Severe Endometriosis - Signs, Symptoms, and How to Treat It

The word severe is one that is often reserved to describe the most extreme circumstance, emotion or pain.  

If you are struggling with severe endometriosis, you’ve experienced symptoms that have left you crippled and writhing in pain. 

Maybe you have dealt with:

  • Chronic pelvic pain
  • Pain during ovulation
  • Extreme bleeding
  • Pain during or after sex
  • Severe cramping

You are not alone!

I know. I’ve been there. I’ve been exactly where you are. 

In this article I’ll answer these questions:

  •     What is endometriosis? 
  •     What makes severe endometriosis different than milder forms?
  •     What are the symptoms of severe endometriosis?
  •     How can I treat severe endometriosis?
  •     What are some natural treatments for endometriosis?

Relief is just a few words away.

What does endometriosis mean?

Endometriosis is a sometimes painful disorder where endometrial tissue that usually grows in your uterus begins to grow outside your uterus. I know, it’s not a pretty picture.

Pain is caused when the endometrial tissue thickens and then breaks down but has nowhere to go. (Again, not super pleasant to think about.) 

Because of all this, it causes irritation, scar formation, and adhesions. 

Endometriosis can affect your ovaries, fallopian tubes, and the tissue lining your pelvis.  

You are not alone in your pain.  

Endometriosis affects 1 in 10 women, nearly 176 million worldwide.

What causes endometriosis?

No one knows what really causes endometriosis, which makes treating it so incredibly difficult. Some suggestions for cause include:

  • Heredity– Endometriosis can run in the family.  It did in mine. Both my mother and grandmother struggled with severe endometriosis symptoms. 
  • Retrograde menstruation– This is where menstrual blood goes back through the fallopian tubes and into the pelvic cavity.
  • Transformation of peritoneal cells– Cells that are normally inside your abdomen that change into endometrial cells.
  • Surgical scar implantation– This is where cells implant onto scars left from surgeries like C-sections.

Endometrial cell transport– This involves endometriosis cells moving to other parts of the body.

What are the most common endometriosis symptoms?

Common endometriosis symptoms include:

  • Excessive bleeding
  • Cramps or intense menstrual pain
  • Severe abdominal pain
  • Severe back pain
  • Fertility problems
  • Pain during sex
  • Bowel movement pain
  • Urination pain

Severe endometriosis symptoms

Severe endometriosis doesn’t have as much to do with the severity of pain as it does with the scope of the spread of endometrial tissue and adhesions.

Endometriosis can be defined in 4 stages:  

  • Minimal
  • Mild
  • Moderate
  • Severe

  • Women suffering from endometriosis may not move from stage to stage.  In fact, they may stay at the same stage for a long time.

    Factors that determine the stage are the location, number, size, and depth of endometrial adhesions.

    How is severe endometriosis different?

    The characteristics of the various stages include:

    • Minimal - Those in the minimal stage have small scars, shallow implants (endometrial growths) on the ovaries, and inflammation in the pelvic lining.
    • Mild– In this stage, the scars are light, and the implants on the ovary and in the pelvic lining are shallow.
    • Moderate– Now the implants are deep on the ovaries and in the pelvic lining.
    • Severe– The most advanced stage is where the implants on the ovaries and in the pelvic lining are deep, and adhesions (where organs become attached to one another and form scar tissue) can be found on the bowels and fallopian tubes.

    Pain can be severe no matter what stage a woman may find herself in

    Severe endometriosis pain, as well as the milder forms, can be debilitating and can impact your quality of life, including work, family, and other relationships.

    Can endometriosis cause severe stomach pain?

    The lesions, adhesions, and implants of endometrial tissue in the pelvic region can cause excruciating pain in the abdomen. 

    Dr. Paul Levine of CCRM Fertility explains, “The nerves associated with the deep pelvis overlap with the nerves of the lower-back, abdomen, groin, and lower extremities. Extreme inflammation and irritation can lead to chronic pain of these associated structures.”  

    In fact, the pain can be so severe that you are in bed for days causing you to miss work and other activities.   

    And this happens month after month after month around your menstrual cycle. 

