In very rare cases, endometriosis occurs outside the abdomen. Although it i s not in the uterus where it belongs, the displaced tissue continues to act as if it were in the uterus. It responds to reproductive hormones, and bleeds during the menstrual cycle. That's generally when women experience the pain and other symptoms of endometriosis. The symptoms vary with the location of the endometrial tissue.
Some women have no symptoms, even with an advanced case of the disease.
Symptoms may start sometime after puberty and often worsen as the years go by. After menopause, endometriosis usually disappears. The most prevalent symptom is pain during menstruation, but here, too, the degree of pain does not reflect the severity of the disease. The pain may be felt as menstrual cramps, back pain or pain at the specific location of the endometrial lesions, as they're sometimes called. There may be pain during intercourse or while moving the bowels.