What Does Endometriosis Feel Like? A Deep Dive Into the Symptoms

Written by Institute for Natural Medicine Staff

Medically Reviewed by BreAnna M. Guan, ND

Published February 20, 2025
Last Updated February 21, 2025

Endometriosis occurs when tissue similar to the lining of the uterus grows outside the womb, causing inflammation, scarring, and severe discomfort. This painful and often misunderstood condition affects millions of women.

Because symptoms vary widely, endometriosis is frequently misdiagnosed or dismissed as normal period discomfort.¹ But for many, the pain is far more than just “bad cramps,” with chronic and sometimes debilitating symptoms disrupting daily life. Understanding how endometriosis feels is essential for proper diagnosis and treatment.

Understanding endometriosis symptoms

When endometrial tissue implants itself on the bladder, ovaries, fallopian tubes, intestines, or diaphragm, it can trigger inflammation, irritate surrounding nerves, and lead to the formation of scar tissue.² Unlike typical menstrual cramps, these lesions can cause relentless pain that intensifies before, during, or after a period and, for some, never fully dissipates.

Severe pelvic pain

Many women describe endometriosis pain as deep, aching, stabbing, or throbbing. The pain may feel like intense pressure in the lower abdomen, making it difficult to stand, sit, or even move comfortably.

Excruciating menstrual cramps

While mild cramping is common during periods, endometriosis cramps are different. They can be so intense that pain medicine barely takes the edge off.³ Some report feeling as if their insides are being squeezed or twisted.

Pain during or after sex

Endometrial lesions growing near the cervix, vagina, or deeper pelvic organs may cause painful intercourse.⁴ Sharp or deep, aching pain may occur during sex and linger for hours afterward.

Gastrointestinal discomfort (endo belly)

Bloating, nausea, constipation, and diarrhea are common symptoms of endometriosis. Many experience “endo belly,” where the abdomen swells,⁵ sometimes making a person look several months pregnant. The pain can resemble irritable bowel syndrome (IBS), making diagnosis tricky.

Painful bowel movements and urination

If endometrial tissue affects the intestines or bladder, even going to the bathroom can be agonizing—especially during the menstrual cycle.⁶ Some describe intensely sharp pain, while others experience a dull, persistent ache.

Radiating leg and lower back pain

Endometriosis pain isn’t limited to the pelvic area. It can extend down the legs and into the lower back,⁷^,⁸ making everyday tasks difficult. Some report numbness, tingling, or sharp nerve pain radiating from the pelvis downward.

Other symptoms

Although pain is the most recognized symptom, endometriosis also affects energy levels. One of the most overlooked symptoms is extreme fatigue.⁹ People with endometriosis may feel constantly drained, no matter how much they rest. Exhaustion comes not just from pain but also from chronic inflammation, hormonal imbalances, and the sheer effort of coping every day.⁴

Heavy, unpredictable periods are another challenge. Some experience bleeding so intense it soaks through pads or tampons in under an hour.¹⁰ Irregular cycles and unexpected spotting add to the frustration.

For many women, fertility struggles are the most heartbreaking symptom. Endometriosis can cause scarring, block fallopian tubes, and create inflammation that makes conception difficult.² Some only receive a diagnosis after struggling to get pregnant.

The emotional and mental toll of endometriosis is profound. Years of being dismissed by doctors, coping with relentless pain, and dealing with the unpredictability of symptoms can lead to anxiety and depression. The lack of clear treatment solutions and uncertainty of the condition’s progression only add to the emotional burden.⁴

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Why does pain vary from person to person?

Woman with endometriosis pain lies on bed

Endometriosis doesn’t look the same for everyone. Some women experience mild discomfort, while others endure relentless, life-altering pain that disrupts work, relationships, and daily life.

One major factor in pain levels is the location of endometrial implants. When lesions grow near nerve-dense areas like the bladder, intestines, or pelvic floor, they can trigger sharp, shooting pain.⁹^,¹¹ If scar tissue (adhesions) causes organs to stick together, it often leads to a deep, persistent ache that worsens over time.¹²

The stage of endometriosis doesn’t always match the severity of pain.³ Some women with mild cases suffer intensely, while others with advanced disease feel little discomfort. Hormonal fluctuations also play a role—since estrogen fuels lesion growth, pain may spike around ovulation or menstruation.

