Early Signs Of Endometriosis You Need To Watch Out For

Over 6.5 million people in the US alone see their lives entirely disrupted by endometriosis – a condition that causes the abnormal growth of the lining of the uterus (endometrial implants) on other organs, including the ovaries, fallopian tubes, bladder, and pelvic cavity. 

Endometriosis isn’t always painful, but leaving it unaddressed inevitably leads to life-limiting consequences, regardless of whether you experience symptoms or not. 

For example, if you experience pain during periods or sex, these symptoms can cause distress and get in the way of your personal, professional, and intimate life. On the other hand, if you only have mild discomfort that can be mistaken for normal menstrual cramps, the endometrial implants can continue growing undetected on other organs, leading to infertility. 

Learning to identify the early signs of endometriosis can help you address the risk factors of this condition, avoid its most severe complications, and find the best treatment option for you. Get started with the guide below.

Endometriosis Early Signs

In people with endometriosis, the lining of the uterus (endometrium) grows outside of the uterus, on nearby tissues and organs. In healthy reproductive systems, the endometrium plays a vital role during the early stages of pregnancy by supporting the growth of the fetus and protecting it from harmful microbes. 

The endometrium thickens during the follicular phase of the menstrual cycle in preparation for a mature egg. If the egg isn’t fertilized and a pregnancy does not occur, the endometrium inside the uterus is then expelled during the menstruation (period). New endometrium is created with each menstrual cycle. 

Endometriosis occurs when the endometrium begins to grow outside of the uterus. This abnormal endometrial tissue, which is known as endometrial implants, can grow on surrounding areas such as the ovaries, bladder, pelvic cavity, rectum, cervix, and exterior walls of the uterus. 

The endometrial implants grow and swell during each menstrual cycle, behaving similarly to the endometrium inside the uterus. However, unlike normal endometrium, endometrial implants are unable to leave the body during your period. 

Over time, the build-up of abnormal endometrial implants leads to a cascade of complications, including:

• Inflammation of tissues in and around the reproductive organs
• Blocked fallopian tubes and trapped blood in the ovaries
• Adhesions, scar tissues, and binding between organs
• Abnormalities with bodily processes like digestion and bowel movements

As the endometrial implants begin to build up outside of the uterus, you may notice a range of symptoms. Learning to identify them can help you prevent dangerous cysts and lifelong problems like infertility.

Painful Periods (Dysmenorrhea)

It is estimated that 80% of women with dysmenorrhea have endometriosis, making painful periods one of the most common symptoms of this condition. 

However, painful menstruation may seem like a normal aspect of a woman’s menstrual cycle, which causes many women with dysmenorrhea to simply dismiss this symptom. Although mild cramping and discomfort are normally associated with menstruation, it is important to clarify that dysmenorrhea is a severe condition that can worsen over time. 

If you are unsure whether your painful periods are, in fact, a sign that you have endometriosis, look for other associated symptoms such as excessively painful cramps, back and abdominal pain that lasts long before and after your period, and heavy or prolonged bleeding.

Pelvic Pain

If you have endometriosis, the pain you experience isn’t always correlated to the extent and location of the endometrial implants. So, you may have a mild form of endometriosis and experience excruciating pelvic pain. On the other hand, you may only experience mild discomfort even if the endometrial implants are widespread. 

Regardless of how intense your pain is, if you have chronic (lasting longer than six months) or cyclic pain below your belly button, you should immediately undergo diagnostic tests for endometriosis. According to studies, up to 38% of people with chronic pelvic pain have endometriosis.

Pain During Intercourse (Dyspareunia)

Pain during intercourse, or dyspareunia, is a symptom that affects over half of people with endometriosis. It can occur due to deep vaginal penetration because the thrusting that occurs during sexual intercourse further inflames and irritates the endometrial growth outside of the uterus. 

Pain during intercourse can change depending on the phase of your menstrual cycle and can be mild or severe. It is often described as stabbing or sharp sensations that last long after having sex. 

Deep dyspareunia is one of the reasons why over 66% of women with endometriosis also suffer from sexual dysfunction.

Fatigue

Endometriosis is sometimes associated with fatigue and personality changes. These symptoms are more noticeable during menstruation when the body attempts to eliminate the abnormal endometrial growths outside of the uterus and any diseased tissue. During this phase of the menstrual cycle, the body’s immune system also triggers the release of inflammatory toxins known as cytokines, in an effort to fight endometriosis. 

As a result of these chemical processes, you’ll feel constantly fatigued and physically exhausted, especially during menstruation. Although this symptom is sometimes dismissed by healthcare providers, it is crucial to undergo the necessary diagnostic tests before severe symptoms of endometriosis appear.

Bloating

Although mild bloating may be a common denominator of several health conditions, up to 96% of women with endometriosis will experience several gastrointestinal problems known as “endo belly”. These digestive issues include constipation, diarrhea, bloating, and nausea. 

