If you've been diagnosed with, or suspect endometriosis, symptoms that seem out of the ordinary can leave you wondering ‘Is this endometriosis, or something else?’ For information on common flare-up symptoms, take a look at our article Endometriosis flare up symptoms.
Endometriosis can present with subtle or "silent" symptoms that often go unnoticed or are mistaken for other conditions. These silent symptoms can still significantly impact a person’s health and well-being. Recognising lesser known symptoms of endometriosis can lead to earlier and more effective intervention. It may also require less invasive procedures with quicker recovery times via robotic surgery for endometriosis.
If you experience persistent symptoms such as chronic fatigue, dizziness, gastrointestinal issues, urinary problems or recurring pain before the age of menopause, it is important to consult with a healthcare provider who can evaluate for endometriosis. Early detection and appropriate management can help mitigate the impacts of this condition and improve overall health and well-being.
This guide will help you identify and understand these less common or “silent” symptoms. We’ll walk you through some unusual signs of endometriosis so that by the time you’ve finished reading, you’ll have a better understanding of why these symptoms occur, what can be done to alleviate them, and the next steps you need to take.
Urinary symptoms of endometriosis
Endometriosis can cause urinary symptoms that are often mistaken for more common conditions like urinary tract infections (UTIs) or overactive bladder. Recognising these symptoms as potential signs of endometriosis can lead to more accurate diagnosis and treatment.
Common urinary symptoms linked to endometriosis
Frequent urination: An increased need to urinate, often more than usual.
Urgency: A sudden, strong urge to urinate that can be difficult to control.
Pain during urination: Discomfort or pain when urinating, especially during menstruation.
Blood in urine: Occasionally, there may be traces of blood in the urine.
Distinguishing endometriosis from regular UTIs and overactive bladder
Timing and cyclical nature: Unlike UTIs or overactive bladder, urinary symptoms related to endometriosis often worsen during menstruation. If you notice a pattern where symptoms intensify around your menstrual cycle, it could be a sign of endometriosis.
Pain localisation: Pain associated with endometriosis can be more generalised in the pelvic area, whereas UTI pain is typically more localised to the bladder and urethra. Endometriosis-related pain may also radiate to other areas such as the lower back or thighs.
Lack of infection: UTIs are usually accompanied by signs of infection, such as a positive urine culture showing bacteria. In contrast, urinary symptoms from endometriosis do not show bacterial infection in urine tests. If you have recurrent urinary symptoms but tests for infection are consistently negative, endometriosis could be a potential cause.
Response to antibiotics: UTIs typically respond well to antibiotics, leading to a quick resolution of symptoms. If your urinary symptoms persist despite antibiotic treatment, this might indicate endometriosis rather than a simple infection.
Associated symptoms: Endometriosis often comes with other symptoms such as severe menstrual cramps, chronic pelvic pain, pain during intercourse, and gastrointestinal issues. The presence of these additional symptoms alongside urinary problems can suggest endometriosis as the underlying cause.
Recognising urinary symptoms as a possible sign of endometriosis is key for early detection and appropriate management. If you experience persistent urinary symptoms, particularly if they align with your menstrual cycle and are accompanied by other signs of endometriosis, consult with a healthcare provider. Early diagnosis can lead to more effective treatment strategies, improving your quality of life and preventing further complications.
Endometriosis pain on one side only
Endometriosis can sometimes cause pain that is only felt on one side of the body. This can be confusing and concerning if you're not sure why it's happening.
Why does this happen?
Localised endometriosis lesions: Endometriosis involves the growth of tissue similar to the lining of the uterus in other parts of the body. If these growths, or lesions, are concentrated on one side of the pelvis, they can cause pain that is localised to that area. For example, if the lesions are on the left ovary or left side of the pelvic wall, you may only feel pain on the left side.
Asymmetrical distribution: Sometimes, endometriosis doesn't spread evenly. It might affect organs or tissues on one side of the body more than the other. This can lead to one-sided pain depending on where the lesions are growing.
Nerve involvement: Endometriosis can irritate the nerves in the pelvis. If a nerve on one side is more affected, it can cause pain that radiates along that side. This is similar to how a pinched nerve in your back can cause pain down one leg.