Pain tolerance and nerve sensitivity add another layer of complexity. Some people have heightened nerve responses, making even small lesions unbearable, while others may have widespread endometriosis with minimal pain.

Treatment options

There is no one-size-fits-all approach to treating endometriosis. Management strategies range from conventional medical treatments to natural therapies, each with benefits and limitations. The best treatment plan depends on the severity of symptoms, individual health factors, and personal preferences.

Conventional treatments

Conventional treatments primarily aim to manage symptoms, reduce pain, and slow endometriosis progression. These include medications, hormonal therapies, and surgical interventions.

Pain medications: Nonsteroidal anti-inflammatory drugs (NSAIDs), such as ibuprofen and naproxen, are commonly used to relieve pain. However, they do not treat the underlying disease and may not be effective for severe pain.
Hormonal therapy: Birth control pills, progestin-only medications, and gonadotropin-releasing hormone (GnRH) agonists help suppress estrogen levels, reducing endometriosis flare-ups. While effective for many, these treatments can cause side effects, including mood swings, weight gain, and bone density loss.¹³ They don’t cure endometriosis, and symptoms often return after discontinuation.
Laparoscopic surgery: This procedure allows doctors to remove endometrial lesions and scar tissue. Some women experience significant improvement, but for others, pain returns over time. Surgery also carries risks such as infection, complications from anesthesia, and potential damage to surrounding organs.¹⁴
Hysterectomy: In severe endometriosis cases, some opt for a hysterectomy (removal of the uterus) with or without removal of the ovaries. While this can provide relief, it is a drastic measure and not guaranteed to eliminate all symptoms, especially if endometriosis is present outside the uterus.¹⁵

Challenges of conventional treatments

Although conventional treatments provide relief for many, they come with significant challenges. Hormonal therapies are not suitable for individuals who want to conceive, and the recurrence of symptoms after stopping medication or undergoing surgery is common. Additionally, diagnosing and treating endometriosis often involves long wait times, misdiagnoses, and trial-and-error approaches, leading to frustration for many patients.

Natural treatments

Woman gets acupuncture on lower back in clinic

Many women turn to natural therapies to complement medical treatments or as an alternative when conventional options fail. Natural approaches focus on reducing inflammation, supporting hormonal balance, and managing pain:

Heat therapy is one of the easiest and most effective at-home remedies. A heating pad or warm bath can relax muscles, boost blood flow, and ease cramping. Using heat consistently throughout the day may lower overall pain levels.
Diet can also play a significant role. Since endometriosis is linked to inflammation, some women find relief by switching to an anti-inflammatory diet. This may mean cutting back on dairy, gluten, processed sugar, and red meat while eating more leafy greens, berries, herbs like turmeric, and omega-3–rich foods¹⁶ like salmon and flaxseeds.
Certain herbs, like turmeric, ginger, and vitex (chasteberry), may help balance hormones and reduce inflammation.¹⁷
Acupuncture has been used to alleviate chronic pelvic pain. In studies, women have reported less pain severity, although long-term symptom relief is still unclear.¹⁸
Gentle movement and physical therapy can help with pelvic pain and muscle tension.² Low-impact exercises like yoga, stretching, and walking reduce stiffness and improve circulation. Pelvic floor therapy may also be beneficial, especially for women dealing with chronic tightness or painful intercourse.
Managing stress is just as important. Chronic pain can increase anxiety, which in turn can worsen symptoms. Mindfulness techniques like meditation, deep breathing, and acupuncture have helped many people feel more in control of their pain.
Finding support makes a difference. Endometriosis may feel isolating, but online forums, support groups, and social media communities provide a space to share experiences, learn from others, and feel understood.¹

Although every woman’s experience with endometriosis is different, finding the right combination of treatment, lifestyle adjustments, and support can make a meaningful difference. With the right approach, managing symptoms and living a full, healthy life is possible.