“Endo belly” arises from a range of processes and reactions. Firstly, people with endometriosis may have gastrointestinal bacterial overgrowth, which can impact the normal functioning of the digestive processes. Additionally, the high levels of inflammation caused by the growing endometrial implants can irritate the surrounding tissues and cause water retention, which can cause your pelvic area to appear bloated.

Bowel Problems

If you suffer from endometriosis, over time, the abnormal endometrial implants may begin to spread to surrounding organs, including the bowel, rectum, and intestines. When this happens, the endometrial implants can cause sustained inflammation, irritation, and lesions to the surrounding tissues. 

Over time, this can impact the normal functioning of your bowel and digestive organs, leading to painful and irregular bowel movements, especially when the endometrium is swelling or thickening (i.e.: during the luteal phase). It is also estimated that up to 52% of women with endometriosis also have irritable bowel syndrome (IBS).

Bladder Issues

Endometriosis can affect the health and function of the bladder in two different ways. 

Firstly, ovarian cysts caused by trapped blood in the ovaries can lead to urinary problems by pressure on the bladder. Additionally, if the endometrial implants begin to grow on the bladder and surrounding organs, you may experience several symptoms, such as:

• Pain during urination (dysuria)
• Bladder irritation
• Bladder urgency and frequent urination
• Pain associated with a full bladder
• Pain around the kidneys area
• Blood in the urine (hematuria)

These symptoms tend to intensify in the days before your period and during your menstruation.

Infertility

Infertility and endometriosis are often connected. Research published in the Journal of Assisted Reproduction and Genetics reports that up to 50% of infertile women have endometriosis and that half of those with endometriosis are infertile. 

Infertility in people with endometriosis is often caused by endometrial implants that cause adhesions between organs and scar tissue. The abnormal growth of endometrial tissue can block the fallopian tubes and prevent the release of mature eggs into the uterus, preventing pregnancy. Excessive endometrial growth can also inhibit the action of the sperm or damage a fertilized egg before its implantation in the uterus. 

It is also important to notice that endometriosis can cause sexual dysfunction in otherwise fertile women, which makes it more difficult to conceive. 

Although some women with endometriosis are infertile, others only experience temporary infertility and are able to carry a baby to term successfully following adequate treatment. Other alternatives, such as in-vitro fertilization (IVF) can assist patients with endometriosis looking to have a baby.

Who Is At Risk Of Getting Endometriosis

The causes and risk factors of endometriosis aren’t always clear. According to different theories, endometriosis occurs when the endometrial tissue in the uterus is spread to nearby organs and tissues. This can happen due to surgery such as a C-section or retrograde menstruation, which occurs when part of the menstrual blood carrying endometrial tissue flows back into fallopian tubes instead of leaving the body during menstruation. 

Besides these causes, several risk factors can make you more prone to developing endometriosis. Being aware of these risk factors can help you undergo the necessary screening tests early on and address the condition as the first symptoms occur.

Let’s start by looking at the factors that put you at risk of endometriosis. 

• Individuals with a family history of endometriosis: Although endometriosis isn’t always hereditary, you may be at greater risk of developing endometriosis if you have a first-degree relative (such as a mother, sister, or aunt) suffering from endometriosis or infertility. 
• Individuals with a history of pelvic infections: A 2023 study shows that individuals with a history of pelvic or genital infections are at greater risk of endometriosis compared to those with no history of these conditions. 
• Individuals with certain reproductive conditions: Some disorders of the reproductive tract like uterine growths (i.e.: polyps) and asynchronous uterine contractions increase the risk that blood containing endometrial growths is transported outside of the uterus or back into the ovaries. This makes it more likely for you to develop endometriosis. 
• Structural abnormality: Some structural abnormalities and conditions that prevent the menstrual blood from exiting the body as expected during menstruation may increase the risk of endometrial tissues flowing back into the ovaries and fallopian tubes. Here, they can contaminate healthy tissues and cause endometriosis to develop. These conditions include cervical stenosis, which causes the narrowing or obstruction of the uterus, cervix, or vagina. 
• Individuals with a high estrogen level: Estrogen is the hormone responsible for the development of the endometrium during the menstrual cycle. Having sustained high levels of estrogen or being exposed to this hormone for years can facilitate the abnormal growth of endometrial implants outside of the uterus, thus increasing the risk of endometriosis. 
• Individuals with a history of uterine surgery: Uterine surgery such as a C-section or hysterectomy (a procedure used to remove parts of the uterus) can facilitate the contamination of surrounding tissues with endometrial growths, which can start the development of endometriosis. The endometrial tissue can also attach to surgical incisions and spread outside of the uterus. 
• Individuals diagnosed with immune system disorders: Recent studies have shown the connection between endometriosis and the immune system. Some disorders of the immune system can prevent your body from recognizing and destroying abnormal endometrial cells as it should. 
• People with certain lifestyle factors: Some lifestyle factors – such as alcohol and caffeine intake, smoking, and physical activity – influence the levels of estrogen in your body, which may contribute to the development of endometriosis. Having a low Body Mass Index (BMI) or a small frame can also put you at greater risk of developing this condition. 
• Hormonal imbalance: An imbalance of progesterone and estrogen, or having too much estradiol (a type of estrogen responsible for uterine tissue growth) can increase the risk of endometriosis. 

