Bladder endometriosis may cause pain during sex and periods: Know how to deal with it

Endometriosis is a condition in which tissue similar to uterine tissue grows outside the uterus, affecting many women during the reproductive stage. It usually occurs in the pelvis or lower abdomen, but can also appear in other parts of the body. The list also includes the bladder. Bladder endometriosis is rare, but when it occurs, it can cause a lot of discomfort. It can lead to problems while you pee or pain during sex. It can also cause severe pain every month. Tell us what causes this form of endometriosis and what you can do about it.

What is bladder endometriosis?

“It is a rare form of endometriosis in which tissue similar to the inside of the endometrium grows within or inside the bladder,” says obstetrician and gynecologist Dr. Chetna Jain. Abnormal tissues can grow on the exterior of the bladder or penetrate the bladder wall. The most common sites of endometriosis are the pelvic area (69.2 percent) and the intestinal (9.9 percent) and bladder (6.4 percent) according to a study published in the 2015 Journal of Obstetrics.

“It doesn’t directly affect fertility, but if you have endometriosis in your ovaries, giving birth to a child may not be easy,” says the expert.

What are the symptoms of bladder endometriosis?

Bladder endometriosis can cause a mix of urine and menstrual-related symptoms. According to an analysis published in Best Practice & Research Clinical Obstetrics & Gynecology in 2024, blood in the urine is two common symptoms associated with bladder endometriosis.

1. Urinary symptoms

• Even when your bladder isn’t full, you feel the need to pee frequently
• Painful urination
• Blood in the urine
• The urine-like mood still remains after pee

2. Pelvic and menstrual symptoms

• Severe pelvic pain, especially during menstruation
• Painful period
• Gender pain, especially during deep penetration
• Lower abdominal or lower back pain

What causes bladder endometriosis?

The exact cause of this condition is not clear, but here are a few reasons.

• Retrograde menstruation: In retrograde menstruation, blood during the period flows backward into the pelvic cavity rather than leaving the body through the fallopian tube. “This blood contains endometrial cells that can be planted and grown in the bladder, ovaries and other pelvic organs,” says the expert.
• Direct diffusion from the uterus: Endometrial tissue can spread directly from the uterus to the bladder, especially if it is close to the bladder wall.
• Surgery: “Women who have had C-section, hysterectomy, or other pelvic surgery are at higher risk,” says Jain. Endometrial cells can adhere to the bladder due to surgical trauma.
• Hormonal imbalance: High estrogen levels can promote endometrial tissue growth in abnormal locations.

How to diagnose bladder endometriosis?

“Diagnosis of bladder endometriosis can be challenging as the symptoms often mimic urinary tract infections,” experts say. If you have an infection in the urinary tract, it can also lead to frequent urination and pain during the sex.

This is how it is diagnosed:

1. Medical history and symptoms assessment

Your doctor asks you:

• Pelvic pain and duration of pain severity
• Urinary symptoms such as painful urination, urinary urination, frequent urination, and blood in the urine
• Pain during sex
• History of endometriosis
• Previous pelvic surgery

2. Urine test

Urine tests can help rule out UTI or bladder infections. Non-invasive procedures involve a physician visually examining the urine. “If your urine test is clear but you still have symptoms, it could be due to bladder endometriosis,” the expert says.

3. Ultrasound

Perfect for detecting large bladder endometriosis lesions. Transvalued ultrasound provides a detailed view of the nearby bladder and organs. “However, during this ultrasound, you may not see small or deeply embedded endometrial growth,” experts say.

Treatment of bladder endometriosis

Bladder endometriosis treatment focuses on relieving symptoms and reducing inflammation.

1. Hormonal therapy

“Hormonal therapy can lower estrogen levels and slow the growth of endometrial tissue,” says an expert. A study published in the Journal of Urology in 2020 shows that it is an effective way to manage bladder endometriosis. This can be considered a tablet or injection, but this therapy does not remove bladder lesions.

2. Laparoscopic surgery

Laparoscopic surgery, which is minimally invasive removal of lesions, is often suggested in people with bladder endometriosis. “Surgeons remove endometrial tissue from the bladder, which is effective in relieving symptoms over the long term,” says Jain.

3. Partial cystectomy

This surgery is performed in severe cases where the lesion penetrates deep into the bladder wall. The affected area of ​​the bladder is surgically removed. “It’s more invasive than laparoscopy, but it can cure. It’s recommended if bladder endometriosis has a serious effect on urination,” says the expert.

4. Dietary changes

Seek for an anti-inflammatory diet. This means you need to eat lush greenery, berries, turmeric, ginger, flaxseed and fatty fish. “These foods help reduce inflammation and control the symptoms of bladder endometriosis,” says Dr. Jain. Also, drink plenty of water and avoid spicy foods.

Endometriosis can affect a variety of body parts, including the bladder. In the case of bladder endometriosis, there are problems with pewing, pain and pain during the period. Hormonal therapy is helpful, but I hope you can go for surgery.