Table of ContentsView AllTable of ContentsPain LocationCyclical or ConstantTriggersDealing With Flare-UpsTreatment and ManagementFrequently Asked Questions
Table of ContentsView All
View All
Table of Contents
Pain Location
Cyclical or Constant
Triggers
Dealing With Flare-Ups
Treatment and Management
Frequently Asked Questions
Endometriosispain occurs in various places in the body, including the pelvis, abdomen, bowels, back, hips, legs, bladder, ribs, and more. It can occur during or after sex, during bowel movements, during urination, during ovulation, constantly, cyclically, or unpredictably.
Endometriosis is a full-body disease in which tissue similar to thelining of the uterusgrows outside the uterus.Pain is the most defining symptom of this disease.
In this article, learn more about where endometriosis pain occurs and how to manage endometriosis pain.
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Where Is Endometriosis Pain?
Endometriosis pain can occur in many places in the body. It is commonly associated with chronic (long-term)pelvic pain. People with endometriosis are 13 times more likely to have abdominal pain than those without endometriosis.
In most cases,endometriosis lesionlocation does not relate to pain location.You may experience pain in the lesion location, tissues around lesions, distant sites from the lesions, or as widespread and generalized pain.
Sciatic Endometriosis
What Does Endometriosis Pain Feel Like?
Endometriosis pain is described as follows:
What Does Endometriosis Pain Feel Like?The experience of endometriosis-related pain is very individual. For example, two people with endometriosis may have different pain sensations in various body areas.
The experience of endometriosis-related pain is very individual. For example, two people with endometriosis may have different pain sensations in various body areas.
What Is an Endometrioma?
Pelvis
Over 60% of people with endometriosis have chronic pelvic pain.The sensation may occur in the lower abdomen any time of the month, although some people report worsening pain during menstruation.
Bowels
Bowel pain is common with endometriosis and may be constant or unpredictable, occurring in sharp waves when the bowels are full, in the hours or minutes before a bowel movement, orduring bowel movements(also calleddyschezia).This pain may occur all month long or worsen during menstruation.
Bladder
Around 70% to 80% of people with endometriosis also have painful bladder syndrome calledinterstitial cystitis.Endometriosis bladder pain is often felt asdysuria(pain during urination). Compared to other locations of endometriosis pain, bladder pain is described as “burning” and feeling similar to aurinary tract infection(UTI).
While most endometriosis lesion locations do not correspond to the area of pain, bladder pain is an exception. Research has found that painful urination is associated with endometriosis lesions on the surface of the bladder.
Back, Hips, and Legs
Some people feel endometriosis pain in the back,hips, andlegs. In one study, people with back pain reported it as constant but worsening during menstruation.Lower body pain associated with endometriosis is frequently described as “radiating” down the lower limbs or feeling likesciatica.
Upper Body
Some people with endometriosis report chest, lung, breast, and neck pain. Upper body pain can lead to breathlessness.Chest pain, in particular, may indicatethoracicendometriosis (endometriosis lesions growth on or around the lungs).
Head
Headaches andmigraines, including light and noise sensitivity, are common pain sources that worsen before or during menstruation.
A 2022 study found that people with endometriosis had migraines more frequently than people without endometriosis. People with migraines were also 4.6 times more likely to have severe stage endometriosis, and they were also more likely to have co-occurringadenomyosis.
Adenomyosis vs. Endometriosis PainAdenomyosisis a painful condition sometimes referred to as the sister of endometriosis because they frequently co-occur. In adenomyosis, the lining of the uterus grows into the uterine wall, causing heavy and painful periods, uterine, pelvic, and abdominal pain, and a feeling of heaviness in the pelvis.
Adenomyosis vs. Endometriosis Pain
Adenomyosisis a painful condition sometimes referred to as the sister of endometriosis because they frequently co-occur. In adenomyosis, the lining of the uterus grows into the uterine wall, causing heavy and painful periods, uterine, pelvic, and abdominal pain, and a feeling of heaviness in the pelvis.