Clinical explanations
Ovarian endometriomas: These are cysts caused by endometriosis on the ovaries. If an endometrioma develops on one ovary, it can cause pain on that specific side. Imagine having a sore spot on one side of your body; the discomfort would be focused there.
Pelvic adhesions: Endometriosis can cause scar tissue, known as adhesions, which can bind organs together. If adhesions form on one side, they can pull on tissues and organs, causing pain that is felt on that particular side.
Differences from general pelvic pain
Location-specific
Unlike general pelvic pain, which might be felt across the entire lower abdomen, one-sided pain is distinctly felt on either the left or right side. It can sometimes be mistaken for other conditions like ovarian cysts or even appendicitis if it's on the right side.
Consistency and triggers
The pain might be more consistent or triggered by specific activities, such as during menstruation, ovulation, or physical activity. You might notice the pain flares up at the same time each month, aligning with your menstrual cycle.
Can it be treated?
Yes, pain from endometriosis on one side can be managed with various treatments:
Medication: Hormonal treatments and pain relievers can help manage the symptoms.
Surgery: In some cases, surgery may be needed to remove the endometriosis lesions or adhesions causing the pain.
Lifestyle changes: Certain lifestyle adjustments, such as regular exercise and dietary changes, can also help manage the pain.
If you're experiencing one-sided pain and suspect it might be related to endometriosis, it’s important to consult with a healthcare professional. They can provide a proper diagnosis and treatment plan to help alleviate your symptoms and improve your quality of life.
Burning pain in the stomach
How this burning pain might feel
The burning pain in the stomach from endometriosis can feel like a deep, persistent ache, akin to the sensation of severe heartburn but more intense and lingering. It can range from a dull, nagging discomfort to a sharp, searing pain that feels like your insides are on fire.
This burning sensation might be described as a gnawing pain that doesn’t go away, even after eating or taking antacids. It often feels like a hot, raw area inside your stomach, and it can be accompanied by a sense of tightness or pressure. This pain can be severe enough to interfere with daily activities, making it difficult to focus on anything else.
How it's different from normal heartburn and indigestion
While normal heartburn and indigestion typically result from eating certain foods or overeating, the burning pain associated with endometriosis is not directly linked to food intake. Heartburn and indigestion usually cause a burning sensation that rises from the stomach up into the chest or throat, often accompanied by a sour or acidic taste.
In contrast, the burning pain from endometriosis tends to be more constant or cyclic, often worsening during menstruation and not alleviated by antacids or dietary changes. Additionally, this pain is due to endometriosis lesions or adhesions rather than issues within the digestive tract itself.
Possible underlying causes
Endometriosis lesions on the bowel: Endometriosis can spread to the bowel, causing inflammation and pain that feels like burning. This is because the lesions irritate the bowel's lining, similar to how acid irritates the stomach in acid reflux.
Adhesions: Adhesions are bands of scar tissue that can form as a result of endometriosis. These can cause organs to stick together, leading to a pulling sensation and burning pain in the stomach. Imagine two pieces of sticky tape pulling at your skin—this can create a burning feeling internally.
Nerve involvement: Endometriosis can affect nerves in the pelvic area, causing referred pain that is felt in the stomach. This is akin to how a pinched nerve in your back might cause pain in your leg.
Understanding that burning pain in the stomach can be a symptom of endometriosis helps in seeking appropriate treatment and relief. If you experience these symptoms, discussing them with your healthcare provider can lead to effective management strategies tailored to your needs.
Nausea and vomiting
Endometriosis can cause a variety of gastrointestinal symptoms, including nausea and vomiting. These symptoms arise when endometrial tissue grows on or near the digestive organs, causing inflammation and irritation.
Characteristics of nausea and vomiting in endometriosis
Unlike gastric flu or food poisoning, nausea and vomiting related to endometriosis often coincide with the menstrual cycle. These symptoms typically worsen during menstruation and may ease during other times of the month. This cyclic nature distinguishes endometriosis-related gastrointestinal symptoms from other types of nausea.
Additionally, this type of nausea is often accompanied by pelvic pain, cramping, and bloating, which are also linked to endometriosis. The pain can be sharp or dull and usually intensifies during periods. Endometriosis-related nausea and vomiting can be persistent, occurring month after month in a predictable pattern, unlike the sporadic nature of food poisoning or stomach flu, which usually resolve within a few days.
