Symptoms and diagnosis

Symptoms

Endometriosis is most commonly found in the areas surrounding the uterus, but can also affect the bladder or the bowel. More rarely, it can occur outside the pelvis, particularly in the chest.

Certain symptoms may occur during your period, including:

  • severe menstrual pain, which may prevent you from carrying out your usual activities;
  • heavy periods, requiring a change of sanitary protection every 1 to 2 hours, or which may lead to leakage that stains your clothes. Heavy periods can lead to anaemia (iron deficiency in the blood), causing fatigue and shortness of breath.

Other symptoms may appear at any time:

  • pain in the lower abdomen and lower back (pelvic region);
  • pain during bowel movements or urination;
  • pain during or after sexual intercourse;
  • severe fatigue (asthenia);
  • pain or bleeding in other areas, particularly in the chest, which may lead to shortness of breath or coughing up blood.

Difficulty conceiving, as well as mood disorders or anxiety, may also be associated with this condition.

Diagnosis

The symptoms of endometriosis vary greatly from person to person and are often non-specific, potentially resembling those of other conditions, which can make diagnosis difficult for healthcare professionals. Some people with symptoms may be unaware they have the condition, whilst others may have it without experiencing any symptoms. On average, it takes between 4 and 12 years to reach a diagnosis.

A careful review of your menstrual history, including the nature of the pain, the intensity of the bleeding and any associated symptoms, can help guide the diagnosis.

In some cases, laparoscopic surgery (a surgical technique that allows the surgeon to operate inside the abdomen through small incisions in the abdominal wall) may be recommended in order to directly examine the lesions or analyse tissue samples. A diagnosis can also be made based on the symptoms described and imaging tests such as ultrasound or MRI. Treatment may be started without necessarily requiring surgery.  

New approaches aimed at detecting the condition at an earlier stage are currently being developed, including simple symptom checklists, blood tests, and self-tests using saliva or menstrual blood.

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