During or After Sex
About half of the people with endometriosis experiencepainful sex(dyspareunia), often described as sharp, stabbing, radiating, and dragging.You may experience pain during orgasm or any intercourse or penetration, with pain lasting for days.
Research has found that the severity of pain from sex is related to theendometriosis stage, mainly contributing to the narrowing of the area between the uterus and rectum, known asPouch of Douglasstenosis.
Does Staging Correspond to Pain Severity?The endometriosis stage does not typically correspond to pain severity.The current American Society of Reproductive Medicine’s (ASRM) staging system for endometriosis measures the impact on fertility, not pain. In other words, a person with stage I “minimal” endometriosis could have more significant, debilitating pain than someone with stage IV “severe” endometriosis.
Does Staging Correspond to Pain Severity?
The endometriosis stage does not typically correspond to pain severity.The current American Society of Reproductive Medicine’s (ASRM) staging system for endometriosis measures the impact on fertility, not pain. In other words, a person with stage I “minimal” endometriosis could have more significant, debilitating pain than someone with stage IV “severe” endometriosis.
Surgery
Laparoscopicexcision surgeryis the gold standard for endometriosis diagnosis and treatment, generally reducing pain and symptoms. However, the surgery can be painful in the short term. Adhesions (scar tissue) from surgery can also cause pain.
Endometriosis Pain Can Be Cyclical or Constant
Endometriosis does not only cause pain during a person’s period. An interview study of people with endometriosis found thatendometriosis paincan occur in the following ways:
Endometriosis Pain Triggers
Some commonly reported endometriosis pain triggers include:
Tips for Dealing With Endometriosis Flare-Ups
For people with endometriosis, it is inevitable to experience flare-ups (when pain and other symptoms worsen for a period of time). This can be physically, mentally, andemotionally challenging.
Some tactics that may help you cope with an endometriosis flare-up include:
Treatment and Management Options
Your healthcare provider will consider your age, the severity of the disease, your symptoms, and your desire to have children when determining the besttreatment optionfor you. They may recommend medication, surgery, or a combination of the two options.
Healthcare providers use excision surgery to remove all visible endometriosis lesions from the body, restore anatomy, and significantly improve symptoms.However, excision surgery is not accessible to everyone due to high costs and a limited number of specialists. Other management options are available.
Additional options can improve some people’s quality of life in the short term. Some examples of other management options include OTC or prescription pain pills, andhormonal treatmentscan improve some people’s quality of life. Hormone medications can reduce current endometrial lesion progression and prevent new endometrial tissue growth.
Summary
Endometriosis is a painful condition in which tissue similar to that which lines the uterus grows elsewhere in the body. It is frequently associated with chronic pelvic pain but can also cause pain across the whole body, including the abdomen, bowels, bladder, upper body, head, back, hips, and legs. Endometriosis pain occurs in various patterns, including cyclical (often worsening during menstruation), constant, and random.
Frequently Asked QuestionsEndometriosis frequently co-occurs with other conditions that cause pain. You may also be misdiagnosed with a different disease but have endometriosis. Some painful conditions that often co-occur or are misdiagnosed include adenomyosis, fibroids, non-endometriosis cysts, irritable bowel syndrome, rheumatoid arthritis, and migraine.Learn MoreEndometriosis vs. PCOS: What Are the Differences?If endometriosis is untreated, lesions will continue progressing. In the long term, this can impact fertility and worsen the pain. However, certain hormonal medications can slow the progression of current endometrial lesions and prevent new ones from forming.Learn MoreWhat to Know About Endometriosis and PregnancyEndometriosis lesion location does not always correlate to pain location. In other words, you may have endometriosis lesions on thediaphragmbut feel no pain in this area. People who feel pain from diaphragmatic lesions may feel pain in their upper abdomen and back, chest pain, rib pain, and breathlessness.Learn MorePain in Endometriosis
Endometriosis frequently co-occurs with other conditions that cause pain. You may also be misdiagnosed with a different disease but have endometriosis. Some painful conditions that often co-occur or are misdiagnosed include adenomyosis, fibroids, non-endometriosis cysts, irritable bowel syndrome, rheumatoid arthritis, and migraine.Learn MoreEndometriosis vs. PCOS: What Are the Differences?
