What is Endometriosis?

Last Updated:

closeup of a woman's stomach, a PTs hands are placed on top of her ribs and her hip bones. You can see scars consistent with endometriosis surgery on her abdomen

Do you have painful menstrual cycles? Do you have to miss school or work due to your period discomfort? Endometriosis can be a scary and sometimes debilitating diagnosis that affects roughly 10% of menstruating women. Many women suffering with endo have pain for years before they receive a formal diagnosis, and often have difficulty finding a treatment that works for them. So, what exactly is it?

What is Endometriosis?

Endometriosis is a condition in which tissue similar to the lining of the uterus grows outside the uterus, causing pain and/or infertility.

It effects the reproductive, respiratory, urinary, digestive, immune, musculoskeletal, endocrine, and nervous systems.

Symptoms associated with it can include painful periods, pain during and/or after sexual intercourse, painful bowel movements, painful urination, abdominal bloating and nausea. These chronics symptoms can often contribute to fatigue, depression and/or anxiety. This condition can cause periods so painful women have to miss school or work. It often causes severe pelvic pain as well.

Some places that endo can often be found, but are not limited to:

  1. The fallopian tubes
  2. The ovaries
  3. The rectum and/or intestines
  4. The bladder
  5. Various positions of the abdominal cavity

The Effects of Endometriosis

This condition can lead to chronic pelvic pain, pain with intercourse, constipation and pain with bowel movements, difficulty and pain with urination.

According to the NIH, between 30 and 50% of women also experience infertility. While the exact correlation between endometriosis and infertility is not known, it is believed to potentially be due to abnormalities in pelvic anatomy, endocrine function, abnormal ovulation, and how the endometrial cells are affected by hormonal changes.

Symptoms of Endometriosis

Some of the symptoms patients may experience include:

  1. Excessive bleeding during menstruation, or bleeding between periods
  2. Extremely painful periods
  3. Diarrhea
  4. Constipation
  5. Bloating or nausea
  6. Painful intercourse
  7. Painful bowel movements or urination (more significant during menstruation)

Many patients’ symptoms are considerably more severe during their period leading them to take time off work, school, or other daily activities.

How to Get a Diagnosis

If you are reading this and feel you might have endometriosis, you might be asking yourself “How do I know? How do I get a diagnosis?” Unfortunately, many women go years before getting a diagnosis. However, there are certain tests that can be helpful in diagnosing this condition. While none of these tests on their own can diagnose endometriosis, when bundled together they can be helpful in ruling out other conditions and can be utilized in preparation for surgery. These tests include:

  1. Pelvic exam– this can be utilized to palpate anatomical abnormalities, cysts, and scar tissue present from endometriosis.
  2. Ultrasound (often abdominal and trans-vaginal)- this test alone cannot be used to identify endo, but can be used to locate/identify cysts on the reproductive organs that may be resultant of endometriosis.
  3. MRI- this test can be used to identify the size and location of endometrial implants, and therefore can be helpful with surgical planning.
  4. Exploratory laparoscopy- this is where a surgeon uses a small camera that is surgically inserted into your abdomen to locate endometrial implants. This procedure can also be used to biopsy the tissue to determine if it is in fact endometriosis.

Risk Factors for Endometriosis

Some other information your doctor might take into consideration when diagnosing you include any risk factors you might have. While none of these risk factors alone point to endometriosis, when they are present in addition to positive findings with the above testing, they often make diagnosis a bit easier. These risk factors include:

  1. Beginning your period earlier than 12 years of age
  2. Heavy periods that last longer than 7 days
  3. A menstrual cycle that is less than 27 days
  4. A family history of endometriosis
  5. Having high levels of estrogen
  6. Abnormalities of the reproductive tract.

Check out the second post in this series on endometriosis for tips on how pelvic floor physical therapy can help and read below for some FAQs!

Frequently Asked Questions About Endometriosis

Does Dry Needling Help? 

Yes, dry needling can help with endometriosis. A woman in my clinic presented with endometriosis and secondary constipation. I used needling to help decrease tissue restriction, increase blood circulation, release trigger points and improve scar mobility. Please keep in mind this is different from acupuncture. The needle is a tool, just like my hands are, to work on muscles and tissues. Inquire with your healthcare provider if dry needling could help you. 

Can It Cause Back Pain?

Endometriosis can cause back pain due to dysmenorrhea. Dysmenorrhea is painful menstruation accompanied by painful cramps, lower back pain, and abdominal pain. Natural pain relief remedies are recommended for pain during periods caused by endometriosis. However, the pain can often be severe. 

How Can You Relieve Back and Hip Pain due to Endometriosis

Below are my top three exercises to help relieve back and hip pain from endo. 

  1. Shoulder blade squeezes
  2. Transverse abdominus contractions
  3. Child’s pose

Can Endometriosis Cause Constipation, Diarrhea, Nausea, etc?

