Different Types of Pain in Endometriosis

Pain in endometriosis

Pain in endometriosis happens when inflammatory lesions and scar tissue irritate nerves, tether organs, and sensitize the nervous system. Causing cramps, deep pelvic pain, and pain with sex, bowel movements, or urination.

How does pain in endometriosis feel?

• Chronic pelvic pain: a daily ache that can radiate to the lower back, hips, or legs.
• Dyspareunia: deep pain during or after intercourse, often worse with penetration or certain positions.
  Bowel and bladder pain: constipation/diarrhea, painful bowel movements, bloating, nausea, or burning with urination—especially during periods.
• Nerve-like pain: burning, shooting, or electric sensations; pelvic floor muscle spasm can add trigger-point tenderness.

Types of endometriosis pain

Endometriosis isn’t just one type of pain; it can actually manifest in several different ways, which often makes it so challenging.

Here are some of the common types of pain in endometriosis you might experience:

• Dysuria: Similarly, if endometriosis impacts your bladder, you might feel pain when you urinate or just general discomfort in that area.
• Pelvic Pain: This is probably the most well-known symptom. It’s often a sharp or cramp-like pain that hits hardest during your period, but honestly, it can stick around throughout the entire month for many.
• Deep Pelvic Pain: This kind of pain is felt deeper in the pelvic area. You might notice it during sexual intercourse, when you have a bowel movement, or even when you urinate, especially around your period.
• Chronic Pain: For some, the pain doesn’t just come and go with their cycle. It can be a persistent, long-term discomfort that’s constant or pops up intermittently, regardless of menstruation.
• Lower Back Pain: Endometriosis can definitely refer to pain in your lower back. This back pain might get worse during your period or even with physical activity.
• Rectal Pain and Bowel-Related Pain: If endometrial tissue affects your intestines or rectum, you could experience pain during bowel movements or even when passing gas.

Common types of endometriosis pain

Patients with endometriosis can experience pain before, during, or after menstruation.

Types of pain include pelvic pain, abdominal pain, joint pain, leg pain, pain during intercourse, and pain during urination.

Some patients who have undergone endometriosis surgery may also experience shoulder pain.

The site and nature of pain can vary from one individual to another.

Why does endometriosis cause pain?

It all comes down to how that endometrial-like tissue behaves when it grows outside the uterus. Just like the lining inside your uterus, this misplaced tissue responds to the hormonal changes throughout your menstrual cycle.

But here’s the problem: unlike the uterine lining, which exits the body during your period, this tissue that’s outside the uterus has nowhere to go. When it tries to shed and can’t, it causes a lot of inflammation, swelling, and irritation in the surrounding areas.

Over time, this ongoing irritation can lead to the formation of scar tissue, adhesions (which are like sticky bands of tissue that can bind organs together), and cysts. All of these contribute to the chronic pain, pelvic discomfort, and other symptoms that people with endometriosis experience.

Why is pain a key factor?

According to Dr. Seckin, pain is the main way of knowing endometriosis is present. Patients can describe their pain, its duration, and its site, which can provide vital diagnostic clues. For instance, pain in the bowels, during intercourse, and orgasms are usually indicative of deep infiltrating endometriosis (DIE).

What causes pain in endometriosis?

The exact mechanism of pain development in endometriosis is not fully understood. However, research suggests that endometriosis can result in excess production of prostaglandins that cause contractions and cramping.

Apart from endometriosis, other related conditions such as adenomyosis, adhesions, and uterine fibroids can also cause pain that is similar to endometriosis.

What is period pain, and should I be concerned?

Period pain or dysmenorrhea is one of the six cardinal symptoms of endometriosis and can be extremely debilitating.

Period pain can persist even after menstruation, and it does not generally respond to painkillers or birth control pills. 

While it is common to have some pain and cramping during periods, debilitating pain should never be ignored. Do not heed ill-informed advice that heavy period pain and bleeding are normal just because it happened before in the family and consult your doctor at the earliest opportunity.

I am experiencing severe abdominal pain. Could this be endometriosis?

Endometriosis can manifest as chronic pelvic pain.

Patients usually experience the most severe pain in cases of DIE and ovarian endometrioma coinciding with the onset of menstruation.

How do I describe my pain to my doctor?

Be as descriptive as possible while talking to your doctor about the pain you are experiencing. Be sure to include valuable information such as the duration, site of occurrence, and source of your pain, as well as any environmental factors that may trigger it. 

You should also inform your doctor if you have been experiencing pain during intercourse, passing of urine, or other events such as constipation, diarrhea, or shortness of breath.

If these symptoms coincide with the onset of periods, they may be indicative of endometriosis.

You could also keep a personal pain diary in which you include information about your periods, the site, extent, and description of your pain. You can also add information about your medications and other symptoms. This pain diary can be a valuable resource when describing your pain to your doctor.

What could be the reason for the irradiating pain in my legs?

Endometriosis lesions can put pressure on nerves such as the sciatic and pudendal nerves and cause pain. Pain in the lower back, hips, and surrounding areas that radiates towards the heel. Sciatic endometriosis can also cause “foot drop,” or the inability to lift the front of your foot.

Why does shoulder pain occur after surgery?

About 35 to 80% of patients complain of shoulder pain following laparoscopic excision surgery. This is usually due to the CO2 gas used during the procedure for better visibility.

Please do not hesitate to share your experience with pain by leaving a comment on our post on Facebook or Instagram if you wish.