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Common symptoms of endometriosis include: Chronic pelvic pain , especially before or during menstruation Painful periods (dysmenorrhea) that interfere with daily activities Pain during sex (dyspareunia), particularly with deep penetration Pain with bowel movements or urination, especially during menstruation Heavy menstrual bleeding or bleeding between periods Digestive issues , including bloating, constipation, or diarrhea (often misdiagnosed as IBS) Fatigue , especially around the menstrual cycle Infertility or difficulty conceiving Lower back or leg pain that worsens with your cycle Mood swings, anxiety, or depression tied to chronic pain and hormone imbalances Although estrogen levels decline in menopausewhich can shrink endo lesions and relieve symptomssome women still experience endometriosis flares due to lingering inflammation, hormone imbalances (like estrogen dominance), or HRT that isnt properly balanced