Endometriosis may occur at any point after the onset of the menstrual cycle (menarche). The symptoms of endometriosis may decline during pregnancy and disappear after menopause.

Importance Of Early Awareness

Unfortunately, the majority of women with endometriosis are only able to obtain an accurate diagnosis when they are trying to conceive, or if they are looking into the causes of unexplained infertility. However, this delay in getting a diagnosis – which can be as long as seven years –  isn’t necessarily related to the lack of symptoms. 

According to estimations, only around 20% of cases of endometriosis are asymptomatic, while 80% of women with this condition experience painful periods, excessive bleeding, digestive issues, and pain during intercourse. At the same time, the majority of women with endometriosis are disbelieved or dismissed by their healthcare providers, which can prevent them from obtaining an adequate diagnosis. 

Fortunately, the increased understanding of the symptoms and prognosis of endometriosis has encouraged developments in the diagnostic tools used and highlighted the importance of early awareness. 

Some of the strategies used to diagnose endometriosis today include:

• A complete review of your medical history, previous pregnancies, and symptoms. 
• A comprehensive physical exam, during which a healthcare provider will palpate the pelvis area to check for cysts and scars.
• Ultrasound and imaging tests. These tools provide healthcare providers with images of your inner pelvic area, which helps them identify the location, extent, and severity of eventual endometrial implants. 
• Minimally-invasive surgical procedures like laparoscopy, use thin viewing instruments inserted in the area inside the abdomen to determine what areas are affected by endometriosis. 

Advocating for your own health and working with a specialist who can help you obtain an accurate diagnosis for your pelvic pain can help you prevent severe complications, like cysts, scars, and infertility.

Conventional Treatment Options for Endometriosis

Endometriosis is considered to be a lifelong condition for which there is no definitive cure. However, your healthcare provider may recommend the following treatment approaches to manage your symptoms: 

• Medications (e.g. pain relievers, hormonal therapy): Certain medications, such as non-steroidal anti-inflammatory drugs (NSAIDs) and painkillers may be used to ease discomfort and distress during flare-ups. Hormonal therapies (such as birth control pills, GnRH medications, and hormone suppressants) can slow down the development of endometrial implants, which are hormone-dependent. 
• Surgery (e.g. laparoscopic excision, hysterectomy): Minimally-invasive procedures such as laparoscopy can be used to view the area inside the abdomen, collect samples for testing, and remove parts of the abnormal endometrial growth. More invasive procedures like hysterectomy can be used to remove parts of the uterus, the ovaries, or the cervix to stop the progression of endometriosis. Since hysterectomy is irreversible and causes permanent infertility, this surgery is only performed if the symptoms of endometriosis are causing disability. 
• Lifestyle changes (e.g. exercise, diet): Switching to a gluten-free diet has been seen to decrease inflammation, regulate hormonal activity, and reduce endometriosis pain. Other remedies such as massages, rest, heat compresses, light exercise, and supplements with anti-inflammatory properties can also help relaxation, reduce muscle cramps, and trigger the release of the body’s natural painkillers, endorphins. 

Before choosing a certain line of treatment, it is important to determine what your goals are. For example, if you are hoping to conceive, birth control pills and irreversible surgical procedures such as hysterectomy are not suitable choices. What’s more, in around 20% of cases, surgical procedures for endometriosis are inefficient, leaving patients to seek an alternative treatment option.

Early Detection Is The Key To Effective Treatment

If you suffer from endometriosis, you may be battling the prospect of living a life reliant on medications or undergoing invasive surgical procedures. Fortunately, non-surgical, non-invasive, and non-pharmaceutical treatment options that are efficient in easing the symptoms of endometriosis and slowing down the progression of this disease exist. 

The whole-person Neurofunctional Pain Management approach pioneered by Relatyv combines several therapies  to help you regain your pelvic health and lay the foundations of long-term health. These include:

• Electroanalgesia: This pain management method utilizes high-frequency pulses of electrical current that are delivered through the skin with an FDA-cleared device. The pulses of electricity prevent pain signals from reaching the brain and trigger the release of endorphins, thus providing long-lasting relief from pain. 
• IV therapy: Custom IV therapy programs designed on your unique needs will aim to address and correct those nutritional imbalances that may be contributing to endometriosis.
• Lifestyle counseling: A lifestyle counselor at Relatyv will help you introduce the positive lifestyle changes needed to prevent the progression of endometriosis, ease pain, and support overall health throughout your life.