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By Rachel Meltzer Warren, MS, RD

At least 5.5 million women in North America have endometriosis, a condition in which uterine tissue mistakenly grows outside of the uterus. While many with endometriosis don't even know they have the disease-it can impact any menstruating woman-awareness of the most common warning signs can help cut short suffering for anyone affected. 

The three most common symptoms of endometriosis, along with a fourth potential sign all raise a red flag for doctors, says MedHelp OB/GYN expert Elaine Brown, MD. 

Painful periods: Extreme discomfort during menstruation is one of the classic symptoms of endometriosis, says Brown. Heavy menstruation can also occur for women with the disease.  

Pelvic discomfort: Many women with endometriosis feel pain in the pelvic region. However the amount of pain experienced does not seem to be related to the amount of area affected in the body.  

Pain during sex: More than 50 percent of women with endometriosis experience dyspareunia, the clinical term for painful intercourse.  

Infertility: Many women don't know they have endometriosis until they have trouble becoming pregnant. About 30 to 40 percent of women with endometriosis have fertility troubles, according to the Cleveland Clinic. If you have been having unprotected sex for six months to a year and have not become pregnant, see your doctor.   

Several common symptoms that are often attributed to endometriosis are more likely due to other causes, says Brown. For instance, while mid-cycle bleeding can occur in women with endometriosis, it is more likely caused by a hormonal imbalance such as polycystic ovarian syndrome. And gastrointestinal discomfort, while it can be associated with endometriosis, is more often seen as a result of an intestinal disorder like irritable bowel syndrome.   

When should you see your doctor?  

If any of the symptoms associated with endometriosis arise, especially suddenly, you should bring it up to your doc, says Brown. If she suspects endometriosis, she may suggest laparoscopy, surgery to take a close look at your reproductive organs, or an imaging test such as ultrasound.  

Rachel is a New York City-based nutrition writer, educator and counselor.

Published: March 29, 2011

See Also:

• Endometriosis: Get the Facts
• Know your symptoms: Track your menstrual cycle pain
• Join our endometriosis community for support and advice
• Talk to our gynecologist, Elaine Brown, MD