. Reproductive and menstrual factors and risk of peritoneal and ovarian endometriosis. Fertil Steril. 1991;56(2):230-234
8
Jenabi E, Khazaei S. Endometriosis and migraine headache risk: a meta-analysis. Women Health. 2020;60(8):939-945. doi:10.1080/03630242.2020.1779905
9
Miller JA, Missmer SA, Vitonis AF, Sarda V, Laufer MR, DiVasta AD. Prevalence of migraines in adolescents with endometriosis. Fertil Steril. 2018;109(4):685-690. doi:10.1016/j.fertnstert.2017.12.016
10
Shafrir AL, Palmor MC, Fourquet J, et al. Co-occurrence of immune-mediated conditions and endometriosis among adolescents and adult women. Am J Reprod Immunol. 2021;86(1):e13404. doi:10.1111/aji.13404
11
Harris HR, Costenbader KH, Mu F, et al. Endometriosis and the risks of systemic lupus erythematosus and rheumatoid arthritis in the Nurses' Health Study II. Ann Rheum Dis. 2016;75(7):1279-1284. doi:10.1136/annrheumdis-2015-207704
12
DiVasta AD, Vitonis AF, Laufer MR, Missmer SA. Spectrum of symptoms in women diagnosed with endometriosis during adolescence vs adulthood. Am J Obstet Gynecol. 2018;218(3):324.e1-324.e11. doi:10.1016/j.ajog.2017.12.007
13
Gallagher CS, Mäkinen N, Harris HR, et al. Genome-wide association and epidemiological analyses reveal common genetic origins between uterine leiomyomata and endometriosis [published correction appears in Nat Commun. 2022 Sep 21;13(1):5543]. Nat Commun. 2019;10(1):4857. Published 2019 Oct 24. doi:10.1038/s41467-019-12536-4
14
Upson K, Missmer SA. Epidemiology of Adenomyosis. Semin Reprod Med. 2020;38(2-03):89-107. doi:10.1055/s-0040-1718920
15
Dunselman GA, Vermeulen N, Becker C, et al. ESHRE guideline: management of women with endometriosis. Hum Reprod. 2014;29(3):400-412. doi:10.1093/humrep/det457
16
Shigesi N, Kvaskoff M, Kirtley S, et al. The association between endometriosis and autoimmune diseases: a systematic review and meta-analysis. Hum Reprod Update. 2019;25(4):486-503. doi:10.1093/humupd/dmz014
17
Thombre Kulkarni M, Shafrir A, Farland LV, et al. Association Between Laparoscopically Confirmed Endometriosis and Risk of Early Natural Menopause. JAMA Netw Open. 2022;5(1):e2144391. Published 2022 Jan 4. doi:10.1001/jamanetworkopen.2021.44391
18
Mu F, Rich-Edwards J, Rimm EB, Spiegelman D, Forman JP, Missmer SA. Association Between Endometriosis and Hypercholesterolemia or Hypertension. Hypertension. 2017;70(1):59-65. doi:10.1161/HYPERTENSIONAHA.117.09056
19
Farland LV, Degnan WJ 3rd, Bell ML, et al. Laparoscopically Confirmed Endometriosis and Risk of Incident Stroke: A Prospective Cohort Study. Stroke. 2022;53(10):3116-3122. doi:10.1161/STROKEAHA.122.039250
Last updated: 
12 March 2024
 | 
Last reviewed: 
31 January 2023

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