Patients with endometriosis may also experience other symptoms such as constipation, diarrhoea, or painful bowel movements, which are not typical of common gastrointestinal infections. This combination of symptoms can help differentiate endometriosis-related issues from other conditions.
Differentiating from gastric flu or food poisoning
Onset and duration: Gastric flu and food poisoning typically have a sudden onset and resolve within a few days to a week. In contrast, endometriosis-related symptoms recur monthly and persist for longer periods.
Triggering factors: Gastrointestinal infections are usually triggered by contaminated food or viral infections and often come with fever and feeling general unwell. Endometriosis-related nausea is tied to the menstrual cycle and is not linked to specific foods or infectious agents.
Response to treatment: While antacids, anti-nausea medications, and hydration can alleviate symptoms of food poisoning or stomach flu, they may not be effective for endometriosis-induced nausea and vomiting, which require hormonal treatments or pain management strategies.
Managing nausea and vomiting from endometriosis
Managing nausea and vomiting caused by endometriosis involves addressing the underlying endometrial tissue growth and associated inflammation. Understanding that nausea and vomiting can be symptoms of endometriosis is important for proper diagnosis and treatment. If you experience these symptoms in conjunction with your menstrual cycle or have other signs of endometriosis, consulting with a healthcare provider can help you find effective management strategies, including lifestyle changes, dietary adjustments and medications.
Dizziness and endometriosis
Can endometriosis make you feel dizzy?
Yes, endometriosis can make you feel dizzy. While it's not one of the most common symptoms, dizziness can occur due to the various effects endometriosis has on the body.
Exploring the link between endometriosis and dizziness
Pain and stress response: Chronic pain from endometriosis can lead to high levels of stress and anxiety, which in turn can cause dizziness. When you're in pain, your body releases stress hormones like cortisol, which can affect your balance and cause light-headedness.
Hormonal imbalances: Endometriosis is influenced by hormonal changes in the body, particularly oestrogen. Fluctuations in hormone levels can sometimes lead to dizziness, similar to how some people feel light-headed during their menstrual cycle.
Anaemia: Heavy menstrual bleeding, a common symptom of endometriosis, can lead to anaemia. Anaemia, or low red blood cell count, reduces the oxygen supply to the brain, which can cause dizziness and fatigue.
Inflammation and immune response: The inflammatory response in endometriosis can affect various body systems, including the nervous system. This systemic inflammation can sometimes result in feelings of dizziness or vertigo.
Managing this symptom effectively
Medical treatments
Hormonal therapies: Medications like birth control pills, GnRH agonists, or progestins can help stabilise hormone levels, potentially reducing dizziness.
Iron supplements: If anaemia is causing dizziness, iron supplements or dietary changes to increase iron intake can help.
Pain management: Proper pain management strategies, including NSAIDs like ibuprofen or naproxen can reduce overall stress on the body.
Lifestyle adjustments
Hydration: Keeping well-hydrated can help manage dizziness as dehydration can exacerbate light-headedness.
Balanced diet: Eating a balanced diet rich in iron and other essential nutrients can support overall health and reduce symptoms like dizziness as this can help reduce the risk of dietary deficiencies.
Rest and relaxation: Deep breathing or meditation can improve sleep and help manage stress, which can sometimes lead to dizziness.
Medical consultation
If dizziness persists, it’s important to consult with your healthcare provider. They can help identify the specific cause and recommend appropriate treatments for you. This might include simple blood tests to check for anaemia or other underlying conditions.
Understanding the link between endometriosis and dizziness can help you manage this symptom more effectively, improve your quality of life and reduce the impact of these dizzy spells.
Chest pain and endometriosis
How endometriosis can cause chest pain
In rare cases, endometriosis can lead to chest pain. This occurs when endometrial tissue implants and grows in the chest cavity, specifically on the diaphragm or lungs. This condition is known as thoracic endometriosis.
Diaphragmatic endometriosis: This occurs when endometrial tissue grows on the diaphragm, the muscle that separates the chest from the abdomen. It can cause sharp or stabbing chest pain, particularly during menstruation. The pain may also radiate to the shoulder or upper arm, mimicking conditions like a pinched nerve or muscle strain.
