What Are the Symptoms of Endometriosis?

Endometriosis is characterized by secondary dysmenorrhea, menstrual abnormalities, pelvic pain, infertility, and dyspareunia. Ectopic endometrial tissue undergoes cyclical proliferation and bleeding in response to hormonal fluctuations, thereby irritating surrounding tissues and causing various physical discomforts. Symptom severity varies considerably among affected individuals. If severe abdominal pain or heavy vaginal bleeding occurs, prompt medical evaluation and treatment are strongly recommended.

1. Secondary Dysmenorrhea: Pain typically begins before menstruation onset, intensifies progressively throughout the menstrual period, and gradually subsides after menses ends. It commonly localizes to the lower abdomen and lumbosacral region; in severe cases, it may radiate to the inguinal area. Conventional analgesics often provide limited relief.

2. Menstrual Abnormalities: Endometrial lesions impair ovarian function, leading to menorrhagia (excessive menstrual flow), prolonged menstrual duration, or prolonged irregular spotting. Some patients experience premenstrual spotting, disrupting normal menstrual cycles and increasing the risk of excessive blood loss.

3. Pelvic Pain: Persistent, dull lower abdominal and lumbosacral pain may occur even outside the menstrual period. Discomfort intensifies when lesions involve the pelvic peritoneum. Pain episodes are frequently triggered by physical exertion or sexual intercourse, and chronic, recurrent pain can significantly impair daily functioning.

4. Infertility: Ectopic lesions can damage ovarian tissue and cause pelvic adhesions, thereby interfering with oocyte pickup by the fallopian tubes and subsequent transport of fertilized eggs. Many patients experience prolonged unsuccessful attempts at conception before diagnosis confirms endometriosis.

5. Dyspareunia: When lesions are located in areas such as the rectovaginal septum, sexual intercourse may trigger deep pelvic pain upon contact. Premenstrual lesion congestion and edema further exacerbate pain perception, adversely affecting marital or sexual relationships.

Maintain regular sleep-wake patterns to stabilize endogenous hormone levels; minimize strenuous physical activity during menstruation; ensure adequate abdominal warmth; monitor changes in menstrual patterns and abdominal pain; and undergo routine gynecological examinations to facilitate early detection and timely intervention.