Footnotes

1
Hudson N. The missed disease? Endometriosis as an example of ‘undone science’. Reprod Biomed Soc Online. 2021 Aug 13;14:20-27. https://doi.org/10.1016/j.rbms.2021.07.003
2
Chauhan S, More A, Chauhan V, Kathane A. Endometriosis: a review of clinical diagnosis, treatment, and pathogenesis. Cureus. 2022 Sep 6;14(9):e28864. https://doi.org/10.7759/cureus.28864
3
Maddern J, Grundy L, Castro J, Brierley SM. Pain in endometriosis. Front Cell Neurosci. 2020 Oct 6;14:590823. https://doi.org/10.3389/fncel.2020.590823
4
Hunsche E, Gauthier M, Witherspoon B, Rakov V, Agarwal SK. Endometriosis symptoms and their impacts on the daily lives of US women: results from an interview study. Int J Womens Health. 2023 Jun 1;15:893-904. https://doi.org/10.2147/IJWH.S409733
5
Velho RV, Werner F, Mechsner S. Endo Belly: What is it and why does it happen? A narrative review. J Clin Med. 2023 Nov 19;12(22):7176. https://doi.org/10.3390/jcm12227176
6
Bień A, Rzońca E, Zarajczyk M, Wilkosz K, Wdowiak A, Iwanowicz-Palus G. Quality of life in women with endometriosis: a cross-sectional survey. Qual Life Res. 2020 Oct;29(10):2669-2677. https://doi.org/10.1007/s11136-020-02515-4
7
Dongxu Z, Fei Y, Xing X, Bo-Yin Z, Qingsan Z. Low back pain tied to spinal endometriosis. Eur Spine J. 2014 May;23 Suppl 2:214-7. https://doi.org/10.1007/s00586-013-2988-x
8
Missmer SA, Bove GM. A pilot study of the prevalence of leg pain among women with endometriosis. J Bodyw Mov Ther. 2011 Jul;15(3):304-8. https://doi.org/10.1016/j.jbmt.2011.02.001
9
Bouaziz J, Bar On A, Seidman DS, Soriano D. The clinical significance of endocannabinoids in endometriosis pain management. Cannabis Cannabinoid Res. 2017 Apr 1;2(1):72-80. https://doi.org/10.1089/can.2016.0035
10
Marnach ML, Laughlin-Tommaso SK. Evaluation and management of abnormal uterine bleeding. Mayo Clin Proc. 2019 Feb;94(2):326-335. https://doi.org/10.1016/j.ogc.2022.02.021
11
Godin SK, Wagner J, Huang P, Bree D. The role of peripheral nerve signaling in endometriosis. FASEB Bioadv. 2021 Aug 2;3(10):802-813. https://doi.org/10.1096/fba.2021-00063
12
Abd El-Kader AI, Gonied AS, Lotfy Mohamed M, Lotfy Mohamed S. Impact of endometriosis-related adhesions on quality of life among infertile women. Int J Fertil Steril. 2019 Apr;13(1):72-76. https://doi.org/10.22074/ijfs.2019.5572
13
Vannuccini S, Clemenza S, Rossi M, Petraglia F. Hormonal treatments for endometriosis: The endocrine background. Rev Endocr Metab Disord. 2022 Jun;23(3):333-355. https://doi.org/10.1007/s11154-021-09666-w
14
Rimbach S, Ulrich U, Schweppe KW. Surgical therapy of endometriosis: challenges and controversies. Geburtshilfe Frauenheilkd. 2013 Sep;73(9):918-923. https://doi.org/10.1055/s-0033-1350890
15
Rizk B, Fischer AS, Lotfy HA, et al. Recurrence of endometriosis after hysterectomy. Facts Views Vis Obgyn. 2014;6(4):219-27
16
Barnard ND, Holtz DN, Schmidt N, Kolipaka S, Hata E, Sutton M, Znayenko-Miller T, Hazen ND, Cobb C, Kahleova H. Nutrition in the prevention and treatment of endometriosis: A review. Front Nutr. 2023 Feb 17;10:1089891. https://doi.org/10.3389/fnut.2023.1089891
17
Ilhan M, Gürağaç Dereli FT, Akkol EK. Novel drug targets with traditional herbal medicines for overcoming endometriosis. Curr Drug Deliv. 2019;16(5):386-399. https://doi.org/10.2174/1567201816666181227112421
18
Giese N, Kwon KK, Armour M. Acupuncture for endometriosis: A systematic review and meta-analysis. Integr Med Res. 2023 Dec;12(4):101003. https://doi.org/10.1016/j.imr.2023.101003

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What Does Endometriosis Feel Like? A Deep Dive Into the Symptoms

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