Endometriosis can be challenging to diagnose based on clinical presentation alone
This disease has a wide range of symptoms and significant symptom overlap with other gynecologic and non-gynecologic conditions1
Consider endometriosis early in your differential diagnosis1-19
![]() |
Select one of the conditions below to see the possible symptom overlap with endometriosis |
Select condition:
![Venn diagram of endometriosis symptoms](/content/dam/herendometriosis/images/graphics/oval-pink.png)
Dysmenorrhea
Non-menstrual pelvic pain
Dyspareunia
Heavy or irregular bleeding
Dysuria
Dyschezia
Constipation
Diarrhea
Lower abdominal or back pain
ENDOMETRIOSIS
SYMPTOMS
![Venn diagram illustrating endometriosis symptoms, shared symptoms, and unique symptoms of a more common condition.](/content/dam/herendometriosis/images/graphics/oval-pink.png)
![Venn diagram illustrating endometriosis symptoms, shared symptoms, and unique symptoms of a more common condition.](/content/dam/herendometriosis/images/graphics/oval-grey.png)
Dysuria
Dyschezia
Diarrhea
Dysmenorrhea
Non-menstrual pelvic pain
Dyspareunia
Heavy or irregular bleeding
Constipation
Lower abdominal or back pain
Anemia
Urinary frequency or urgency
ENDOMETRIOSIS
SYMPTOMS
SHARED
SYMPTOMS
UTERINE
FIBROIDS
SYMPTOMS
![](/content/dam/herendometriosis/images/graphics/oval-pink.png)
![](/content/dam/herendometriosis/images/graphics/oval-grey.png)
Dyschezia
Constipation
Diarrhea
Dysmenorrhea
Non-menstrual pelvic pain
Dyspareunia
Heavy or irregular bleeding
Dysuria
Lower abdominal or back pain
Fever
Vaginal discharge
ENDOMETRIOSIS
SYMPTOMS
SHARED
SYMPTOMS
PELVIC
INFLAMMATORY
DISEASE
SYMPTOMS
![](/content/dam/herendometriosis/images/graphics/oval-pink.png)
![](/content/dam/herendometriosis/images/graphics/oval-grey.png)
Dysuria
Dyschezia
Constipation
Diarrhea
Lower abdominal or back pain
Dysmenorrhea
Non-menstrual pelvic pain
Dyspareunia
Heavy or irregular bleeding
Anemia
ENDOMETRIOSIS
SYMPTOMS
SHARED
SYMPTOMS
ADENOMYOSIS
SYMPTOMS
![](/content/dam/herendometriosis/images/graphics/oval-pink.png)
![](/content/dam/herendometriosis/images/graphics/oval-grey.png)
Constipation
Diarrhea
Lower abdominal or back pain
Dysmenorrhea
Non-menstrual pelvic pain
Dyspareunia
Heavy or irregular bleeding
Dysuria
Dyschezia
Urinary frequency or urgency
Fever
ENDOMETRIOSIS
SYMPTOMS
SHARED
SYMPTOMS
OVARIAN
CYSTS
SYMPTOMS
![](/content/dam/herendometriosis/images/graphics/oval-pink.png)
![](/content/dam/herendometriosis/images/graphics/oval-grey.png)
Dysmenorrhea
Dysuria
Heavy or irregular bleeding
Non-menstrual pelvic pain
Dyspareunia
Dyschezia
Constipation
Diarrhea
Lower abdominal/back pain
ENDOMETRIOSIS
SYMPTOMS
SHARED
SYMPTOMS
IRRITABLE
BOWEL
SYNDROME
SYMPTOMS
![](/content/dam/herendometriosis/images/graphics/oval-pink.png)
![](/content/dam/herendometriosis/images/graphics/oval-grey.png)
Heavy or irregular bleeding
Dysuria
Dyschezia
Constipation
Dysmenorrhea
Non-menstrual pelvic pain
Dyspareunia
Diarrhea
Lower abdominal or back pain
Fever
Anemia
ENDOMETRIOSIS
SYMPTOMS
SHARED
SYMPTOMS
INFLAMMATORY
BOWEL
DISEASE
SYMPTOMS
![](/content/dam/herendometriosis/images/graphics/oval-pink.png)
![](/content/dam/herendometriosis/images/graphics/oval-grey.png)
Dysmenorrhea
Heavy or irregular bleeding
Dyschezia
Constipation
Diarrhea
Non-menstrual pelvic pain
Dyspareunia
Dysuria
Lower abdominal or back pain
Urinary frequency or urgency
ENDOMETRIOSIS
SYMPTOMS
SHARED
SYMPTOMS
INTERSTITIAL
CYSTITIS
SYMPTOMS
This symptoms list is not all-inclusive.
