Endometriosis Symptoms (In the Bladder, Bowels or Ovaries)

Medical review: Dr. Sheila Sedicias
May 2022

Endometriosis is a painful syndrome in which the tissue that lines the uterus (known as the endometrium) grows in other parts of the abdomen, such as the ovaries, bladder, or bowels. It can lead to symptoms such as intense pelvic pain, heavy periods, and infertility.

The intensity and frequency of these symptoms may vary each month, and from woman to woman. Therefore diagnosis can be quite difficult. Nevertheless, if you suspect you might have endometriosis, it's important to visit a gynecologist, to make a detailed medical evaluation.

Depending on where endometrial tissue has spread to, there are different symptoms that can arise:

1. Bowel endometriosis

This type of endometriosis happens when the tissue develops inside the intestines. In these cases, there are some specific symptoms such as:

  • Constipation
  • Strong abdominal cramps
  • Blood in feces
  • Pain that gets worse when passing stool
  • Intense bloating
  • Persistent pain in the rectum

It is common for most women to suspect of a bowel condition, such as IBS, Chron's, or colitis, which can delay the diagnosis of endometriosis.

2. Ovarian endometriosis 

Ovarian endometriosis (also known as endometrioma) is characterized by the growth of endometrium around the ovaries, causing symptoms that are often more general, such as intense pelvic pain, heavy periods, and pain during intercourse.  

Diagnosis from a gynecologist is very important to identify where endometrial tissue is growing in the ovaries and whether ovarian function has been impacted. It is common for the doctor to order a laparoscopy to evaluate the ovaries.. 

3. Bladder endometriosis

Some specific symptoms that are characteristic of endometrial tissue in the bladder include:

  • Intense pelvic pain that gets worse while urinating;
  • Presence of pus or blood in urine;
  • Strong pain during sexual intercourse;
  • Frequent need to urinate;
  • Constant feeling of a full bladder.

Some women may only present one or two of these symptoms, which can be quite similar to a urinary infection. However, with bladder endometriosis, the symptoms do not improve with the use of antibiotics.  

How to diagnose endometriosis

A gynecologist may suspect endometriosis following an evaluation of symptoms reported by the woman. However, to confirm a diagnosis, a pelvic ultrasound should be ordered. This scan also serves to rule out other conditions that present with similar symptoms, like ovarian cysts.  

In addition, the doctor may also prescribe a biopsy, which is a small surgical procedure that involves the insertion of a long hose with a camera on the tip into the abdomen. The camera is able to visualize the pelvic cavity, and the hose provides access for collection of a small tissue sample, that will then be analyzed in the lab. 

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Atualizado por Tua Saude editing team, em May de 2022. Medical review por Dr. Sheila Sedicias - Gynecologist, em September de 2021.


  • ESHRE. Information for women with endometriosis. 2014. Available on: <https://www.eshre.eu/-/media/sitecore-files/Guidelines/Endometriosis/ESHRE-ENDOMETRIOSIS-GUIDELINE_Patient-version_FINAL.pdf?la=en&hash=52A8A838A070CAF508B43C65DE5D0BEEF1B8438F>. Access in 07 Oct 2019
  • CAMPOS; Cláudia et. al.. Endometriose – Epidemiologia, Fisiopatologia e Revisão Clínica e Radiológica. Acta Radiológica Portuguesa. 80. 20; 67-77, 2008
Show more references
  • PROTOCOLOS CLÍNICOS E DIRETRIZES TERAPÊUTICAS - MINISTÉRIO DA SAÚDE. Endometriose. 2010. Available on: <https://portalarquivos2.saude.gov.br/images/pdf/2014/abril/02/pcdt-endometriose-retificado-livro-2010.pdf>. Access in 07 Oct 2019
Medical review:
Dr. Sheila Sedicias
Physician graduated in Mastology and Gynecology by UFPE in 2008 and member no. 17459 of CRM-PE, Brazil.