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The Difference Between IBS, Endometriosis, and Painful Periods

Published on 04/29/21

Determining pain in your pelvic area can be very difficult to determine what’s causing a total discomfort. These pains can vary – maybe you deal with constipation, diarrhea, nauseousness, mild to severe cramping or maybe, pain during intercourse or during a bowel movement. These can be mildly annoying to entirely interruptive and incapacitating. 

Common PMS and Period Pains

We all know that cramps just come with the period territory. It’s not an uncommon symptom of premenstrual syndrome, or PMS. In fact, more than 50% of women say they deal with some level of pain or discomfort from one to two days a month. Cramping happens when hormone-like substances help the uterus shed its lining by causing it to contract. 

Other discomforts may revolve around diarrhea, nausea, constipation, emotional stress like anxiety, irritability, depression and moodiness. These typically start right before your period and may dissipate as your period starts. 

Although it sounds like this is a common occurrence for most women, cyclical timing helps determine PMS from other conditions. If you experience discomfort that cannot be remedied by over the counter medications like ibuprofen and your symptoms incapacitate you by preventing you from doing daily activities, it’s time to schedule an appointment with your doctor.


Unlike PMS symptoms from your period cycle, pain from endometriosis isn’t caused by the contractions of the uterus. It’s caused by the implantation of cells outside of the uterus from the bowel, bladder or pelvic cavity which causes inflammation, which causes pain.

Endometriosis affects over 6 million women in the United States alone. You should talk to your doctor if you experience symptoms like fatigue, painful periods, intestinal pain, pelvic pain, bladder pain, and pain with sex.

One of the most common signs of endometriosis is pain during your period but you may also feel that pain in combination with urination, bowel movements and intercourse. It may also cause irregular cycles from every two to six week or even skipping whole months entirely. 

One of the most profound ways of distinguishing endometriosis from IBS, or irritable bowel syndrome, is that the pain is cyclical and normally revolves around your period.

However, some women have constant pain so it cannot be ruled out entirely.

Endometriosis can be hard to diagnose because the symptoms can be associated with other conditions. Some women chalk it up to “terrible periods” altogether. Not realizing these symptoms are a collection of signs for a more serious condition.

There is no prevention or cure for endometriosis, but it can be treated. It’s very common to treat endometriosis with hormone therapies like birth control pills, patches, the ring, or injections. This helps inhibit ovulation and suppresses the secretion of hormones. There are also medications that can be prescribed that work in the brain to help stimulate the ovaries. This only happens after there’s an endometriosis diagnosis through surgery when there are clear signs of inflammation and scarring.

Another way of managing endometriosis is through pregnancy. Pregnancy’s side effect is the suppression of the ovaries. Unfortunately, the scarring caused by endometriosis can make it very difficult to get pregnancy but does not affect the pregnancy once conceived. 

The only way to treat endometriosis entirely is to remove the ovaries and uterus entirely. This isn’t optimal for all patients, especially for young females who wish to become pregnant in the future. However, for older patients, this can help adjust all levels of discomfort.


Although the symptoms can be felt as low as the pelvic area, IBS generally affects the large intestine. This causes abdominal bloating, constipation, cramping, and diarrhea. You’ll also find that the pain doesn’t coincide with your cycle. The discomfort felt by IBS can be at any time of the week and continue over the course of months. 

Most of the time, IBS is diagnosed by the pain associated with or after a bowel movement. Which also changes the frequency of your bowel movements. 

Curing IBS isn’t an option but managing it can be done through lifestyle and dietary changes, probiotics, mental health therapies, and even medicines to help treat symptoms. 

If you’re feeling pain that keeps you from partaking in your daily activities – whether it be PMS, endometriosis or IBS – it’s time to talk to your doctor and make an appointment today to discuss diagnosis and a plan of treatment.

How Can You Tell The Difference?

As discussed above, a majority of symptoms between PMS, endometriosis, and IBS are extremely similar. So, how do you know, or how can you tell the difference between the three conditions? To top it off, menstruation can intensify these symptoms which can cause diagnosing these issues to become confused with other conditions.

