Endometriosis Symptoms: Understanding Your Hormones

Endometriosis is a chronic reproductive health condition that affects an estimated 1 in 10 women in the UK. It’s characterised by painful, heavy periods and a host of other debilitating symptoms that severely impact quality of life.

Despite its high prevalence, many people live with endometriosis and diagnosis times are on average over 8 years. This delay is frequently due to a lack of awareness and the dismissal of women’s pain. Understanding the true nature of this condition is the first crucial step towards getting the expert care you deserve.

This article outlines everything you need to know about Endometriosis. We’ll also explain how our Advanced At-Home Hormone and Fertility Test can uncover the root causes of your symptoms and step towards a quicker diagnosis. 

What is Endometriosis?

Endometriosis occurs when cells similar to those lining the uterus (endometrium) grow in other parts of the body, outside of the uterus (Endometriosis UK, 2024). These endometrial-like lesions are most commonly found in the ovaries and fallopian tubes, but can also grow on the vagina, cervix, bowel, bladder, and other pelvic organs. Rarely, they may appear in other parts of the body.

Just like the lining of the uterus, these ectopic cells build up and eventually shed in response to your hormones. But unlike a period, this blood and tissue has nowhere to go. This internal bleeding leads to inflammation, crippling pain, and a build-up of scar tissue and adhesions (tissue that can bind organs together).

Endometriosis can affect women of any age.

The Main Symptoms of Endometriosis

Endometriosis is a systemic, whole-body disease. Not everyone will experience all symptoms, and the severity of pain doesn’t necessarily correlate with the stage of the disease.

Pain and Menstruation

Intense period and pelvic pain are often reported to be the most debilitating symptoms. This pain is frequently described as ‘a razor blade pain’.

• Severe Period Pain: While the uterus releases chemicals called prostaglandins that cause cramping and period pain, with endometriosis, the shedding of the ectopic lesions causes profound inflammation and pain.
• Timing of Pain: Unlike typical period pain that peaks on the first or second day of bleeding, the crippling pain of endometriosis often kicks in a few days before your period’s arrival and can make an unwelcome return during ovulation or even throughout the month, leading to chronic pelvic pain.
• Deep Pain: People can also experience chronic pain, increased lower back pain, and pain around their legs. Dyspareunia, or pain during or after vaginal penetration, is a common symptom, usually felt deep inside the pelvis.

Heavy Bleeding

Another common symptom is heavy periods (menorrhagia). Heavy periods are clinically defined as:

• Bleeding for more than seven days.
• Having to change your period product every hour or two for several hours in a row.
• Passing blood clots that are bigger than a 10p coin.

Monthly heavy bleeding can lead to anaemia (iron deficiency), which results in secondary symptoms such as chronic fatigue, hair thinning, and constantly feeling cold.

Bowel, Bladder, and Other Symptoms

Endometrial lesions can cause symptoms that mimic other common conditions:

• Gastrointestinal Issues: Symptoms similar to irritable bowel syndrome (IBS) are common, including diarrhoea, constipation, and abdominal bloating – often referred to as “endo belly”. These symptoms often worsen in the days before your period.
• Bowel and Urination Pain: Lesions can grow on the surface of the bowel or bladder, causing pain when urinating or passing bowel movements, especially during your period. Pain during urination can sometimes be misdiagnosed as a UTI.
• Chronic Pain and Fatigue: Living with chronic pain and systemic inflammation leads to persistent fatigue.
• Mental Health Struggles: Living with a chronic, painful, and often isolating condition significantly impacts mental health, increasing the risk of depression and anxiety.

💡 Suspect endometriosis is the cause of your pain?

Take our Advanced At-Home Hormone and Fertility Test to investigate the link between your cycle and inflammatory conditions like endometriosis.

Endometriosis and Hormones: The Oestrogen Link

Endometriosis is fundamentally an oestrogen-dependent condition. This is the main hormonal driver for the initiation, growth, and maintenance of the lesions.

• Oestrogen Dominance: The lesions themselves have been found to contain the necessary enzymes to produce oestrogen locally, effectively creating their own fuel source. This local high-oestrogen environment promotes lesion growth and inflammation.
• Progesterone Resistance: Normal progesterone acts to inhibit the growth of the uterine lining, but endometriotic cells often exhibit progesterone resistance. This inability to respond to progesterone means the growth-promoting effects of oestrogen go unchecked, preventing the lesions from shrinking or dying off.
• Endometriosis and Fertility: Unfortunately, endometriosis can affect your fertility (infertility affects ~30–50% of peple with endometriosis). This can be due to structural issues (adhesions blocking the fallopian tubes), ovarian cysts (endometriomas) damaging ovarian tissue, or widespread inflammation in the pelvic cavity that affects egg function.

Getting to a Diagnosis

Diagnosing endometriosis is challenging, as the symptoms overlap with many other conditions (NHS, 2024). A definitive diagnosis typically requires surgery (laparoscopic keyhole surgery).

However, hormonal and blood marker testing can be a vital first step on the road to a specialist referral and diagnosis.

Testing a full panel of personalised hormones provides essential diagnostic data needed to find the root cause, tailored to your symptoms and concerns.

1. Assess Ovarian Health: We check oestradiol, LH, FSH, and AMH to determine if the condition is structurally or hormonally impacting your ovarian reserve or ovulation, which is crucial if you are planning to conceive.
2. Investigate Anaemia: Blood work can screen for iron deficiency anaemia, a common consequence of unmanaged heavy bleeding in endometriosis.
3. Rule Out Other Conditions: We check thyroid-stimulating hormone (TSH) and free thyroxine to rule out thyroid dysfunction, and other hormones to check for conditions like PCOS (which also causes pelvic pain and heavy bleeding), ensuring a precise pathway.
4. Inform Treatment: Your hormone levels guide clinicians on whether hormonal suppression therapy (a common treatment for endometriosis pain) is the right choice for you.

If you are experiencing any of the debilitating symptoms listed,you don’t have to suffer in silence. It’s important to seek expert medical advice to clarify the cause.

💡 Take the first step toward getting answers

Our team of specialists, including Private Gynaecologists, can offer you a tailored care plan to manage your endometriosis symptoms and explore treatment options. Take our Advanced At-Home Hormone and Fertility Test today.

References

• https://www.nhs.uk/conditions/endometriosis/ 
• https://www.endometriosis-uk.org/what-endometriosis 
• https://www.womenshealth.gov/a-z-topics/endometriosis 
• https://www.nice.org.uk/guidance/conditions-and-diseases/gynaecological-conditions/endometriosis-and-fibroids