March is Endometriosis Awareness Month: an important time to raise understanding about a condition that affects millions of women and people with uteruses worldwide — yet is often misunderstood, misdiagnosed, or minimized for far too long. At Cary OB/GYN, we know that education and early recognition are powerful tools in helping patients get answers, access personalized care, and improve their quality of life.
Endometriosis can show up in many ways — sometimes subtle, sometimes severe — and its impact is not only physical but emotional and social as well. In this post, we’ll explain what endometriosis is, common signs and symptoms, why it’s often missed, and when it’s time to see your OB/GYN for evaluation.
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What Is Endometriosis?
Endometriosis occurs when tissue similar to the lining of the uterus (the endometrium) grows in places outside the uterus — most commonly on the ovaries, fallopian tubes, pelvic lining, or other pelvic structures. Unlike the endometrial lining that sheds during menstruation, these displaced implants have no way to exit the body. They can break down, bleed internally, and cause irritation, inflammation, and scarring over time.
Although endometriosis is common — affecting an estimated 1 in 10 women of reproductive age — it is not “normal” or something patients simply have to endure. Yet many women wait years before receiving a diagnosis, often because symptoms are dismissed as typical period pain.
Common Signs and Symptoms to Watch For
- Painful Periods (Dysmenorrhea)
Pain that is more intense than typical menstrual cramps — especially pain that interferes with daily activities — is a hallmark symptom of endometriosis. If OTC pain medications aren’t effective, that’s a signal worth assessing. - Pelvic Pain Outside Your Period
Endometriosis pain isn’t limited to menstrual days. Chronic pelvic discomfort — before, during, or after your cycle — may suggest something more than routine menstrual symptoms. - Pain During or After Intercourse
Pain with sexual activity is a symptom many patients hesitate to discuss, but it’s important and common with endometriosis. Open communication with your provider is key to understanding and treating the cause. - Painful Bowel Movements or Urination
Pain during bowel movements or urination — particularly around your period — can be associated with endometriosis, especially if tissue implants involve the bowel or bladder. - Heavy or Irregular Bleeding
While many people experience variation in flow and timing, significantly heavy or unpredictable bleeding may be a sign that warrants evaluation. - Bloating, Nausea, or Digestive Symptoms
Pelvic endometriosis can affect organs near the reproductive system, leading to gastrointestinal discomfort, bloating, or nausea. - Fatigue
Chronic pain and inflammation can be exhausting. Persistent fatigue — especially in conjunction with other symptoms — is not something to ignore. - Challenges With Fertility
Endometriosis is associated with difficulty conceiving in some patients. Not all individuals with endometriosis will experience infertility, but it’s a known correlation that merits conversation if you’re planning a pregnancy.
Why Endometriosis Is Often Misdiagnosed or Delayed
Endometriosis can be a challenge to diagnose for several reasons:
- Symptom Overlap: Symptoms often mimic those of irritable bowel syndrome (IBS), ovarian cysts, or other conditions.
- Normalization of Pain: Many women are told period pain is “normal,” leading them to hesitate before seeking evaluation.
- Variability of Symptoms: No two patients experience endometriosis in exactly the same way — some have intense pain, others have subtle symptoms.
- Lack of Awareness: Both patients and sometimes clinicians may not immediately recognize the complexity of the condition.
As a result, many women wait years from the onset of symptoms to diagnosis — a delay that can impact quality of life and, in some cases, fertility.
When Should You See an OB/GYN for Endometriosis Evaluation?
If you’re experiencing any of the following — especially if symptoms disrupt your life or persist month after month — it’s time to schedule an evaluation:
- Painful periods that affect daily activities
- Pelvic pain between periods
- Pain with sex, bowel movements, or urination
- Heavy or irregular menstrual bleeding
- Gastrointestinal symptoms tied to your cycle
- Difficulty achieving pregnancy
You don’t need to “wait it out” or hope symptoms improve on their own. Early evaluation allows your provider to review symptoms in context, perform a thorough history and exam, and recommend appropriate next steps.
How Is Endometriosis Evaluated and Managed?
There is no single test that definitively diagnoses endometriosis outside of surgical evaluation, but your OB/GYN may use:
- A detailed symptom history
- Physical pelvic examination
- Ultrasound imaging
- Referral for MRI when indicated
- Diagnostic laparoscopy in select cases
Management is tailored to your symptoms, goals, and reproductive plans. Options may include:
- Hormonal therapies to suppress menstrual cycles
- Pain management strategies
- Minimally invasive surgery to remove implants and scar tissue
- Supportive care for digestive or pelvic floor symptoms
- Fertility counseling when pregnancy is a goal
No one approach fits everyone. Your care plan should reflect your unique needs.
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Cary OB/GYN Patient Review
You Don’t Have to Live With Chronic Pain
Endometriosis is a medical condition, not a rite of passage. Persistent pain, significant discomfort, or symptoms that affect your quality of life deserve attention and respect.
If you suspect endometriosis — or if pain has become part of your routine — the best next step is a frank conversation with your OB/GYN. At Cary OB/GYN, we’re here to listen, evaluate, and walk with you toward clarity and relief.
This Endometriosis Awareness Month, honor your body by giving your symptoms a voice. Don’t wait — it’s time to be heard.