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Endometriosis pain is almost impossible to describe. It’s such a unique and individual sensation that is different for everyone. It can affect multiple locations and be triggered by many things. And, if you don’t have endometriosis, you truly can not appreciate how immobilizing it can be.

Describing Endometriosis Pain

I’ve experienced endo pain on so many different levels. In the beginning, I only had painful periods that would disrupt my life and lead to excruciating pain. But, as my endometriosis progressed, so did my discomfort. In addition to painful periods, I experienced chronic pelvic cramping, painful bowel movements, radiating leg pain, ovulation pain, and low back pain. I also dealt with vaginal and rectal pain and the dreaded endo belly. And while endometriosis pain varies for each person, the sensation is often described the same. For example, experiencing intense contractions or labor pains. Dealing with sharp, stabbing sensations in the abdomen and pelvis. Or a dull, gnawing, and throbbing sensation in the low back.  


Where is Endometriosis Pain Felt and What Causes It?

My endometriosis pain manifested itself in various locations. This included my pelvis, lower back, legs, groin, rectum, and sides of my abdomen. But, you will experience endometriosis pain differently than me. Where pain is felt will depend on where endometriosis is located. Common pain sites associated with endometriosis are the pelvis, lower back, legs, groin, rectum, vagina, and anus.  

woman with endometriosis pain covering pelvis with a card with a sad face tucked into underwear

In addition to inflammation, other factors increase endometriosis pain. Normal activities such as sex, bowel movements, or urinating can cause a pain flare-up. Additionally, ovulation and menstruation can lead to severe pain and discomfort. Stress is another factor that increases pain and flare-ups. Lastly, certain types of food can trigger flare-ups, pain, and inflammation.

When Sex is Painful

Intimacy can be difficult with endometriosis. I experienced intense pain with penetration that created a sharp, shooting ache from my vagina to my anus. It was awkward and embarrassing to deal with.

The reason sex contributes to endometriosis pain is because of lesions behind the vagina and lower part of the uterus. These lesions irritate the uterine nerves and ligaments during sexual activity. Usually, thrusting is the main culprit for the aggravation. Thus causing growths to be pushed and pulled during intercourse.

When it Hurts to Use the Bathroom

Another pain point with endometriosis is using the bathroom. I struggled with symptoms that mimicked irritable bowel syndrome (IBS). I had issues with constipation and would struggle to poop. Consequently, this led to me straining while defecating and painful bowel movements.    

Additionally, it sometimes hurt to urinate. There were many times when I experienced sharp pains in my pelvis and vagina when urinating.

Most of this pain was due to adhesions and scarring in the bowels and the bladder. This results from the bowels becoming stuck to the ovaries, uterus, or pelvic sidewall. In turn, this can cause painful bowel movements and pain during urination. Additionally, adhesions in the bowels can lead to constipation or diarrhea. 

frustrated couple sitting on separate ends of the bed with man looking away and woman covering her face with her hands

When Ovulation and Menstruation Are Unbearable

Painful periods and ovulatory pain are two of the most common endometriosis symptoms. As I mentioned, earlier painful periods were the primary symptom of my endometriosis for many years. The first 24 hours of my period were the worst. During that time, I was feverish, nauseous, and completely immobilized.

My cramps felt like severe contractions. I would bang my head against the wall or scratch at my arms to distract myself from the pain. In addition to painful periods, I experienced painful ovulation, which worsened with age. It started with light cramping and sharp aches with ovulation. And it progressed to heavy cramping with low back pain and radiating leg pain.   

Painful menstruation is caused by endometriosis implants that are outside of the uterus. These implants react the same as the tissue that lines the uterus. Yet, instead of shedding and exiting the body through the vagina, it sheds and becomes trapped within the body. This causes irritation, scarring, and adhesions to develop.

It’s not altogether clear why ovulation is painful with endometriosis. Under normal circumstances, pain with ovulation occurs when a follicle ruptures in the ovary, the egg bursts from the follicle, or spasms from the fallopian tube and uterus. However, this is heightened with endometriosis and leads to severe pain, possibly due to ovarian cysts, scarring, or adhesions.

When Stress and Overexertion Causes Pain

When it comes to endometriosis pain stress, and overexertion is significant issues. At the height of my endometriosis, I found that stress and excess physical activity would trigger flare-ups and pain. You probably take the simple things for granted, such as walking your dog or going to an event with a friend. But unfortunately, these ordinary activities would often lead to me being bedridden for weeks.

Additionally, it’s why I had to quit my job. It had gotten to the point where having a demanding and physical job had become too much for me to handle. My pain levels were through the roof, and each day was a challenge. 

A 2008 study revealed a positive correlation between stress and endometriosis (3). It was found that high-stress levels contributed to increased endometrial growth and increased pain. The main reason for this is cortisol and inflammation. For starters, stress increases cortisol levels. Elevated cortisol levels impair immune system function. Therefore, creating more inflammation in an already inflamed body. Thus causing endometriosis pain, and flare-ups. 

woman standing with hands covering groin

Trigger Foods & Food Intolerances

Another culprit for pain and flare-ups is nutrition. I noticed that there were foods that triggered flare-ups. And my body couldn’t tolerate them. This caused gastrointestinal issues from constipation, diarrhea, nausea, bloating, and abdominal distension. I would deal with a combination of these symptoms, commonly referred to as endo belly.

Whenever I ate a trigger food, my body would respond by having my belly swell and become distended. And I would have sharp abdominal pains that made standing difficult. Additionally, I would have bowel issues where I alternated between diarrhea and constipation. As if those symptoms weren’t bad enough, I also had a fever and was nauseated and unable to eat. It took me a while to connect the dots and realize that many of the foods I was eating were increasing the occurrence of these flare-ups.

There is little research regarding how nutrition impacts endometriosis. But some studies explore the improvement of symptoms when dietary changes are applied. Such as a 2013 study that found an increase in vegetables and omega-3 fatty acids decreased endo symptoms (4). And many endo sufferers follow an anti-inflammatory-style diet and find relief. This diet style focuses on reducing or eliminating pro-inflammatory foods such as alcohol, caffeine, dairy, gluten, added sugar, and processed foods. 

In Reality, It’s Indescribable

Trying to explain endometriosis pain is difficult. As mentioned earlier, it’s unique to each person. But, understanding more about how painful this condition is increases awareness regarding symptoms. So, often endometriosis is overlooked and ignored because it causes pain and symptoms in unusual ways. However, openly talking about these symptoms sheds light on what living with endometriosis is genuinely like.  


References & Related Reading

  1. Everyday Health | What to Do When Sex Hurts with Endometriosis 
  2. Center for Endometriosis Care | Endometriosis and Bowel Symptoms
  3. Science Daily | Uncontrollable Stress Worsens Symptoms of Endometriosis | source American Psychological Society l April 10, 2008
  4. Reproductive Biomedicine Online Journal | Diet and Endometriosis Risk: A Literature Review April 2013 Vol 26, Issue 4 pages 323-336
  5. Very Well Family | Is Ovulation Pain Normal?