Endometriosis occurs when tissue resembling the uterine lining develops outside the uterus. While it is associated with pelvic pain and fertility issues, the disease can present in many other ways. Understanding uncommon symptoms of endometriosis, as well as why they sometimes go unnoticed, helps raise awareness and supports timely diagnosis and treatment. Here are several unusual indicators of endometriosis that are easily missed:

Gastrointestinal Disruptions

Endometriosis can impact the intestines or regions around the rectum, causing digestive discomfort. The endometrial-like tissue responds to hormonal changes and becomes inflamed during the menstrual cycle, disrupting bowel function. This process may lead to bloating, constipation, diarrhea, nausea, or painful bowel movements each month.

These symptoms are similar to those caused by irritable bowel syndrome or food sensitivities. Doctors may recommend dietary changes, fiber supplements, or antispasmodic medications without addressing the underlying cause. Because gastrointestinal complaints are common, the connection to menstruation is not always explored. This similarity to other digestive disorders contributes to why these indicators can be overlooked.

Rectal pain or bleeding is another less common symptom. Patients may attribute it to hemorrhoids, while physicians focus on colorectal issues first. When pain and bleeding occur in conjunction with the menstrual cycle, it suggests bowel involvement from endometriosis.

Lower Back and Leg Pain

Endometriosis may affect pelvic nerves, particularly the sciatic nerve, leading to radiating pain. Compression or inflammation from nearby lesions causes discomfort that spreads to the lower back, hips, or thighs. Some individuals experience sharp pain or a sense of weakness that disrupts movement, especially during menstruation.

These symptoms are mistaken for musculoskeletal issues in some cases. Patients may undergo physical therapy, chiropractic care, or spinal imaging with little improvement. Because back and leg pain are common in the general population, clinicians sometimes begin by evaluating orthopedic causes first. The distinguishing factor is a predictable monthly pattern, which may be missed in the early stages. Another reason this symptom is overlooked in some cases is that pain worsens with sitting or physical activity; this mimics sports injuries or nerve compression disorders. Comprehensive assessments should include gynecological causes to avoid misdiagnosis.

Urinary Symptoms

Endometrial tissue in the bladder or ureters can lead to urinary imbalances. Perimenstrual inflammation causes urgency, frequent urination, localized pain, or abdominal discomfort. In more severe cases, lesions may obstruct urine flow, resulting in flank pain or kidney-related complications.

These uncommon symptoms of endometriosis are sometimes mistaken for recurrent urinary tract infections. Patients with negative urine cultures may undergo multiple courses of antibiotics without relief. The gynecological connection is overlooked because urinary issues are usually managed by primary care or urology.

Cognitive and Fatigue Symptoms

Endometriosis impacts the functions of reproductive organs and affects systemic health. Prolonged pain, inflammation, and poor sleep result in fatigue. During menstruation, patients are likely to experience tiredness, and this may continue throughout the month.

Cognitive issues such as memory lapses and difficulty concentrating can also impact daily productivity. These symptoms of endometriosis are sometimes attributed to psychological stress, anxiety, or insomnia. Clinicians may recommend lifestyle changes without recognizing that endometriosis is the underlying cause of inflammation and sleep disruption. Because fatigue and cognitive stress are nonspecific, they are often not linked to a gynecological condition.

Addressing Uncommon Symptoms of Endometriosis

Digestive changes, nerve-related pain, and urinary issues are all possible signs of endometriosis, but they can also resemble other common health conditions, delaying diagnosis and treatment. BCL6 testing provides a tool to detect underlying inflammation in the endometrium when these uncommon symptoms are present. It involves analyzing an endometrial biopsy for elevated BCL6 protein levels, which indicate inflammatory activity associated with endometriosis.

If the test detects elevated BCL6 levels, clinicians can recommend further evaluation. Options include imaging studies or laparoscopic examination to confirm the presence and extent of endometrial growths. Identifying inflammation early allows for timely interventions, including hormone therapy or targeted surgical options. This approach helps manage symptoms effectively and supports fertility planning when needed.

Ask Your Doctor About Endometriosis Testing

Endometriosis is not limited to pelvic pain and infertility. When endometrial tissue grows outside the uterus, it can cause digestive changes, radiating nerve pain, urinary issues, respiratory problems, and systemic fatigue. These symptoms result from a clear biological process, yet they are sometimes overlooked because they resemble other conditions. BCL6 testing helps detect inflammation, enabling patients and clinicians to identify potential endometriosis even when traditional symptoms are absent. Ask your doctor about BCL6 testing today.