Endometriosis: Explaining the Pain Down There

While endometriosis often evades diagnosis, it's a treatable condition affecting millions of women. Learn how to detect if endometriosis is causing your unexplained pain down there.

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When most women experience pain down below, they usually immediately attribute their discomfort to menstrual cramping or fibroids.  While these 2 conclusions are commonly at play, another lingering and painful condition could be the culprit. It's called endometriosis and it plagues millions of American women

What is Endometriosis?

Endometrium are the cells that grow in your uterus and are shed during your menstrual cycle. Endometriosis is when these cells somehow slip out of the uterus and begin to grow in places they do not belong. No one is quite sure how they make their way to the abdomen, but once they start to grow outside of the womb, painful and lingering symptoms follow.

Because the endometrium cells are from the uterus, they will still respond to the changes in hormones that are stimulated by your period.  This means that they still grow and break down on a monthly basis, but there is no where for them to discharge from your body. That blood becomes trapped and the surrounding tissue will accordingly become inflamed and irritated. In some cases, scar tissue or cysts may form.

Symptoms of Endometriosis

Symptoms differ depending on where in your body the endometrium have latched onto. The most common symptoms include:

Pelvic Pain

This is the main symptom of endometriosis. This pain may include severe cramping in both the lower back and abdomen that begins before your period and lasts several days after your period has started.

Painful Sex

If endometriosis spreads to the top of your uterus, it's likely you will experience a sharp pelvic pain during intercourse. 


If endometriosis gets into the ovaries, it can actually block off the fallopian tube, causing infertility. One estimate approximates that 30-40% of women that have endometriosis may be infertile.

Painful Bowel Movements

Endometriosis cells can get into the intestinal system, causing pain when you go to the bathroom. When the colon is infected, you will experience pain when trying to push out a stool. Diarrhea and constipation may also occur, especially around the time of your period.

Excessive Bleeding

If you have exceptionally heavy periods, or consistent bleeding between periods, you may have endometriosis.

Diagnosing and Treating Endometriosis

If you have 2 out of these 3 symptoms, you should speak to your doctor. This is a particularly difficult diagnosis, because it will not show up on an ultrasound or other imaging tests. That means that some women will literally wait years for a diagnosis. The only definitive test to diagnose endometriosis is a laparoscopy. Your doctor looks at your abdominal organs using a small visualizing tool called a laparoscope.  A physician can view your abdomen through a small incision made near your navel and see the presence and extent of endometrium cells.

Treatment for this condition varies depending on the severity of your symptoms and if you wish to have children. Some options include hormonal therapy, pain treatment, nutritional therapy and, in some instances, surgery. Each case is different and your course of action is best determined by an open conversation with your doctor. 

Despite the pain and discomfort associated with endometriosis, the bottom line is that it is a treatable condition. Evaluate your symptoms using this consultation questionnaire and for tips on being a smart patient when it comes to consulting with your doctor, click here.