Before diving in, it will probably be helpful to define endometriosis. Endometriosis is a condition in which tissue similar, but not identical, to the lining of the uterus is found elsewhere in the body. According to EndoWhat?, this tissue creates lesions that may cause pain, inflammation, and organ dysfunction and may lead to infertility. Endometriosis is most often found in the pelvis but has also been found in the bladder, bowels, diaphragm, lungs, and kidneys.

Each month, endometrial tissue grows inside the uterus to prepare for the fertilization and implantation of an egg. If the egg does not get fertilized by sperm, the uterus will shed the endometrial tissue during menstruation. With endometriosis, the endometrial-like tissue that grows outside of the uterus often grows on the endometrial lining, potentially creating a physical barrier for an embryo to attach or remain attached for 9 months. In addition, the abnormal tissue may also shed during menstruation and may not have anywhere to properly drain. This trapped tissue can prevent your eggs from traveling through the fallopian tube, which is necessary to get pregnant. 

woman gripping her mid-section due to endometriosis pain

What are the symptoms of Endometriosis?

Endometriosis can cause physical symptoms, however, in many cases women are asymptomatic. This is known as silent endometriosis. Many asymptomatic women don’t know they have endometriosis until they experience what doctors call “unexplained infertility," a euphemism for not knowing what the actual cause is, or multiple pregnancy losses. 

Let’s look at some common signs and symptoms of endometriosis, as well as silent endometriosis, that may help you determine whether or not you have it.  

Symptomatic Endometriosis

Linking physical symptoms to endometriosis can sometimes be difficult, as it can cause pain in many areas. If you have endometriosis, you may experience pain in your lower abdomen, lower back, pelvis, vagina, and rectum. Some women also suffer from pain during intercourse, as well as during urination and bowel movements.

Endometriosis can also cause menstrual cycle irregularities, such as intense cramps and excessive bleeding, or even more unusual symptoms like diarrhea, constipation, nausea, bloating, and more. 

Silent Endometriosis

The term silent endometriosis is used when the condition is present, but you don’t have any physical symptoms or your symptoms are atypical and/or mild. If asymptomatic, some women may live for years without knowing they even have endometriosis. In fact, it takes 7.5 years on average for women with endometriosis to get diagnosed! One can only imagine how this can impact women trying to grow their families. 

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So, how do you know if you have silent endometriosis?

Oftentimes, the topic of endometriosis will come up with your healthcare provider when you are trying to conceive. That’s because endometriosis is one of the leading causes of infertility. Endometriosis can block the passage of the egg through the fallopian tube as well as hinder successful implantation, which is why it can also cause issues during IVF. If you have been diagnosed with unexplained infertility or have suffered multiple miscarriages, it may be time to get tested for endometriosis, which can get worse if left untreated.   

According to Dr. Bruce Lessey, Reproductive Endocrinologist & Infertility Specialist, and scientific advisor for Receptiva Dx, endometriosis is a leading cause of unexplained infertility and unexplained pregnancy loss. It is also the major cause of IVF failure.

ReceptivaDx is a test performed on an endometrial biopsy to determine whether a woman has an inflammatory condition most often caused by endometriosis. The test looks for a protein called BCL6 in your uterine lining, and the endometrial biopsy can be conveniently taken at a normal visit to your reproductive specialist or OB/GYN's office.  

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“Based on the use of a novel biomarker, BCL6, we find that whenever there is no apparent reason for achieving or maintaining an early pregnancy, it is almost always endometriosis,” says Dr. Lessey on the connection between BCL6 and endometriosis. 75% of women with unexplained infertility will test positive for BCL6.

Roughly 20-25% of women with endometriosis are asymptomatic, and Receptiva Dx focuses on diagnosing it for women. 

medical professional looking at a patient's chart

The bottom line? If you think, for any number of reasons, that you may have endometriosis, don't hesitate to talk to your physician. Whether you have physical symptoms that are either typical or atypical of the condition or you are experiencing unexplained infertility, your healthcare team can help you get a diagnosis and discuss potential treatment options. You don't have to suffer in silence! 

Brighid Flynn is a freelance writer based in Philadelphia where she lives with her husband and puppy. She is just beginning her journey toward motherhood.