    Sometimes the pain can even last throughout the month, can be sharp or dull, and can be felt in the inner thigh during your menstrual cycle.

    Can endometriosis cause severe back pain?

    But the pain doesn’t stop there.  Endometriosis and severe back pain go hand in hand. 

    Throbbing back pain can be dull or stabbing and is usually felt deep in the body.  

    Similar to pain in the abdomen, back pain is caused by endometrial cells adhering to the back as well as the pelvis.

    Endometriosis and severe lower back pain - Why Does It Happen?

    How can you tell the difference between regular back pain and endo back pain?

    Endo back pain:

    • is felt deep in the body 
    • doesn’t go away with meds 
    • feels like a heavy weight and like the pelvis is being pulled down
    • can be sharp and stabbing
    • is caused when the endometrium sticks to the lower back 
    • isn’t relieved by changing position or moving around

    How to treat severe endometriosis pain?

    Even though severe endometriosis is a chronic condition that has no cure, it can be managed.  That’s good news.

    Because each woman is an individual and has her own symptoms, each one may respond differently to different treatments.  

    Some treatment options include medications to manage pain, hormonal treatment, surgery, or a mixture of them all. 

    A conservative approach may be warranted depending on how serious your pain is, your age, and your desire to become pregnant.

    Conventional treatment options

    So, what can be done for severe endometriosis pain? 

    There are various conventional treatments:

    • Medications like Advil or Aleve for pain management 
    • Surgery
    • Hormonal therapies
      • Birth control regulates hormones that cause endometrial tissue to form.
      • Birth control can also help with pain control even though symptoms may return.
      • Gonadotropin-releasing hormone (Gn-RH) blocks hormones stimulated in the ovaries and can cause symptoms of menopause. 
      • Progestin therapy stops periods and slows the growth of implants.
      • Aromatase inhibitors work by reducing the amount of estrogen produced.

    Severe endometriosis surgery

    Most surgeries can be done laparoscopically, though some may require traditional abdominal surgery.

    Conservative surgery removes endo implants but keeps your reproductive organs intact.

    More invasive surgeries, like hysterectomies, require the removal of reproductive organs.  

    However, some doctors may shy away from this treatment because of other health concerns.

    Natural treatment options

    Natural treatments are abundant and include.

    • Herbal treatments 
    • Diet
    • Supplements like vitamin D, vitamin A and vitamin C


    A healthy diet can make all the difference.

    An endo diet should include:

    • Omega 3 fats
    • Healthy fats
    • Anti-oxidants
    • Veggies and fruits 

    An endo diet should avoid:

    • Trans fats
    • Sugar
    • Processed foods
    • Red meat
    • Gluten


    Without a doubt, the greatest benefit of herbal therapies is the reduction of inflammation.

    Some common herbs and how they work to treat endometriosis include:

    • Vitex from the chaste tree – changes how estrogen receptors behave
    • Green Tea – inhibits aromatase
    • Evening Primrose oil - reduces inflammation
    • Curcumin – found in turmeric, acts as an anti-inflammatory, and may slow down tissue migration
    • Chamomile – reduces PMS symptoms and has a calming effect
    • Peppermint – has antioxidant properties and can reduce severe endometriosis pain
    • Lavender – as aromatherapy and helps with cramps
    • Ginger – for pain reduction
    • Pine bark – an anti-inflammatory
    • Ashwagandha – helps reduce STRESS which makes EVERYTHING worse.


    Lifestyle is the last, and maybe the most important, aspect to consider when trying to manage endometriosis symptoms.

    Consider adding the following to your regular routines:

    • Get moving! 
      • Regular exercise can benefit you in so many ways.  It can make your periods lighter and cause a drop in estrogen.  Take a walk, go for a bike ride, or go for a run. Take someone along. Exercising with a friend provides motivation and makes it more fun.
    • Relax!
      • Get a massage, soak in a warm bath or try other relaxation techniques like meditation, deep breathing, or yoga.
    • Be bold!
      • Try alternative treatments like acupuncture.
    • Be encouraged!
      • Seek encouragement and support from support groups or find Endo groups on Facebook or other social media outlets.
    • Be natural!
      • Use natural and clean products like my all-natural lubricants.

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