Pelvic pain, heavy periods, and pain during sex are common symptoms of endometriosis.
However, the symptoms of the condition, which affects one in 10 women of childbearing age in the UK and US, can vary considerably.
They can range from bowl problems and fatigue to difficulty getting pregnant.
Here, MailOnline reveals four of the lesser-known signs of the condition for the endometriosis awareness month.
The condition, which affects 176 million people worldwide, causes tissue, similar to the lining of the uterus, to grow outside the uterus, causing inflammation and pain. It can also cause bowel problems, fatigue, difficulty getting pregnant, and painful urination
The debilitating condition, which affects 176 million women worldwide, causes tissue similar to the lining of the uterus to grow in other places, such as the ovaries and fallopian tubes, causing inflammation and pain.
But many struggle to get a diagnosis despite pain interfering with daily life.
Bina Mehta, a pharmacist at Boots, explains: ‘It can be difficult to diagnose endometriosis because the symptoms can vary considerably.
“Some women experience severe symptoms, others don’t. And their symptoms can be similar to other conditions, including menstrual cramps.”
Pelvic and lower abdominal pain are shared symptoms of both conditions, she said.
But endometriosis is more than menstrual pain.
Intestinal problems
Although it is a condition that affects the uterus and is often associated with menstrual cramps, it can also cause intestinal problems.
For this reason, endometriosis is often misdiagnosed as IBS because of the digestive problems the condition causes, such as abdominal pain, bloating, and constipation.
The symptoms are caused by endometrial tissue attaching to the intestines and causing inflammation, which can lead to symptoms such as bloating, abdominal pain and diarrhea, said dietitian Dr. Caitlin Hall.
She adds that in severe cases, endometrial tissue can cause a blockage in the gut, leading to constipation, nausea, and even vomiting.
Pharmacist Ms. Mehta warns that in some cases endometriosis can cause blood in your pee or poop during your period.
She said: ‘If you think you have endometriosis you should see your GP.
“While there is no cure, there are treatments that can ease symptoms, including pain relievers and hormone medications.”
Fatigue
Feeling tired is also a symptom of endometriosis.
According to Dr. Irem Tezer Ates, the chronic pain and inflammation associated with the condition could contribute to this fatigue.
She explained that for many women, these symptoms are ignored and others struggle to recognize the warning signs.
Being physically exhausted can be a debilitating symptom of the disease that affects women’s daily life, stress levels, and sleep.
The fatigue is thought to be caused by the body’s effort to eliminate the disease, according to the Endometriosis Foundation of America.
Experts say the fatigue is a result of the body trying to fight off the inflammatory toxins caused by the disease.
It hurts to urinate
Just as endometriosis tissue can grow in the gut, it can also grow around the bladder and cause irritation.
This is why the disease can cause pain when urinating.
Bladder endometriosis can be superficial — when tissue is found on the outer surface of the bladder — or deeper — when the tissue is found in the bladder lining or wall.
The symptoms include bladder irritation, increased urination, pain when the bladder is full, occasional blood in the urine and sometimes pain in the kidney area, according to Endometriosis UK.
However, people with endometriosis who experience pain when urinating may not have uterine tissue on their bladder, such as due to a UTI instead – which is more common in people with endometriosis.
Jenny Saft, CEO and co-founder of fertility platform Apryl, said: ‘Some women with endometriosis will experience recurrent bouts of thrush, as well as other gastrointestinal infections such as UTIs.
“This may be due to immune dysfunction. Many people with endometriosis seem to have reduced immunity to other conditions – and thrush is more common in people with weakened immune systems.”
However, she adds, it’s not yet known whether impaired immune function contributes to endometriosis, or occurs as a result of endometriosis.
Difficulty getting pregnant
Many women with endometriosis struggle to conceive, but it’s still not clear why.
Due to a lack of research, the links between fertility problems and the condition are not fully known. But doctors think it’s because of the disease that interferes with the reproductive organs.
This can lead to women having to have surgery or undergo IVF to get pregnant.
But Ms Saft says it’s a misconception that people with endometriosis can’t get pregnant naturally at all.
However, she admits it can be more difficult in people with endometriosis.
She said, “If you get a diagnosis and still hope to start a family, don’t get discouraged. It is estimated that 60 to 70 percent of women with endometriosis can become pregnant naturally.
“For those who are struggling to conceive naturally, options include having surgery to remove bits of endometriosis tissue, or trying fertility treatment such as IVF.”