Pleural endometriosis: This involves the presence of endometrial tissue in the pleural cavity, which surrounds the lungs. It can lead to chest pain, shortness of breath, and even coughing up blood, particularly during the menstrual cycle.
Differentiating from other causes of chest pain
Chest pain is understandably alarming and can be caused by various serious conditions, such as heart attacks or pulmonary embolisms, so it's of key importance to distinguish the endometriosis chest pain from other causes:
Pattern and timing: Chest pain related to endometriosis often coincides with the menstrual cycle. If you notice that your chest pain occurs or worsens during your period, this may be an indicator of thoracic endometriosis.
Location and type of pain: Endometriosis-related chest pain is usually sharp or stabbing and may radiate to the shoulder or upper arm. It is often localised to one side of the chest. As these symptoms are similar to heart attack symptoms, call 999 urgently if you have any concerns.
Associated symptoms: Pay attention to other symptoms that accompany the chest pain. For instance, if you experience shortness of breath or cough up blood, especially during your period, this could be a sign of pleural endometriosis. Any coughing up of blood should always be urgently investigated by a doctor.
When to seek help
Chest pain should never be ignored. Here are some guidelines on when to seek immediate help:
Sudden, severe chest pain: If you experience sudden, severe chest pain, especially if it is accompanied by shortness of breath, sweating, nausea, or pain radiating to your arm or jaw, seek emergency medical attention immediately. These could be signs of a heart attack.
Persistent or worsening pain: If your chest pain persists or worsens over time, consult your healthcare provider to explore the underlying causes.
Menstrual cycle connection: If you notice a pattern where your chest pain aligns with your menstrual cycle, mention this to your healthcare provider. They can perform specific tests to diagnose thoracic endometriosis and recommend appropriate treatment.
While the idea of endometriosis causing chest pain can be frightening, it's important to remember that there are effective treatments available. Managing thoracic endometriosis typically involves hormonal treatments to reduce or eliminate the endometrial tissue, and in some cases, surgical intervention will provide long term relief.
Always consult with your healthcare provider if you experience any form of chest pain to ensure you receive the appropriate diagnosis and treatment.
Leg pain and endometriosis
Endometriosis can cause leg pain when endometrial tissue grows near nerves that travel through the pelvis and down the legs. This tissue can irritate or compress these nerves, leading to pain that radiates into the legs. The sciatic nerve, which runs from the lower back through the hips and down each leg, is often involved in these cases.
Sciatic endometriosis occurs when endometrial tissue affects the sciatic nerve, causing pain that radiates from the lower back or buttocks down the back of the leg. This pain can be sharp, shooting, or burning, and may be accompanied by numbness, tingling, or weakness in the leg, often worsening during menstruation.
Endometrial growths can also compress other pelvic nerves, leading to leg pain that might feel like muscle cramps or deep aching in the thigh or calf. This pain can vary from mild to severe and may include intermittent sharp pains.
Differentiating from other causes of leg pain
Sciatica: Typically caused by a herniated disc or spinal stenosis. The pain is similar but not usually linked to the menstrual cycle. MRI scans can identify disc issues or spinal problems.
Muscle strain: Caused by overuse or injury to the muscles in the leg. The pain is localised and often follows physical activity. It generally improves with rest and treatments like ice or heat application.
Peripheral neuropathy: Often related to diabetes, alcohol use, or certain medications. This condition causes tingling, numbness, or burning pain in the feet and legs, which is not related to the menstrual cycle. Diagnosis is typically confirmed through blood tests and nerve conduction studies.
Recognising endometriosis-related leg pain
If leg pain consistently worsens during your menstrual cycle, it may be linked to endometriosis. Look for other endometriosis symptoms, such as pelvic pain, heavy menstrual bleeding, or gastrointestinal issues. If traditional treatments for sciatica, muscle strain, or neuropathy don’t alleviate the pain, it might be worth exploring endometriosis as a potential cause.
