Endometriosis causes severe pain. Doctors have medical terms to describe these symptoms.
Dysmenorrhoea- this means painful periods. Women with endometriosis typically describe severe low pelvic pain with their period, it often starts the day before bleeding and lasts for 3 days.
Dyspareunia – this means pain with sex. Endometriosis causes deposits of tissue on the top of the vagina and this can cause severe pain with sex – typically this pain occurs with deep penetration where the penis hits up against deposits of endometriosis high in the vagina.
The other problem seen in endometriosis is tightening of the muscles of the pelvic floor (around the vagina). When we experience pain we tend to pull away or withdraw from it. When the pelvis is in pain the muscles of the pelvic floor contract in an attempt to protect us. Unfortunately, this muscle contraction can lead to a complex pain syndrome. Sometimes women with endometriosis need to do work with a pelvic floor physiotherapist to learn to relax the muscles to decrease pain. Typically muscle spasm leads to pain during sex on first entry into the vagina. Sometimes the muscle tension is so severe that a woman is unable to have sex. This is also known as “vaginismus”.
Dysuria – this means pain passing urine. Women with endometriosis can have depositsi of endometriosis on the outside of the bladder which cause pain passing urine – particularly with a pereiod.
Dyschezia – this means pain passing poo, it can be particularly painful during menstruation.
Constipation – if there is endometriosis in the bowel (10% of women with endometriosis) during menstruation the bowel can become obstructed.
Infertility – Unfortunately, endometriosis can make it difficult to get pregnant. There are several reasons for this. The first is; that due to pain women with endometriosis are unable to have sex therefore making it impossible to fall pregnant. The second reason is that the chemicals produced by the endometriotic deposits in the pelvis are toxic to sperm. The third problem is that endometriosis can cause severe adhesions (scar tissue) in the pelvis. The fallopian tubes, the uterus, the ovaries and bowel can all become stuck together, so the egg and sperm are unable to meet to form an embryo.