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Is Endometriosis Painful? Understanding the Types of Endo Pain

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One of the hallmark symptoms of endometriosis is pain. Whether it occurs only during a menstrual period or it’s more constant throughout the month, endometriosis pain is more than just period cramping. And while endometriosis is a gynecological condition, pain can often be felt in locations outside of the pelvis.

For many people with endometriosis, severe pain can interfere with their ability to participate in regular events and activities, causing them to frequently miss school or work. That type of pain isn’t normal and needs to be evaluated by an endometriosis specialist who understands how to recognize the condition’s symptoms.


Why Is Endometriosis Painful?

Endometriosis is a gynecological condition that occurs when cells that are typically found in the lining of the uterus begin to grow and implant in areas outside of the uterus. Just as uterine lining sheds and bleeds during a menstrual cycle, endometriosis lesions may also shed and bleed along with your cycle. But because endometriosis is growing outside of the uterus, the shedding tissue typically has no place to exit the body. The trapped tissue can cause inflammation and swelling, irritating nerve endings and often creating severe pain.1

Endometriosis can also lead to the formation of adhesions, which are bands of scar tissue that can cause organs in the pelvis to adhere to each other. In some cases, adhesions may cause no symptoms, but in others, they can cause severe pain and discomfort in the organs that become stuck together.

Types of Endometriosis Pain

Depending on the location of endometriosis lesions, pain can occur in a variety of areas — most commonly in and around the pelvis.

  • Endometriosis leg pain – Though rare, endometriosis can affect the sciatic nerve2 in some cases, causing pain that radiates down the leg.
  • Endometriosis hip pain – Patients who have leg pain from endometriosis may also experience pain in one or both hips, also caused by endometriosis lesions on or around the sciatic nerve.
  • Endometriosis lower back pain – Also caused by the involvement of the sciatic nerve, some patients with endometriosis may experience lower back pain.3 It’s possible for lesions to spread to areas of the spine, causing localized pain that can’t be solved by a chiropractor or orthopedic surgeon.
  • Endometriosis bowel pain – One of the most commonly affected organs in cases of endometriosis is the bowel.4 Lesions on the bowel can cause painful bowel movements, constipation or diarrhea, symptoms that are often misdiagnosed as irritable bowel syndrome (IBS).
  • Endometriosis pelvic pain – Pelvic pain is the symptom most associated with endometriosis and may occur only during menstrual periods or be present consistently throughout the month. Chronic pelvic pain can significantly impact patients’ quality of life and mental health.5
  • Endometriosis pain during sex – One of the less talked about symptoms of endometriosis is pain during sex. In some cases, certain positions can cause sharp or stabbing pain6 if endometriosis lesions are present around the uterus, cervix or bowel.

In addition to pain, endometriosis can cause other symptoms, including:

Bloating – Some patients with endometriosis may experience painful abdominal bloating, which often goes along with gastrointestinal issues.7 Patients may perceive abdominal bloating as weight gain.

Gastrointestinal issues – Endometriosis located on or around the bowel can cause gastrointestinal issues that often mimic IBS, including diarrhea, constipation and cramping.

Nausea – For some, endometriosis-related period cramps and pelvic pain can be so intense that they lead to nausea and vomiting.

Painful ovulation – In some cases, endometriosis can cause painful ovulation (the process that occurs when an ovary releases an egg), especially when lesions implant on one or both ovaries.

Find a Specialist Who Understands Endometriosis Pain

Because pain and its different locations can be indicative of a wide variety of conditions, endometriosis-related pain is often dismissed or misdiagnosed by general physicians. But if pain and other symptoms tend to occur or grow more severe during your menses, an evaluation by a GYN specialist may provide more accurate answers.

CIGC surgical specialists are experts in diagnosing and treating gynecological causes of pain, like endometriosis. In milder cases, the condition can sometimes be temporarily managed with nonsurgical methods like acupuncture, pelvic floor physical therapy or diet changes under the supervision of a nutritionist. In more severe cases, our endometriosis specialists have perfected their endometriosis excision procedure, which involves thoroughly removing all lesions, even those from harder-to-reach areas, through just two small incisions.

The most important factor in resolving endometriosis pain is finding a highly skilled specialist who can give you a definitive diagnosis. A specialist will understand the difference between regular period discomfort and severe endometriosis pain, and can recommend the best treatment plan for your individual case.

CIGC endometriosis specialists can help you find relief from the painful symptoms of endometriosis. Talk to a patient advocate to get started today.

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CIGC is dedicated to providing resources and materials for women to better understand the symptoms and best treatment options for gynecological conditions like endometriosis. The CIGC founders, minimally invasive GYN surgical specialists Natalya Danilyants, MD, and Paul MacKoul, MD, and developed their advanced GYN surgical techniques — using only a few small incisions — with patients’ well-being in mind. 

Their personalized approach to care helps patients gain a better understanding of their condition and the recommended treatment so they can have confidence from the very start. Our specialists have performed more than 25,000 minimally invasive GYN procedures, and women come from all over the world to receive their expert care. 



1. Morotti M, Vincent K, Becker CM. Mechanisms of pain in endometriosis. Eur J Obstet Gynecol Reprod Biol. 2017;209:8-13. doi:10.1016/j.ejogrb.2016.07.497

2. Saar TD, Pacquée S, Conrad DH, et al. Endometriosis Involving the Sciatic Nerve: A Case Report of Isolated Endometriosis of the Sciatic Nerve and Review of the Literature. Gynecol Minim Invasive Ther. 2018;7(2):81-85. doi:10.4103/GMIT.GMIT_24_18

3. Uppal J, Sobotka S, Jenkins AL 3rd. Cyclic Sciatica and Back Pain Responds to Treatment of Underlying Endometriosis: Case Illustration. World Neurosurg. 2017;97:760.e1-760.e3. doi:10.1016/j.wneu.2016.09.111

4. Nezhat C, Li A, Falik R, et al. Bowel endometriosis: diagnosis and management. Am J Obstet Gynecol. 2018;218(6):549-562. doi:10.1016/j.ajog.2017.09.023

5. Facchin F, Barbara G, Saita E, et al. Impact of endometriosis on quality of life and mental health: pelvic pain makes the difference. J Psychosom Obstet Gynaecol. 2015;36(4):135-141. doi:10.3109/0167482X.2015.1074173

6. Wahl KJ, Imtiaz S, Lisonek M, et al. Dyspareunia in Their Own Words: A Qualitative Description of Endometriosis-Associated Sexual Pain. Sex Med. 2021;9(1):100274. doi:10.1016/j.esxm.2020.10.002

7. Luscombe GM, Markham R, Judio M, Grigoriu A, Fraser IS. Abdominal bloating: an under-recognized endometriosis symptom. J Obstet Gynaecol Can. 2009;31(12):1159-1171. doi:10.1016/s1701-2163(16)34377-8