Managing leg pain from endometriosis
Understanding that endometriosis can cause leg pain helps in seeking appropriate diagnosis and treatment, including physiotherapy, pain medication, and in severe cases, surgical removal of endometrial tissue to alleviate nerve compression. If you experience leg pain that aligns with your menstrual cycle or doesn’t respond to typical treatments, discussing this with your healthcare provider can lead to more effective management strategies.
Endometriosis throat symptoms
How common is this?
Throat symptoms caused by endometriosis are very rare. While endometriosis primarily affects the pelvic area, in exceptional cases, the tissue can travel to unusual places, including the throat.
How and why does this happen?
Endometriosis involves tissue that normally lines the uterus growing outside of it. Sometimes, this tissue can move to other parts of the body through the bloodstream or lymphatic system. When it reaches the throat, it can cause inflammation and irritation.
Signs that it’s different from a regular sore throat
Persistent symptoms: Unlike a common sore throat from a cold or infection, symptoms persist for a long time and don’t respond to typical treatments.
Feeling of a lump: You might feel like there’s something stuck in your throat that you can’t swallow, which is not common with a regular sore throat.
Voice changes: Your voice might become hoarse or raspy for no apparent reason.
Difficulty swallowing: You might find it hard to swallow, feeling like your throat is tight or blocked.
Can it be treated?
Yes, throat symptoms caused by endometriosis can be treated. The treatment often involves managing the underlying endometriosis. If you experience persistent throat symptoms and have a history of endometriosis, it’s important to talk to your doctor. They can help determine the cause and provide appropriate treatment such as hormonal treatment, symptom management medications and in some cases, surgery. Understanding these uncommon symptoms can help you get the right care and improve your quality of life.
Fatigue and endometriosis
Fatigue is a common symptom of endometriosis, often described as a persistent, overwhelming tiredness that doesn’t go away with rest. This chronic fatigue can significantly impact daily life, making even simple tasks feel exhausting. Unlike temporary tiredness from lack of sleep or overexertion, endometriosis-related fatigue is constant and can be debilitating.
How it impacts daily life
Chronic fatigue can make it difficult to get out of bed in the morning and can lead to physical exhaustion throughout the day. Activities that were once easy, like walking or climbing stairs, can become daunting. This type of fatigue can also affect cognitive functions, leading to difficulties with concentration, memory, and decision-making. You might find it hard to focus on work, remember appointments, or make simple decisions.
Constant tiredness can lead to emotional stress, including feelings of frustration, sadness, or anxiety. The inability to engage in normal activities can contribute to a sense of isolation or depression. Fatigue can severely impact productivity at work or school, with tasks taking longer to complete or being left unfinished.
Distinguishing from other types of fatigue
Temporary fatigue: Usually caused by lack of sleep, stress, or temporary overexertion, and it typically improves with rest and relaxation.
Fatigue from illness: Conditions like the flu or a cold can cause fatigue, but it generally resolves once the illness passes.
Fatigue from depression: Depression can cause similar feelings of exhaustion but often comes with other symptoms like persistent sadness, lack of interest in activities, and changes in appetite or sleep patterns.
Deficiency fatigue: This type of fatigue can result from deficiencies in essential nutrients like iron, vitamin D, or B12. Endometriosis can lead to heavy menstrual bleeding, which may cause iron-deficiency anaemia, contributing to fatigue. Symptoms of deficiency fatigue include persistent tiredness, weakness, and pale skin.
What your doctor may recommend
Understanding that fatigue can be a symptom of endometriosis and related deficiencies is really important for proper diagnosis and treatment. If you experience persistent fatigue in conjunction with your menstrual cycle or have other signs of endometriosis, consulting with a healthcare provider can help you find effective management strategies, which may include stress management techniques, lifestyle adjustments, blood tests, medication, supplements and pain management.
Red flags of endometriosis
Endometriosis can present with various symptoms, but certain signs indicate a need for immediate medical attention.
Severe pelvic or abdominal pain: Severe pelvic or abdominal pain that disrupts daily activities and is unresponsive to over-the-counter pain medication is a major red flag for seeking urgent help.
Unexplained heavy menstrual bleeding: Unexplained heavy menstrual bleeding that soaks through sanitary products rapidly can signal severe endometriosis and lead to anaemia.
Painful urination or blood in urine: Intense pain during urination or visible blood in the urine, particularly if it worsens during menstruation, suggests possible involvement of the bladder or urinary tract.