References:
1. Mao AJ, Anastasi JK. Diagnosis and management of endometriosis: the role of the advanced practice nurse in primary care. J Am Acad Nurse Pract. 2010;22(2):109-116. 2. American College of Obstetricians and Gynecologists. Practice bulletin no. 114: management of endometriosis. Obstet Gynecol. 2010;116(1):223-236. 3. Sturpe DA, Pincus KJ. Endometriosis. In: DiPiro JT, Talbert RL, Yee GC, Matzke GR, Wells BG, Posey LM, eds. Pharmacotherapy: A Pathophysiologic Approach, 9th ed. New York, NY: McGraw-Hill; 2014. 4. Association of Professors of Gynecology and Obstetrics. Diagnosis & Management of Endometriosis: Pathophysiology to Practice. Educational Series on Women's Health Issues. https://pdfs.semanticscholar.org/2f57/078beb656b74691969f0a494021dca8e094f.pdf. Accessed June 10, 2019. 5. Woo J, Armstrong AY. Gynecologic disorders. In: Papadakis MA, McPhee SJ, Rabow MW, eds. Current Medical Diagnosis & Treatment 2017. New York, NY: McGraw-Hill; 2017. 6. Uterine fibroids. Mayo Clinic website. http://www.mayoclinic.org/diseases-conditions/uterine-fibroids/symptoms-causes/syc-20354288. Accessed June 10, 2019. 7. The Practice Committee of the American Society for Reproductive Medicine. Treatment of pelvic pain associated with endometriosis: a committee opinion [published correction appears in Fertil Steril. 2015;104(2):498]. Fertil Steril. 2014;101(4):927-935. 8. Goje O. Pelvic inflammatory disease (PID). Merck Manual website. http://www.merckmanuals.com/professional/gynecology-and-obstetrics/vaginitis,-cervicitis,-and-pelvic-inflammatory-disease-pid/pelvic-inflammatory-disease-pid. Updated May 2018. Accessed August 22, 2018. 9. Kilpatrick CC. Uterine adenomyosis. Merck Manual website. https://www.merckmanuals.com/professional/gynecology-and-obstetrics/miscellaneous-gynecologic-disorders/uterine-adenomyosis. Updated May 2019. Accessed June 10, 2019. 10. Evans P. Vaginal bleeding. In: South-Paul JE, Matheny SC, Lewis EL, eds. Current Diagnosis & Treatment: Family Medicine, 4th ed. New York, NY: McGraw-Hill; 2015. 11. Adenomyosis. Mayo Clinic website. https://www.mayoclinic.org/diseases-conditions/adenomyosis/symptoms-causes/syc-20369138. Updated June 8, 2018. Accessed June 10, 2019. 12. Heniff M, Fleming HRB. Abdominal and pelvic pain in the nonpregnant female. In: Tintinalli JE, Stapczynski JS, Ma OJ, Yealy DM, Meckler GD, Cline DM, eds. Tintinalli's Emergency Medicine: A Comprehensive Study Guide, 8th ed. New York, NY: McGraw-Hill; 2016. 13. Ovarian cysts. Mount Sinai website. http://www.mountsinai.org/health-library/diseases-conditions/ovarian-cysts. Accessed October 19, 2017. 14. Benign ovarian cysts. Johns Hopkins Medicine website. http://www.hopkinsmedicine.org/gynecology_obstetrics/specialty_areas/gynecological_services/conditions/ovarian_cysts.html. Accessed June 10, 2019. 15. Owyang C. Irritable bowel syndrome. In: Kasper D, Fauci A, Hauser S, Longo D, Jameson JL, Loscalzo J, eds. Harrison's Principles of Internal Medicine, 19th ed. New York, NY: McGraw-Hill; 2014. 16. Moleski SM. Irritable bowel syndrome (IBS). Merck Manual website. http://www.merckmanuals.com/professional/gastrointestinal-disorders/irritable-bowel-syndrome-ibs/irritable-bowel-syndrome-ibs. Updated November 18, 2017. Accessed June 10, 2019. 17. Inflammatory bowel disease (IBD). Mayo Clinic website. https://www.mayoclinic.org/diseases-conditions/inflammatory-bowel-disease/symptoms-causes/syc-20353315. Updated April 2019. Accessed June 10, 2019. 18. Interstitial cystitis. Mayo Clinic website. https://www.mayoclinic.org/diseases-conditions/interstitial-cystitis/symptoms-causes/syc-20354357. Updated May 14, 2019. Accessed June 10, 2019. 19. Warren JW. Dysuria, bladder pain, and the interstitial cystitis/bladder pain syndrome. In: Kasper D, Fauci A, Hauser S, Longo D, Jameson JL, Loscalzo J, eds. Harrison's Principles of Internal Medicine, 19th ed. New York, NY: McGraw-Hill; 2014.