Medically reviewed by: Melissa A. Delgado, MD, FACOG
Melissa A. Delgado, MD, FACOG is the founder and owner of The Chronic Pelvic Pain Center of Northern Virginia. Dr. Delgado is an experienced, board-certified OB/GYN and has spent the past 10 years dedicating her time to understanding complex and persistent pelvic pain.
Endometriosis, or “endo,” is a distressing condition experienced by countless women globally. It's a persistent, frequently incapacitating ailment that can result in intense pain, abnormal periods, and other assorted health issues.
A particularly difficult aspect of endometriosis is the unpredictability of its symptoms, which can vary significantly from person to person. Endo symptoms can occur spontaneously and may be set off (or “triggered”) by diverse factors.
Let’s go over the most common symptoms of endometriosis flare-ups and what you should know about each symptom.
What is an endometriosis flare up?
Endometriosis occurs when tissue that's similar to the inner lining of your uterus (called the endometrium) starts growing in places it shouldn't. This tissue can show up on your ovaries, fallopian tubes, and other pelvic organs. Endometriosis can cause inflammation and pain, particularly during the menstrual cycle.
The exact cause of endometriosis is unknown, but it could be caused by hormonal imbalances in the body. Women with endometriosis may experience a variety of symptoms, including pain during menstruation, pain during intercourse, and infertility.
Endometriosis flare ups are periods when endo symptoms worsen and become more painful. Flare ups can be caused by a variety of factors, including stress, hormonal changes, and certain foods. Caffeine and alcohol, in particular, have been reported to trigger endometriosis flare up symptoms.
Understanding the most common symptoms of endometriosis flare-ups is essential to managing the condition and improving quality of life.
What are common endometriosis flare up symptoms?
Endometriosis flare ups can be unpredictable and may vary in their severity. Some women may have mild symptoms, while others may suffer severe pain and other health problems.
Many patients have described feeling pain that feels like twisting or stabbing. Others experience symptoms like abdominal bloating accompanied by lower pelvic pain.
The following are endometriosis symptoms that are also common endometriosis flare up symptoms. During endometriosis flare ups, these symptoms may be more intense than usual:
Severe pelvic pain
One of the most common symptoms of endometriosis flare ups is severe pelvic pain. Endo-related pelvic pain is often intense and can affect daily activities, like working productively, exercising, and even socializing. Pelvic pain may be localized to one area of the pelvic region or may radiate further, most frequently into the lower back and down the inner thighs.
Painful periods
Women with endometriosis may also frequently experience more painful periods than women without the condition, also called dysmenorrhea. The pain may be severe and may last longer than usual. Some women may also experience heavy bleeding and blood clots during their menstrual cycle.
Painful sex
Endometriosis can sometimes cause pain or discomfort during intimacy, also called dyspareunia. Pain during intercourse is often felt deep in the pelvis and may be accompanied by other symptoms, such as cramping or bloating. Women with endometriosis may also experience pain during other activities, such as exercising or going to the bathroom.
Irregular digestive issues
Endometriosis flare ups can also lead to unusual digestive problems that a person living with endometriosis may not normally experience, like bloating, excess gas, constipation, and diarrhea. These symptoms may be more severe during a flare-up and can be difficult to manage since they’re often unpredictable.
Frequent bladder issues
Women suffering from endometriosis flare ups often report experiencing more frequent and intense bladder or bowel movements. Chronic urinary tract infections (UTIs) are not uncommon during endometriosis flare ups.
Intense fatigue
Endometriosis can sometimes cause fatigue, which can be debilitating and affect daily activities and productivity. Women with endometriosis may feel significantly more tired during a flare up, and in some severe cases, they report feeling tired all the time.
Diagnosing endometriosis and endometriosis flare ups
Endometriosis should not be difficult to diagnose if you find an endo specialist. But symptoms can and do vary widely. They may also overlap with symptoms of other conditions, like irritable bowel syndrome (IBS) or premenstrual dysphoria disorder (PMDD). A healthcare provider may perform a pelvic exam, ultrasound, or other tests to diagnose the condition.
Managing endometriosis flare ups often involves a variety of treatments, including pain management, hormonal therapy, surgery, and more holistic options. Women with endometriosis may also benefit from lifestyle changes, such as managing or reducing daily stress and avoiding certain pro-inflammatory trigger foods, like caffeine and alcohol.
Managing and preparing for endometriosis flare ups
Endometriosis flare ups can be quite surprising whenever they show up. But because endometriosis symptoms vary so much from person to person, it’s important to pay attention to the factors that often lead to flare ups. A symptom tracker or endo journal can help you keep track of your endo triggers.
You may notice that some of your symptoms intensify or only show up during ovulation or the onset of your period. By identifying the triggers that worsen your endometriosis, you can proactively prepare yourself to handle a flare-up before it occurs.
For example, some women with endo find that applying heat to their abdomen provides temporary relief from endo-related pain. This can be as simple as snuggling up with a heating pad, reclining with a hot water bottle placed on the lower back, or enjoying a warm bath. Other calming activities, like practicing mindfulness, may also help you manage endo pain.
Finding relief from endometriosis flare ups
Understanding the symptoms of endometriosis flare ups is essential to managing the condition and improving your quality of life. So, if you’re experiencing any symptoms of endometriosis flare ups, it may be time to speak with an endo specialist.
Dr. Delgado has spent the past 10 years dedicating her time to understanding complex and persistent pelvic pain. She specializes in diagnosing and treating endometriosis, as well as its accompanying symptoms and conditions. Dr. Delgado combines cutting-edge procedures and treatment methods with a holistic, mind-and-body approach to provide lasting relief.
Contact Dr. Delgado today to start on your journey to healing.