Severe pain during bowel movements: Severe pain during bowel movements, accompanied by diarrhoea, constipation, or blood in the stool, can indicate endometriosis affecting the intestines.
Symptoms of bowel obstruction: Symptoms such as severe abdominal pain, bloating, nausea, vomiting, and inability to pass gas or stools require urgent medical attention and may indicate a bowel obstruction.
Shortness of breath or chest pain: Sudden shortness of breath, chest pain, or coughing up blood could signal thoracic endometriosis affecting the lungs or diaphragm and necessitate immediate medical evaluation.
Recognising these red flags can lead to timely medical intervention, potentially preventing severe complications and improving outcomes for those with endometriosis. If you experience any of these signs, seek medical attention promptly to ensure appropriate care and management.
Conclusion
If you suspect you have endometriosis or experience any of the symptoms discussed, it is important that you seek help promptly. Consulting with a knowledgeable healthcare provider can significantly improve your quality of life and prevent complications from untreated endometriosis.
Next steps
Endometriosis can be complex and challenging to diagnose and manage. Healthcare providers with experience in women's health are equipped with the expertise and tools necessary to provide an accurate diagnosis and effective treatment plan. Early intervention is key, as it can help manage symptoms and prevent the condition from worsening.
How Rylon Clinic can support and provide care
Rylon Clinic is dedicated to supporting women’s health. We are equipped to treat early-stage endometriosis (Stages 1 and 2), offering comprehensive care and advanced diagnostic services to ensure a speedy and accurate diagnosis. By addressing endometriosis early, we help our patients manage symptoms effectively and improve their overall well-being.
It is essential to consult your GP if you have not yet received a diagnosis of endometriosis. For those seeking quicker access to diagnosis and care, a private clinic like Rylon can provide the necessary services promptly. Early detection and treatment are crucial in managing endometriosis and maintaining a high quality of life. If you have any concerns or symptoms, do not hesitate to seek professional medical advice and support.
About Rylon Clinic
The Rylon Clinic, located in the heart of central London with branches at Harley Street and The Shard, is a leading private gynaecology clinic. Under the expert leadership of Mr Osama Naji, a consultant gynaecologist at Guy's and St Thomas' Hospital, the clinic offers a one-stop service with advanced gynaecology scanning, minimally invasive procedures, and a commitment to exceptional patient care. Mr Naji's bilingual capabilities and international reputation attract patients from across the globe, making Rylon Clinic a trusted destination for women's health services.
Sources
National Institute for Health and Care Excellence (NICE)
NICE Endometriosis Guidelines https://www.nice.org.uk/guidance/ng73
European Society of Human Reproduction and Embryology (ESHRE)
ESHRE Guidelines https://www.eshre.eu/Guidelines-and-Legal/Guidelines/Endometriosis-guideline.aspx
The Lancet
The Lancet Endometriosis Review https://www.thelancet.com/journals/lancet/article/PIIS0140-6736(19)32458-1/fulltext
British Medical Journal (BMJ)
BMJ Endometriosis Article https://www.bmj.com/content/358/bmj.j3981
National Institutes of Health (NIH)
NIH Endometriosis https://www.nichd.nih.gov/health/topics/endometri/conditioninfo
Author: Mr Osama Naji
Mr Naji offers a “one-stop” gynaecology clinic for instant detection of various gynaecological cancers as well as providing all the diagnostic and treatment services needed under one roof.
Mr Naji provides advanced gynaecology scanning which is essential when conducting any gynaecology consultation, he is bilingual in English and Arabic and has an NHS base at the highly reputable Guy's and St Thomas' Hospital in London.
He is passionate about raising awareness of various subtle signs and symptoms of gynaecological conditions that are often overlooked by patients.
DISCLAIMER: The information provided in this article is intended for general informational purposes only and should not be construed as medical advice, diagnosis, or treatment. The products and methods mentioned are not a substitute for professional medical advice from a trained healthcare specialist. Always seek the guidance of your doctor or other qualified health professional with any questions you may have regarding your health or a medical condition. Never disregard professional medical advice or delay in seeking it because of something you have read on this website. Use of the information and products discussed is at your own risk.