Endometriosis Symptoms (In the Bladder, Bowels or Ovaries)

Updated in March 2024

Endometriosis is a condition that causes symptoms such as severe pelvic pain, heavy periods and even infertility. This condition is associated with the growth of endometrial cells (which typically line the uterus) in other locations outside of the uterus, such as the ovaries, bladder or intestines.

The intensity and frequency of symptoms can vary from month to month and from woman to woman, which is why diagnosis can be difficult.

If you suspect your may have endometriosis, it is very important to consult a gynecologist for testing, such as a pelvic ultrasound, to confirm a diagnosis and start treatment. Treatment does not cure this condition, but it can significantly relieve symptoms.

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Online symptom checker

Enter your symptoms below to determine your risk for endometriosis.

  1. 1. Severe pain in the pelvic region that worsens during menstruation
  2. 2. Heavy flow during period
  3. 3. Cramps during sex
  4. 4. Pain when urinating or with bowel movements
  5. 5. Diarrhea or constipation
  6. 6. Excessive fatigue and tiredness
  7. 7. Difficulty getting pregnant

This symptoms quiz does not confirm a diagnosis and should only be used as a guidance tool to determine the need for further assessment. If you have any questions about the symptoms you are experiencing, be sure to follow-up with your family doctor.

Symptoms by type of endometriosis

There are different types of endometriosis that depend on where uterine tissue is growing. These symptoms may vary and may be classified as follows:

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.