Endometriosis Symptoms | 6 Common Signs

Jana Stehler is a former Hyrox athlete, queen of new beginnings, and someone living with endometriosis. In this article, she takes us into her world and shares her experiences with the condition endometriosis. Particularly important to her are endometriosis symptoms, which are often overlooked or dismissed by doctors as normal cycle-related symptoms.
On Instagram, she raises awareness about the condition and gives further insights into her daily life with endometriosis – feel free to check it out!

What Is Endometriosis?

Endometriosis is a chronic inflammatory condition in which tissue similar to the uterine lining grows outside the uterine cavity – for example on the ovaries, in the abdominal and pelvic cavity, on the intestines, bladder, ureters, and peritoneum. It can even occur outside the abdominal cavity, such as in the lungs. It is assumed that, just like the normal uterine lining, endometriosis tissue builds up and breaks down periodically during the cycle and bleeds. However, the shed tissue cannot leave the body. It accumulates in the body, for example in the abdominal cavity in the form of endometriosis lesions or on the ovaries in the form of cysts. Due to internal bleeding, these cysts are also called “chocolate cysts.” This often causes severe pain and other endometriosis symptoms.

Your Knowledge To Go: Endometriosis Symptoms

• The symptoms of endometriosis can affect the entire body and are not, as many assume, only recognizable by severe period pain.

• Endometriosis symptoms and pain are often diagnosed late and frequently not taken seriously by doctors. If you feel like you’re not being heard, seek opinions from different experts and do not give up.

• The most common signs of endometriosis: endometriosis belly (severely bloated abdomen), extreme lower abdominal pain before/during your period, cycle-independent pain, digestive issues such as severe bloating, pain during intercourse, reduced fertility, and severe fatigue.

• Endometriosis can occur on the ovaries, in the abdominal and pelvic cavity, on the intestines, the bladder, and/or the peritoneum. In rare cases, other areas of the body such as the lungs may also be affected.

My Endometriosis Experience

Endometriosis is painful and often goes undetected for years – just like in my case. It has been exactly ten years since my first laparoscopy, and I only received the diagnosis six months ago. How is that possible?

Back in 2016, a chocolate cyst was removed from my ovaries, but after the surgery, I was not told that I had endometriosis. Six years ago, I stopped taking the pill to live hormone-free. Two years later, the pain before and during my period became increasingly unbearable – to the point of almost fainting. Endometriosis symptoms are often dismissed as “normal period pain.” But such intense pain is not normal and should be taken seriously. Severe menstrual pain is a very common symptom – however, pain can occur both cycle-dependent and cycle-independent.

My endometriosis symptoms summarized: extreme endobelly, digestive issues (bloating, pain during bowel movements, ...), unexplained exhaustion, extremely long menstrual cycles (sometimes up to 50 days), increasingly lighter periods, sharply smelling urine (due to endometriosis on the bladder/ureter), pain during intercourse. And the worst were the flare-up symptoms: I was lying there, unable to move, constantly on the verge of calling an ambulance, crawling on all fours to the medicine cabinet. It felt like I was about to faint at any moment.

In July 2025, I had another surgery – initially only on suspicion, because nothing was visible on ultrasound. The result? What was supposed to be outpatient surgery turned into a hospital stay, and suspicion turned into stage 4 endometriosis affecting the intestines, bladder, ureters, ovaries, peritoneum, and pelvis. And I thought the pain was just from stress – no joke. I always thought I was exaggerating and that it was normal, since I had been dealing with severe period pain, irregular cycles, and spotting since childhood.

That’s why I want to tell you: pay attention to your body – and if it sends you signals, don’t stop investigating them.

Endometriosis Symptoms Explained in Detail

Cycle-Dependent Pain
One of the most common endometriosis symptoms is pain associated with the menstrual cycle. This includes severe menstrual cramps that go beyond what is considered typical and may worsen over the years. The pain can occur in the lower abdomen, pelvic area, or lower back. In addition, periods may be unusually heavy or unusually light.

Pain Outside of Menstruation
In some individuals, pain occurs independently of their period. This pain may be constant or appear in certain situations, such as during intercourse or physical activity. Spotting between periods may also occur repeatedly.

Gastrointestinal and Urinary Symptoms
Endometriosis can be associated with digestive issues such as bloating, diarrhea, or constipation, especially during menstruation. Pain during urination or bowel movements are also possible endometriosis symptoms, depending on which organs are affected.

Fatigue and Reduced Performance
Many affected individuals report pronounced fatigue or exhaustion. This may be related to both the pain and the progression of the condition.

Unfulfilled Desire to Have Children
Endometriosis can impair fertility. Some women only seek medical clarification after trying unsuccessfully to conceive for an extended period.

Varying Severity of Endometriosis Symptoms
The intensity of symptoms does not always directly correlate with the extent of endometriosis lesions. While some individuals experience severe pain, others have few or no endometriosis symptoms.

Conclusion: Signs of Endometriosis

Endometriosis is often referred to as the “chameleon of gynecology.” How endometriosis develops and its exact causes are still not fully understood, but awareness of the condition is steadily increasing. If you now realize that many endometriosis symptoms apply to you, don’t panic right away. My tip: write down all your symptoms and schedule a doctor’s appointment. If you feel that you’re not being taken seriously, search online for doctors in your area who specialize in endometriosis and seek a second opinion.

Do you have questions? Then feel free to send us an email – we look forward to hearing from you! :)

The information shared in this article does not replace individual medical or nutritional advice.

Literature & Sources

1. AOK (2022). Diagnose Endometriose: So lassen sich die Symptome lindern.
2. Endometriose-Vereinigung Deutschland e.V. (2025). Was ist Endometriose
3. Ludwig-Maximilians-Universität München (2025). Endometriose: Eine Krankheit, die Millionen trifft.
4. NDR (2025). Endometriose: Symptome, Diagnose und Behandlung. Ratgeber Gesundheit.