An endometriosis flare-up feels like an intense worsening of pelvic pain, often sharp, cramping, or throbbing, extending beyond typical period cramps to include deep aches, bloating ("endo belly"), severe fatigue, lower back pain, painful sex/urination/bowel movements, and sometimes brain fog or digestive issues, with symptoms peaking around hormonal shifts but also triggered by stress, sleep, and diet. It's a heightened inflammatory state where the endometrial-like tissue outside the uterus swells and bleeds, causing significant discomfort that can disrupt daily life.
Typical endometriosis flare-ups usually involve heightened versions of your regular symptoms, such as increased pelvic pain, bloating, and fatigue. However, when endometriosis spreads, the symptoms may not only intensify but also diversify, affecting parts of the body that were not previously impacted.
Endometriosis and Early Pregnancy Symptoms
Typical pregnancy signs include fatigue, nausea, breast tenderness, and mild cramping. However, if you have endometriosis, it's possible you may notice heightened pelvic pain or discomfort during early pregnancy.
Bloating is the most common presenting symptom, and is typically reported by 83% of women with endometriosis[1]. In addition to bloating, other gastrointestinal symptoms including diarrhea, constipation, painful bowel movements, nausea and/or vomiting are also common symptoms in women with endometriosis.
Research has recently found evidence for endometriosis in human female fetuses at different gestational ages. This paper reports a new case of fetal endometriosis in a 25-week female fetus, deceased due to placental pathology, from a series of 13 female fetuses analysed at autopsy.
Endometriosis is commonly diagnosed in women and girls, from when their periods start (puberty) through to menopause. It can affect anyone who has or had a womb.
The exact cause of endometriosis isn't clear. But some possible causes include: Retrograde menstruation. This is when menstrual blood flows back through the fallopian tubes and into the pelvic cavity instead of out of the body.
Adenomyosis, often referred to as the 'evil sister' of endometriosis, is a uterine condition in which endometrial cells from the inner lining of the uterus (the endometrium) migrate from that lining into the muscle wall of the uterus (the myometrium).
Endometriosis can lead to difficulties conceiving. Other common symptoms may include gastrointestinal symptoms such as nausea and vomiting, bloating, constipation or diarrhoea, acid reflux, dizziness, headaches and migraines.
For many patients living with endometriosis, the ER is one of the first—and most painful—stops in their care journey. Severe pelvic pain, ruptured cysts, and flares can bring you to an emergency department or urgent care quickly.
What can I do?
Pain Relief for endometriosis
Five key warning signs during pregnancy needing immediate medical attention include vaginal bleeding, severe headaches with vision changes, decreased baby movement, severe abdominal pain/cramping, and signs of preterm labor like regular contractions or fluid leakage, as these can signal serious issues like miscarriage, preeclampsia, placental problems, or infection. Always contact your healthcare provider or seek emergency care for these symptoms.
Common triggers for people with endometriosis can include things like:
While people with endometriosis may experience ongoing discomfort, flare-ups are usually more severe and harder to control. These painful episodes often occur when the body reacts to certain triggers, such as hormonal changes, stress, or diet.
A pelvic MRI scan produces images (or pictures) from various angles in your pelvis and shows up soft tissues (such as your uterus, ovaries and bladder) very clearly. These images are then reviewed by an experienced radiologist to look for signs of disease and a report is generated.
Endo belly refers to abdominal bloating linked to endometriosis and can cause discomfort, pain and swelling. Endometriosis is a condition where tissue similar to the lining of your womb (endometrium) starts to grow elsewhere and attaches to other organs, such as your ovaries and fallopian tubes.
6 Endometriosis Imposters That Could Delay a Correct Diagnosis and Wreck Your Future
The Power of Self Care During a Flare Up
Fusobacterium infection facilitates the development of endometriosis through the phenotypic transition of endometrial fibroblasts.
Adenomyosis is often referred to as the "evil twin sister" of endometriosis, as the two conditions share similarities but also have distinct differences in their pathogenesis and management. Symptoms can also overlap.
Pelvic pain that extends beyond menstruation: While adenomyosis pain is usually more intense around the menstrual period, endometriosis pain can be chronic, lasting throughout the cycle.
Endometriosis most often happens in people of childbearing age. This age runs from about 12.5 years old to just after menopause, or about age 51. It only rarely affects a person outside this age range. Researchers don't know whether your risk increases with age.
The cause of endometriosis is still unknown, but there are several theories as to the cause of the condition, including: Retrograde menstruation – This is the backward flow of menstrual debris and lining of the uterus through the fallopian tubes which then embeds itself into other organs.
Preventing and Addressing Endometrioma Recurrence
For many women, the signs of returning endometriosis after hysterectomy or another procedure will appear about two to five years following surgery.