It can take up to 11 years from the onset of symptoms to get diagnosed with this painful condition in which the type of tissue that grows inside of your uterus begins to grow outside of it. While there’s no cure for endometriosis—a disease that strikes one in ten women—recognizing the symptoms means you can save yourself a world of hurt. Look for these signs:

By Lynya Floyd
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1. Your periods are painful. Maybe really painful.

“Many women dismiss their symptoms as just ‘bad periods,’” explains Joy Brotherton, MD, associate professor of obstetrics and gynecology at the David Geffen School of Medicine at UCLA. Don’t suffer in silence—especially if you’ve constantly taking Advil or calling in sick to get through the day. “Speak up whenever you experience pain, as no amount of pain is normal,” says Brotherton, who encourages women to not only express their concerns to their healthcare provider but also talk about what’s going on with friends and family members so they understand how you’re feeling. You could start by forwarding this story link to a friend.

Related: Five Signs You Need to Have Your Thyroid Checked

2. You’re avoiding sex.

“A lot of women may feel shy coming in to see their doctor with pain during intercourse being the only complaint,” says Natalya E. Danilyants, MD, minimally invasive GYN surgical specialist at The Center for Innovative GYN Care in Rockville, Maryland. But you should overcome that embarrassment and make an appointment. offers several educational resources, including a symptoms quiz and a discussion guide for your next appointment with your healthcare provider. “Pain during sex is an extremely common symptom of endometriosis,” says Danilyants, who notes that when tissue similar to what’s found in the uterine lining grows in other places in the pelvis it can be aggravated and cause intense pain during intercourse. “The pain can vary in severity but any level is abnormal and should raise the suspicion.”

3. You’re using more pads and tampons than usual.

Having a heavy flow or spotting in between periods—symptoms often associated with hormonal imbalances, fibroids or even having an IUD—are yet another reason to talk to your doctor. “Endometriosis is called ‘The Great Imitator,’” explains Brotherton, who is also director of minimally invasive gynecologic surgery at Harbor-UCLA Medical Center. “It can cause symptoms in multiple different organs and the symptoms can be similar to other diseases.” Consider using a period-tracking app (like Glow or Clue) or a pain-tracking app (like CatchMyPain or My Pain Diary) to stay on top of your symptoms so you can share specific details with your MD.

4. You’re having trouble getting pregnant.

Because endometriosis can also damage your ovaries and fallopian tubes, thus making it hard for your eggs to meet sperm, the disease can cause you to have to a tough time making a baby. Research shows that 25-50% of infertile women have the condition. “It is important for women with endometriosis to talk to their doctors and develop a reproductive life plan, essentially a timeline for having children,” says Brotherton.

5. It hurts when you go to the bathroom.

Take note particularly if it’s during your period when lesions can get inflamed. “Often with endometriosis the pain while urinating or having a bowel movement can be cyclical,” explains Danilyants. Here’s another case where you might mistake your discomfort for other health concerns. “When people think of pain with bowel movements, for example, they think of gastrointestinal issues, but if it is happening simultaneously with your menstrual cycle, that is another sign to watch,” explains Danilyants. Discuss your options with your MD. When it comes to treatment, hormonal treatments (birth control pills, injections, inserting an IUD) and minimally invasive surgery can help.