The type, number and severity of symptoms varies widely. Some women experience many symptoms which may be debilitating at times. Others experience none or only discover that they have endometriosis because they cannot fall pregnant.

Other symptoms experienced and their severity are not necessarily related to the severity of the disease but are often more closely related to the location of the implants. Consequently, mild endometriosis consisting of a couple of implants in the Pouch of Douglas can cause debilitating pain while severe endometriosis located on the ovaries may cause little pain.

As the disease progresses the number and severity of symptoms experienced often increases, as does the number of days in the month for which the symptoms are felt. Thus, in the early stages of the disease one or two mild symptoms may be felt with increasing serverity for a greater proportion of the month.

The symptoms associated with endometriosis include:

Pain:

* Painful periods.

* Pain during and / or after sexual intercourse.

* Pelvic and / or abdominal pain (not necessarily at the time of the menstruation).

* Lower back pain.

* Ovulation pain.

* Thigh and / or leg pain.

* Pain during internal examination of the virgina and / or bowel.

Bleeding problems:

* Heavy bleeding and / or clotting.

* Prolonged bleeding.

* Premenstrual spotting.

* Irregular bleeding.

* Irregular cycles.

Bowel and bladder symptoms:

* Painful bowel movements.

* Pain when passing wind.

* Bowel pain.

* Diarrhoea and / or constipation.

* Bleeding from the bowel.

*Nausea and / or vomiting.

* Pain when passing urine.

* Urinary frequency.

Infertility / Other:

* Lethargy and / or milaise.

* Depression and / or irritability.

* Premenstrual syndrome (PMS).

* Swollen abdomen.

* Insomnia.

Pain is the dominate symptom for many women. It may be felt in different parts of the body, at different times, and as different types of pain. The pain is thought to be due to a variety of causes. It may be the result of the irritation and inflammation which occurs when the implants bleed onto the tissues and organs surrounding them; stretching and / or compression of the implants and cycts; and adhesions pulling or holding the pelvic organs in abnormal positions.

Bowel symptoms are far more common than is generally acknowledged by the medical profession and many women with endometriosis have previously been diagnosed with 'irritable bowel syndrome' or 'spastic colon'. Most bowel symptoms are not due to the presence of endometriosis on the bowel itself rather to irritation from implants located on adjacent organs or tissues, such as in the Pouch of Douglas or on the uterosacaral ligaments.

Very little is known about why some women with endometriosis are infertile. However, about 50% of infetile women with endometriosis will eventually conceive following treatment.