Struggling with heavy and painful periods? Gynaecologist warns it could be endometriosis; shares 7 symptoms

Most women accept period pain as normal, but unusually heavy bleeding and severe pain deserves medical attention. Dr Gupta shares 7 signs to watch out for.

For many women, painful periods are considered “normal” and something they are expected to tolerate every month. However, severe menstrual pain, persistent pelvic discomfort, or unexplained fertility issues may sometimes indicate an underlying condition like endometriosis. Often, women continue to ignore these symptoms for years, either because they are told that period pain is common or because the symptoms come and go. This delay in recognising the warning signs can affect not only daily quality of life but also reproductive health in the long run.

HT Lifestyle reached out to Dr Shobha Gupta – medical director, gynaecologist and IVF expert at Mother's Lap IVF Centre, New Delhi and founder of Mumma's Blessing IVF and Birthing Paradise, Vrindavan – who highlights, “Many women live with endometriosis symptoms for years before receiving a diagnosis because they assume their pain is just part of their menstrual cycle. Persistent or unusual symptoms should never be ignored because early diagnosis can make a significant difference in managing the condition and protecting fertility.”

What is endometriosis?

Dr Gupta explains, “Endometriosis is a condition where tissue similar to the lining of the uterus grows outside the uterus, commonly affecting the ovaries, fallopian tubes, and pelvic tissues. During the menstrual cycle, this tissue responds to hormonal changes, leading to inflammation, pain, and sometimes scar tissue formation.”

Symptoms of endometriosis

According to Dr Gupta, while painful periods are one of the most recognised symptoms, endometriosis can present through several less obvious signs. She outlines the following symptoms:

1. Severe period pain that affects daily life

Many women experience cramps during menstruation, but pain that disrupts normal activities should not be dismissed.

Signs to watch for:

• Pain that prevents routine work
• Severe lower abdominal or pelvic pain
• Pain that does not improve with usual pain relief

“Period pain should not be so intense that a woman has to plan her life around it. When pain becomes severe, recurring, or progressively worse, it deserves medical evaluation,” explains Dr Gupta.

2. Pain during or after intercourse

Pain during sexual activity is another symptom that is often ignored due to hesitation or embarrassment. The gynaecologist notes, “Endometriosis-related inflammation and tissue growth can cause discomfort during deep penetration. Many women consider it something they have to accept, but it is important to discuss such symptoms with a gynaecologist.”

3. Difficulty in conceiving

For some women, fertility concerns may be the first indication of endometriosis. The condition can affect fertility by causing inflammation, affecting egg quality, interfering with the fallopian tubes, or creating an environment that makes conception more challenging.

Dr Gupta highlights, “Endometriosis does not mean pregnancy is impossible, but it is one of the conditions that can impact fertility. Women struggling to conceive should undergo proper evaluation rather than delaying medical advice.”

Painful periods and heavy bleeding can be signs of endometriosis. (Pexel)

4. Heavy or irregular bleeding

Changes in menstrual patterns can sometimes be linked with endometriosis. Women may experience the following:

• Heavy periods
• Spotting before menstruation
• Longer menstrual cycles

Although many factors can cause abnormal bleeding, recurring changes should be assessed to identify the underlying reason.

5. Digestive problems during periods

The gynaecologist points out that a lesser-known symptom of endometriosis is the impact it can have on the digestive system. Some women report experiencing the following issues:

• Bloating
• Pain during bowel movements, especially during periods
• Constipation or diarrhoea linked to menstrual cycles

Since these symptoms can resemble common digestive issues, the connection with reproductive health is often missed.

6. Chronic pelvic pain

Endometriosis pain is not always limited to periods. Dr Gupta stresses, “Some women experience ongoing pelvic discomfort, heaviness, or pain that continues throughout the month. Persistent pelvic pain should not be considered normal and requires assessment.”

7. Fatigue and emotional stress

Living with chronic pain can affect overall well-being. The gynaecologist points out that women with endometriosis may experience fatigue, reduced energy levels, and emotional stress due to ongoing discomfort and uncertainty. The condition can affect quality of life beyond physical symptoms, making timely support important.

Why does early diagnosis matter?

Endometriosis can vary widely from person to person. The gynaecologist notes that some women may have severe symptoms with minimal disease, while others may have significant disease with mild symptoms. Diagnosis usually involves a detailed medical history, examination, imaging tests, and sometimes further evaluation depending on the individual case.

Recognising the silent signs of endometriosis can help women seek care earlier, manage symptoms effectively, and make informed decisions about their reproductive health. Dr Gupta concludes, “Women should pay attention to patterns in their symptoms. Tracking menstrual pain, cycle changes, and other discomforts can help doctors identify problems earlier. Endometriosis is manageable, but awareness is the first step toward timely treatment.”

Note to readers: This article is for informational purposes only and not a substitute for professional medical advice. Always seek the advice of your doctor with any questions about a medical condition.