Endometriosis frequently co-occurs with other conditions that cause pain. You may also be misdiagnosed with a different disease but have endometriosis. Some painful conditions that often co-occur or are misdiagnosed include adenomyosis, fibroids, non-endometriosis cysts, irritable bowel syndrome, rheumatoid arthritis, and migraine.
Learn MoreEndometriosis vs. PCOS: What Are the Differences?
If endometriosis is untreated, lesions will continue progressing. In the long term, this can impact fertility and worsen the pain. However, certain hormonal medications can slow the progression of current endometrial lesions and prevent new ones from forming.Learn MoreWhat to Know About Endometriosis and Pregnancy
If endometriosis is untreated, lesions will continue progressing. In the long term, this can impact fertility and worsen the pain. However, certain hormonal medications can slow the progression of current endometrial lesions and prevent new ones from forming.
Learn MoreWhat to Know About Endometriosis and Pregnancy
Endometriosis lesion location does not always correlate to pain location. In other words, you may have endometriosis lesions on thediaphragmbut feel no pain in this area. People who feel pain from diaphragmatic lesions may feel pain in their upper abdomen and back, chest pain, rib pain, and breathlessness.Learn MorePain in Endometriosis
Endometriosis lesion location does not always correlate to pain location. In other words, you may have endometriosis lesions on thediaphragmbut feel no pain in this area. People who feel pain from diaphragmatic lesions may feel pain in their upper abdomen and back, chest pain, rib pain, and breathlessness.
Learn MorePain in Endometriosis
13 SourcesVerywell Health uses only high-quality sources, including peer-reviewed studies, to support the facts within our articles. Read oureditorial processto learn more about how we fact-check and keep our content accurate, reliable, and trustworthy.World Health Organization.Endometriosis.Maddern J, Grundy L, Castro J, Brierley SM.Pain in endometriosis.Front Cell Neurosci. 2020;14:590823. doi:10.3389/fncel.2020.590823Drabble SJ, Long J, Alele B, O’Cathain A.Constellations of pain: a qualitative study of the complexity of women’s endometriosis-related pain.Br J Pain. 2021;15(3):345-356. doi:10.1177/2049463720961413Hsu AL, Sinaii N, Segars J, Nieman LK, Stratton P.Relating pelvic pain location to surgical findings of endometriosis.Obstet Gynecol. 2011;118(2 Pt 1):223-230. doi:10.1097/AOG.0b013e318223fed0Nezhat C, Lindheim SR, Backhus L, et al.Thoracic endometriosis syndrome: a review of diagnosis and management.JSLS. 2019;23(3):e2019.00029. doi:10.4293/JSLS.2019.00029Wu Y, Wang H, Chen S, et al.Migraine is more prevalent in advanced-stage endometriosis, especially when co-occuring with adenomoysis.Front Endocrinol. 2022. doi:10.3389/fendo.2021.814474MedlinePlus.Adenomyosis.Shum LK, Bedaiwy MA, Allaire C, et al.Deep dyspareunia and sexual quality of life in women with endometriosis.Sex Med. 2018;6(3):224-233. doi:10.1016/j.esxm.2018.04.006Kor E, Mostafavi SRS, Mazhin ZA, et al.Relationship between the severity of endometriosis symptoms (Dyspareunia, dysmenorrhea and chronic pelvic pain) and the spread of the disease on ultrasound.BMC Research Notes. 2020;13(1):546. doi:10.1186/s13104-020-05388-5Johnson NP, Hummelshoj L, Adamson GD, et al.World Endometriosis Society consensus on the classification of endometriosis.Hum Reprod. 2017;32(2):315-324. doi:10.1093/humrep/dew293Moawad NS, Arkerson B, Laguerre M, Robinson M.92: long-term outcomes of laparoscopic surgery for endometriosis.American Journal of Obstetrics & Gynecology. 2018;218(2):S949.Mount Sinai.Living with endometriosis.The American College of Obstetricians and Gynecologists.Endometriosis.
