Dysmenorrhoea and Endometriosis

Endometriosis may cause pelvic pain or infertility although many women with endometriosis have neither problem. Having more endometriosis does not mean you will have more pain, as women with only a minimal amount can have more pain than women with severe disease.

Pelvic pain in endometriosis is mostly associated with menses and occurs on a monthly basis. However, other significant symptoms may be:

• Pain felt deep inside the vagina during or after sexual intercourse
• Pain felt during passing of motion

These also tend to be worse during menses. Pain can also occur throughout the month and may then be described as chronic pelvic pain.

Although it is normal to have some discomfort during menses, it is not normal to have pain that is not relieved by simple painkillers or if it forces you to take time off work or miss social events. These may suggest that you have endometriosis and should seek medical help.

Rarer forms of endometriosis

In more rare cases, you may have bleeding from the back passage or bleeding when you pass urine during menses, suggesting that endometriosis is affecting the rectum or bladder.

Cyclical pain during menses in an old operation scar (e.g. caesarean section scar) may suggest that there is endometriosis in it. Coughing up blood during your menses may indicate lung endometriosis.

Is endometriosis linked with fertility problems?

When we look at women who are struggling to become pregnant, we find that a greater number of them have endometriosis than we would expect to find in the general population showing a link between endometriosis and infertility but this is poorly understood.