Endometriosis is a condition where tissue similar to the uterine lining (endometrium) grows outside the uterus, typically within the pelvic cavity on organs like the ovaries, fallopian tubes, or pelvic lining. This tissue responds to hormonal changes by building up and bleeding during the menstrual cycle. Since the blood has no pathway to exit the body, it causes inflammation, irritation, and scar tissue formation, leading to a wide range of physical sensations.
The Defining Sensation: Cyclical Pelvic Pain
The most common and characteristic feeling of endometriosis is severe, cyclical pelvic pain, medically termed dysmenorrhea. This pain is distinctly tied to the menstrual cycle, often starting days before the period and continuing throughout the flow. Many individuals describe this sensation as far more intense than typical menstrual cramps.
The pain is frequently centered in the lower abdomen and pelvis, but it can also radiate intensely into the lower back and thighs. People often use words like “wrenching,” “crushing,” or “stabbing” to describe the debilitating nature of the monthly pain. This intensity can be severe enough to interfere with daily life, making it difficult to attend work or school.
Chronic and Deep Non-Menstrual Pain
The physical experience of endometriosis extends far beyond the menstrual window, manifesting as persistent discomfort and sharp pain during specific bodily functions. Chronic pelvic pain is a persistent feeling, often described as a constant, dull ache or burning sensation in the pelvis and lower abdomen, occurring every day regardless of the menstrual cycle. This ongoing discomfort can also present as lower back pain that remains even when no bleeding is present.
A distinct and often distressing sensation is deep pain during sexual intercourse, known as deep dyspareunia. This is typically felt as a sharp jab or deep, throbbing ache deep within the pelvis during or immediately after penetration. This sensation occurs when deep penetration causes the cervix or upper vagina to move, colliding with endometriosis lesions or scar tissue often found on the uterosacral ligaments behind the uterus.
Endometriosis can also feel like intense, tearing pain during bowel movements (dyschezia) or a burning sensation during urination (dysuria), particularly when implants are located on the bowel or bladder. When the bladder is affected, the sensation can be similar to a urinary tract infection, with frequent urges and pain when the bladder is full. For those with bowel involvement, the pain can be cramping or rectal, often accompanied by digestive symptoms like alternating constipation and diarrhea.
Systemic Physical Manifestations
Beyond localized pelvic pain, endometriosis often involves systemic physical feelings that contribute to an overall sense of being unwell. One of the most common sensations is profound, debilitating fatigue that is frequently not relieved by rest. This exhaustion is linked to the chronic, low-grade inflammation and immune system activation triggered by the disease.
Gastrointestinal distress is another frequent physical manifestation, often referred to as “endo belly.” This is the feeling of sudden and severe abdominal bloating and distension, sometimes making the abdomen appear visibly swollen. This sensation of tightness and swelling is caused by inflammation, trapped gas, and slowed bowel motility resulting from lesions near the digestive tract.
The physical experience also includes other general symptoms, such as nausea and sometimes vomiting, especially during flare-ups or the menstrual cycle. Some individuals also report a feeling of general malaise or a low-grade fever, indicating the body is actively battling the widespread inflammatory process.