13 Sources
Verywell Health uses only high-quality sources, including peer-reviewed studies, to support the facts within our articles. Read oureditorial processto learn more about how we fact-check and keep our content accurate, reliable, and trustworthy.World Health Organization.Endometriosis.Maddern J, Grundy L, Castro J, Brierley SM.Pain in endometriosis.Front Cell Neurosci. 2020;14:590823. doi:10.3389/fncel.2020.590823Drabble SJ, Long J, Alele B, O’Cathain A.Constellations of pain: a qualitative study of the complexity of women’s endometriosis-related pain.Br J Pain. 2021;15(3):345-356. doi:10.1177/2049463720961413Hsu AL, Sinaii N, Segars J, Nieman LK, Stratton P.Relating pelvic pain location to surgical findings of endometriosis.Obstet Gynecol. 2011;118(2 Pt 1):223-230. doi:10.1097/AOG.0b013e318223fed0Nezhat C, Lindheim SR, Backhus L, et al.Thoracic endometriosis syndrome: a review of diagnosis and management.JSLS. 2019;23(3):e2019.00029. doi:10.4293/JSLS.2019.00029Wu Y, Wang H, Chen S, et al.Migraine is more prevalent in advanced-stage endometriosis, especially when co-occuring with adenomoysis.Front Endocrinol. 2022. doi:10.3389/fendo.2021.814474MedlinePlus.Adenomyosis.Shum LK, Bedaiwy MA, Allaire C, et al.Deep dyspareunia and sexual quality of life in women with endometriosis.Sex Med. 2018;6(3):224-233. doi:10.1016/j.esxm.2018.04.006Kor E, Mostafavi SRS, Mazhin ZA, et al.Relationship between the severity of endometriosis symptoms (Dyspareunia, dysmenorrhea and chronic pelvic pain) and the spread of the disease on ultrasound.BMC Research Notes. 2020;13(1):546. doi:10.1186/s13104-020-05388-5Johnson NP, Hummelshoj L, Adamson GD, et al.World Endometriosis Society consensus on the classification of endometriosis.Hum Reprod. 2017;32(2):315-324. doi:10.1093/humrep/dew293Moawad NS, Arkerson B, Laguerre M, Robinson M.92: long-term outcomes of laparoscopic surgery for endometriosis.American Journal of Obstetrics & Gynecology. 2018;218(2):S949.Mount Sinai.Living with endometriosis.The American College of Obstetricians and Gynecologists.Endometriosis.
Verywell Health uses only high-quality sources, including peer-reviewed studies, to support the facts within our articles. Read oureditorial processto learn more about how we fact-check and keep our content accurate, reliable, and trustworthy.