Better understanding of the main differences between all three conditions can help you determine the right diagnosis, or encourage you to make an appointment with your healthcare provider about treatment. 

Endometriosis And It’s Symptoms

Endometriosis is when the uterine lining starts to grow on other organs outside the uterus. This can prevent a woman from shedding her endometrial lining during her period. Because of this, the result can lead to cysts and/or inflammation. 

These types of tissue growths can also grow on the organs in the lower abdomen and interfere with bladder and bowel functions.

Because endometriosis pains tend to intensify around a woman’s cycle, it tends to go undetected. Many women assume that the symptoms they experience are only related to menstruation.

If the growths develop around the large intestine, this type of inflammation can contribute to bowel movements specifically and can cause confusion with a diagnosis of IBS.

Common symptoms of endometriosis may include:

  • Strong abdominal pain and cramping, particularly during one’s period (dysmenorrhea), but maybe present throughout the cycle
  • Pain experienced during or after sexual intercourse (dyspareunia)
  • For some women, infertility
  • Bladder difficulties
  • Infertility
  • Pain during bowel movements
  • Constipation
  • Diarrhea
  • Nausea and/or vomiting
  • Irregular bleeding between periods
  • Vaginal tenderness

IBS and Digestive Symptoms

  • Pain during bowel movements
  • Difficulty having a bowel movement
  • At times, the severe abdominal pain resulting from endometriosis may be accompanied by nausea, diarrhea, and/or vomiting

Endometriosis VS IBS

Both conditions share common symptoms like cramping and lower abdominal pain. Aside from these, some IBS patients report having one or couple additional symptoms:

  • Nausea
  • Abdominal distension
  • Constipation
  • Diarrhea
  • Colicky pain
  • Upper abdominal pain

If you notice that your symptoms worsen around your period, it’s likely you don’t have IBS, you have endometriosis. Talk to your gynecologist about your discomforts and symptoms to ensure the necessary tests are utilized for an accurate diagnosis.

However, some women may have endometriosis present without any symptoms present and may confuse pain with a normal part of getting a period. In other cases, women who have endometriosis are at higher risk of an inaccurate diagnosis of IBS. 

Why such confusion on both conditions? Mainly, when the uterine tissue grows alongside the large intestine, the inflammation is associated with bowel movements which can be confused with IBS pain with bowel movements. 

The Differences To Look For:

Even though both conditions can result in cramping and abdominal pains in the same location. There are some important differences between the two health disorders. Research shows that IBS patients are more likely to report these symptoms:

  • Bowel habit changes, i.e. constipation, and/or diarrhea
  • Colicky pain
  • Distension
  • Nausea
  • Upper abdominal pain
  • Pain worsened by food and/or stress

Versus Endometriosis Patients Who Reported…

  • Bleeding between periods
  • Increased pain during the premenstrual phase of the menstrual cycle
  • Tenderness within the vagina

If you start to notice pains worsening around the time of your period, you may feel concerned that you’ve been misdiagnosed. If you have questions about your previous diagnosis or looking for a new one, set up an appointment to speak with your gynecologist. Diagnosing endometriosis can be difficult. The only way to be truly diagnosed through a surgery called laparoscopy. So don’t be discouraged and call your healthcare provider for more information to help determine how to properly manage your pains.

Need Medical Help Diagnosing Your Lower Abdominal Pain? Call Rosh MFM in NYC To Book An Appointment!

The doctors at Rosh Maternal & Fetal Medicine are experts at determining the precise cause of your pain and initiating a customized treatment plan to alleviate the pain and correct the underlying cause. When you have sudden, severe pain, don’t wait to get medical help. Call their office in the Midtown East area of New York City, or go to your local emergency department.

These underlying health problems should be treated to prevent more serious problems from developing. You can count on the extensive experience of the doctors at Rosh Maternal & Fetal Medicine to identify the cause and effectively treat endometriosis. If you have any questions about your menstrual periods or pains, call their office in the Midtown East area of New York City, or schedule an appointment online.

Talk to our team by phone or book an appointment online to get started. Call one of our six convenient NYC locations or schedule a video consultation online today! They’ve helped thousands of women. Come visit your NYC OBGYN.