Endometriosis can cause constipation, diarrhea, nausea, bloating, and other gastrointestinal issues. An anti-inflammatory diet may help with these issues, including a plant-based diet. Check with your healthcare provider or a registered dietician to see if diet can improve your endometriosis. Cramps caused by endometriosis may induce nausea and vomiting. 

Can It Cause Bloating (endo belly)?

Yes, bloating of the abdomen is known as endo belly. Endo belly can be extremely painful and can impact the individual emotionally as well. 

Can Endometriosis Cause Leg Pain?

Endometriosis can cause leg and back pain. 

Can It Cause Bladder or Bowel Issues?

Endometriosis can cause bladder and bowel movement issues. Endometriosis can cause bowel issues such as gas, bloating, constipation, and more. 

What about Hemorrhoids? 

Endometriosis isn’t likely to cause hemorrhoids. Hemorrhoids are swollen veins around your anus and rectum that can either be painful or painless and present internally or externally. 

Can Endometriosis Cause Tailbone Pain? 

Yes, tailbone (also known as coccyx) discomfort is literally a pain in the butt! You may notice that simple, everyday activities become bothersome. For example, sitting can be extremely irritating, and you may constantly need to change positions or even avoid hard surfaces.

Pooping may become painful and more difficult, and you may even notice increased discomfort with intercourse. However, even movements like transferring from sitting to standing can improve your symptoms. Tailbone pain isn’t serious. However, endometriosis can be the source. 

What About Vulvar Pain?

Vulvar pain from endometriosis is rare but can happen. 

Can it Cause Dyspareunia? 

Endometriosis can cause dyspareunia. Painful sex, also known as dyspareunia, is a common diagnosis with up to 18% of the worldwide population (and affects ALL genders).

Individuals who have dyspareunia often don’t know how to seek treatment. Unfortunately, it is taboo, and discussing symptoms might be difficult.

Lastly, medical providers may not take the reports of these symptoms seriously. People are not getting the help they need, leading to mental health issues, relationship challenges, and an overall decreased quality of life. Fortunately, when diagnosed appropriately, dyspareunia can be managed and treated by a team specializing in pelvic health.



Interested in more tips on how to prevent or overcome Pelvic Floor Problems?
Download this free guide for some simple, do-able, totally-not-weird tips to take better care of your down there.

Some links may be affiliate links. The products we recommend are products we use or recommend to clients.

Join The V-Hive

Online pelvic floor fitness programs from a board-certified Women’s Health Physical Therapist. Your first week is free.

Free Pelvic Floor Guides

Download these free guides for some simple, do-able, totally-not-weird tips to take better care of your down there.

You might also like…

Menopause and Painful Sex

Menopause and Painful Sex

Hot flashes. Sleep issues. Mood swings.  These are the three horsemen of the meno-pocalypse. And then there’s the fourth horseman—the menopause symptom no one talks much about, despite how common it is. Painful sex. Let’s talk about why you may have painful sex during...

read more
PCOS, Pelvic Pain, and Physical Therapy

PCOS, Pelvic Pain, and Physical Therapy

Polycystic ovarian syndrome (PCOS) is a challenge that’s misdiagnosed, misunderstood, and all too often just plain missed.  So let’s set the record straight on what PCOS and pelvic pain is, why it’s so dang painful, and how to ease your symptoms.  What is PCOS? People...

read more
Bladder Health Tips for Teachers

Bladder Health Tips for Teachers

7 Tips for Peeing at School It’s back-to-school time, and if you’re an educator, you’re likely experiencing some mixed feelings. One on hand, yay school! We know you’re passionate about (and good at) what you do.  But the thought of returning to your busy classrooms...

read more

Join the V-Hive waitlist!

Enter your name and email below and you'll be the first to know when our new membership launches.

You have Successfully Subscribed!

How to Take Great Care of Your Pelvic Floor

6+ Simple Tips to Prevent or Overcome Pelvic Floor Problems

Pregnant? Postpartum? Struggling with peeing or pooping probs? Experiencing painful sex? Download this free guide for some simple, do-able, totally-not-weird tips to take better care of your down there.

Thank you! Check your inbox.

How to Take Great Care of Your Pelvic Floor

Enter your name and email below and we'll send it right over.

You have Successfully Subscribed!

5 Myths We’ve Been Told About Pregnant Bodies

Enter your name and email below and we'll send it right over.

You have Successfully Subscribed!

4 Signs of Pelvic Floor Muscle Tension

Enter your name and email below and we'll send it right over.

You have Successfully Subscribed!

How to Prepare Your Pelvic Floor & Core for Childbirth

Enter your name and email below and we'll send it right over.

You have Successfully Subscribed!

6 Exercises To Strengthen Your Pelvic Floor and Core

Enter your name and email below and we'll send it right over.

You have Successfully Subscribed!

6 Exercises To Strengthen Your Pelvic Floor and Core

Enter your name and email below and we'll send it right over.

You have Successfully Subscribed!