World Health Organization.Endometriosis.Maddern J, Grundy L, Castro J, Brierley SM.Pain in endometriosis.Front Cell Neurosci. 2020;14:590823. doi:10.3389/fncel.2020.590823Drabble SJ, Long J, Alele B, O’Cathain A.Constellations of pain: a qualitative study of the complexity of women’s endometriosis-related pain.Br J Pain. 2021;15(3):345-356. doi:10.1177/2049463720961413Hsu AL, Sinaii N, Segars J, Nieman LK, Stratton P.Relating pelvic pain location to surgical findings of endometriosis.Obstet Gynecol. 2011;118(2 Pt 1):223-230. doi:10.1097/AOG.0b013e318223fed0Nezhat C, Lindheim SR, Backhus L, et al.Thoracic endometriosis syndrome: a review of diagnosis and management.JSLS. 2019;23(3):e2019.00029. doi:10.4293/JSLS.2019.00029Wu Y, Wang H, Chen S, et al.Migraine is more prevalent in advanced-stage endometriosis, especially when co-occuring with adenomoysis.Front Endocrinol. 2022. doi:10.3389/fendo.2021.814474MedlinePlus.Adenomyosis.Shum LK, Bedaiwy MA, Allaire C, et al.Deep dyspareunia and sexual quality of life in women with endometriosis.Sex Med. 2018;6(3):224-233. doi:10.1016/j.esxm.2018.04.006Kor E, Mostafavi SRS, Mazhin ZA, et al.Relationship between the severity of endometriosis symptoms (Dyspareunia, dysmenorrhea and chronic pelvic pain) and the spread of the disease on ultrasound.BMC Research Notes. 2020;13(1):546. doi:10.1186/s13104-020-05388-5Johnson NP, Hummelshoj L, Adamson GD, et al.World Endometriosis Society consensus on the classification of endometriosis.Hum Reprod. 2017;32(2):315-324. doi:10.1093/humrep/dew293Moawad NS, Arkerson B, Laguerre M, Robinson M.92: long-term outcomes of laparoscopic surgery for endometriosis.American Journal of Obstetrics & Gynecology. 2018;218(2):S949.Mount Sinai.Living with endometriosis.The American College of Obstetricians and Gynecologists.Endometriosis.
World Health Organization.Endometriosis.
Maddern J, Grundy L, Castro J, Brierley SM.Pain in endometriosis.Front Cell Neurosci. 2020;14:590823. doi:10.3389/fncel.2020.590823
Drabble SJ, Long J, Alele B, O’Cathain A.Constellations of pain: a qualitative study of the complexity of women’s endometriosis-related pain.Br J Pain. 2021;15(3):345-356. doi:10.1177/2049463720961413
Hsu AL, Sinaii N, Segars J, Nieman LK, Stratton P.Relating pelvic pain location to surgical findings of endometriosis.Obstet Gynecol. 2011;118(2 Pt 1):223-230. doi:10.1097/AOG.0b013e318223fed0
Nezhat C, Lindheim SR, Backhus L, et al.Thoracic endometriosis syndrome: a review of diagnosis and management.JSLS. 2019;23(3):e2019.00029. doi:10.4293/JSLS.2019.00029
Wu Y, Wang H, Chen S, et al.Migraine is more prevalent in advanced-stage endometriosis, especially when co-occuring with adenomoysis.Front Endocrinol. 2022. doi:10.3389/fendo.2021.814474
MedlinePlus.Adenomyosis.
Shum LK, Bedaiwy MA, Allaire C, et al.Deep dyspareunia and sexual quality of life in women with endometriosis.Sex Med. 2018;6(3):224-233. doi:10.1016/j.esxm.2018.04.006
Kor E, Mostafavi SRS, Mazhin ZA, et al.Relationship between the severity of endometriosis symptoms (Dyspareunia, dysmenorrhea and chronic pelvic pain) and the spread of the disease on ultrasound.BMC Research Notes. 2020;13(1):546. doi:10.1186/s13104-020-05388-5
Johnson NP, Hummelshoj L, Adamson GD, et al.World Endometriosis Society consensus on the classification of endometriosis.Hum Reprod. 2017;32(2):315-324. doi:10.1093/humrep/dew293
Moawad NS, Arkerson B, Laguerre M, Robinson M.92: long-term outcomes of laparoscopic surgery for endometriosis.American Journal of Obstetrics & Gynecology. 2018;218(2):S949.
Mount Sinai.Living with endometriosis.
The American College of Obstetricians and Gynecologists.Endometriosis.
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