Pain  

Secondary dysmenorrhea is a typical symptom, condition worsen with lesion aggravating over time. The pain often occurs in lower back and lumbosacral area, and even vagina, perineum and legs, 1-2 days before menstruation. The most desperate pain is usually on the first day of the period and abates during the following days , the pain stops after the menstruation. The amount of pain corelate poorly with the extent of lesion., with some women having little pain despite having severe adhesion, while other women may have great pain even though they have only a few small areas of endometriosis. A few women may have a constant pain in lower abdomen, worsen with the menstrual cycle.

Irregular menstruation   

15%-30% of patient have heavy menstrual flow, prolonged menstrual periods, and spotting after periods. Irregular menstruation may relate to ovarian lesion anovulation, luteal phase deficiency, adenomyosis or fibroids.

Infertility   

Up to 40% of endometriosis patients suffer from infertility. The reason of which may include:
①anatomical distortion: Adhesions between tissues and organs in pelvic cavity and Fallopian tubes peristalsis abate in patient with serious endometriosis affect the act of ovulation and fertilization.
②Ovarian dysfunction: Incidence of ovarian disease is 17%-27% in patients with endometriosis. It may relate to the rising of PGs in peritoneal fluid effects follicle growth and ovulation.
③Autoimmune reaction: B-lymphocytes produce EMAb interfere with the transportation and implantation of early fertilized egg. Macrophage in abdominal cavity swallow germs and interfere with egg cell division leads to infertility.

Painful sex   

Rectouterine pouch cause local tissue edema ,adhesion or fixed retroversion of uterus. Fornix of vagina during sex intercourse, uterine contraction and elevation may give rise to the pain, most obvious before the menstruation

Ovarian endometriosis ruptured cyst   

After cyst ruptured ,stale thick dark blood would flow into abdominopelvic cavity causes sudden gnawing pain with nausea , vomiting and anus bulge. Pain occurs before and after menstruation or after sexual intercourse, the symptom of which similar with rupture of tubal pregnancy.

Other special symptoms  
①rectal endometriosis: cause stomachache ,diarrhea, constipation minor hemafecia ,  hemorrhage due to intestinal mucosa hyperemia.
②endometriosis of the urinary system: ectopic endometrium violates bladder wall may cause painful urination and frequent urination during periods. Ectopic endometrium violates and oppresses ureter may cause pain on side of lower back and hematuresis ,but only in rare cases.
③endometriosis to abdominal wall scar after surgery: recurrent pain on the scar and enlarging of the lump months or years after surgery..
④The reports about endometriosis of other parts of body, such as lung, brain tissues and limbs are rarely seen.The symptoms of which is the recurrent pain at lesion parts and bleeding or forming lumps, and lead to corresponding symptoms.