Endometriosis symptoms: What’s normal, what’s not?

You’ve probably heard that period pain is “normal.” But what if it’s not just cramps? What if it’s pain that wakes you up at night, spreads down your legs, or shows up even when you’re not menstruating?

The Essentials

May 17, 2025,

2 min read

Sarah, 28, spent years thinking her pain was just “bad periods.” Every month, she stocked up on heating pads and painkillers. She missed work more than she liked to admit, and sex had become something she avoided—not because she didn’t want to connect with her partner, but because it left her doubled over for hours. It wasn’t until a friend mentioned endometriosis that she began to wonder if something deeper was going on.

What’s “normal” period pain?

It’s not uncommon to feel some cramping during your period. Mild discomfort that lasts a day or two and that can be managed with over-the-counter medication is generally considered normal.

Symptoms that might signal endometriosis

If your experience sounds more like Sarah’s, here are signs that your pain might not be “just part of being a woman”:

Severe menstrual cramps that interfere with daily life
Pain during or after sex
Chronic pelvic pain, not limited to your period
Painful bowel movements or urination, especially during menstruation
Heavy periods or bleeding between cycles
Fatigue that feels like you’ve been hit by a truck
Bloating (often called “endo belly”) that makes you look months pregnant
Infertility or trouble conceiving

These symptoms don’t just affect your reproductive system—they can impact your gut, bladder, energy levels, and even mental health.

Why it’s often dismissed

Endometriosis symptoms can mimic other conditions like irritable bowel syndrome (IBS), ovarian cysts, or even appendicitis. And because it’s an invisible illness, many people—doctors included—don’t take it seriously until it’s advanced. Some are told it’s all in their head. (It’s not.)

How to track your symptoms

One of the most helpful things you can do is track your symptoms over time. Use a symptom tracker app or a simple journal to note:

Pain levels
When pain occurs (e.g., cycle day, after eating, during sex)
Bowel/bladder changes
Fatigue levels
Mood changes

Bringing this record to your doctor can help guide the conversation and get you closer to a diagnosis.

What’s next?

If these symptoms sound familiar, you’re not alone and you’re not imagining things. Endometriosis affects an estimated 1 in 10 people with periods, and yet it often goes undiagnosed for years.