Endometriosis can be linked with bladder and urinary symptoms. These symptoms may flare around a period, happen throughout the month, or be mistaken for urine infections.

Bladder symptoms can be frustrating and worrying, especially if tests for infection keep coming back negative or symptoms return again and again.

This article explains bladder and urinary symptoms that may be worth tracking and discussing with a healthcare professional.

Symptoms to look out for

Bladder and urinary symptoms may include:

  • pain when passing urine
  • bladder pressure
  • needing to wee more often
  • urgency to wee
  • pain when the bladder is full
  • pain after emptying the bladder
  • pelvic pain linked with urination
  • blood in the urine, especially if cyclical
  • repeated UTI-like symptoms
  • negative urine infection tests despite symptoms
  • night-time urination
  • pain that flares before or during a period

These symptoms can have different causes, so proper assessment matters.

Why urinary symptoms can happen

Urinary symptoms may be linked with endometriosis involving the bladder, endometriosis involving or pressing near the ureters, inflammation, adhesions, pelvic floor muscle tension, pain sensitivity, urinary tract infection, or other bladder pain conditions.

Users do not need to know the cause before asking for help. Their role is to explain what is happening clearly so a healthcare professional can decide what assessment is needed.

Why ureter symptoms matter

The ureters are the tubes that carry urine from the kidneys to the bladder.

Endometriosis involving the ureters can be important because it may affect urine flow from the kidney. This does not mean every person with urinary symptoms has ureter involvement, but symptoms should not be ignored.

Users should ask about further assessment if they have urinary symptoms alongside suspected or confirmed endometriosis, especially if symptoms are severe, cyclical or worsening.

Repeated UTI-like symptoms

Some people experience symptoms that feel like urine infections, such as burning, urgency or bladder pain, but infection tests may be negative.

This can happen for several reasons. It may be linked with bladder irritation, pelvic floor tension, bladder pain conditions, endometriosis or another cause.

A negative infection test does not automatically mean symptoms are not real or not worth investigating.

What to track before an appointment

Users should use the Prepare for Appointment Tool to organise urinary symptoms.

It can help record how often they wee, urgency, pain before/during/after urination, whether pain changes when the bladder is full or empty, whether symptoms flare around a period, whether urine tests have shown infection, whether there is blood in the urine, whether symptoms happen with bowel or pelvic pain, and whether symptoms affect sleep or daily life.

Example wording: "My bladder pain is worse when it is full and flares during my period."

Questions to ask

Users may want to ask:

  • Could my bladder symptoms be linked with endometriosis?
  • Could my symptoms be caused by pelvic floor tension?
  • Should I have urine tests or imaging?
  • Is bladder or ureter involvement possible?
  • Should I be referred to urology?
  • Should I be seen by an endometriosis specialist?
  • What symptoms should make me seek urgent help?

When to seek urgent medical help

Seek urgent medical help for blood in the urine, fever with urinary symptoms, severe back or flank pain, vomiting with urinary symptoms, inability to pass urine, severe sudden pelvic or abdominal pain, signs of kidney infection, or new loss of bladder control.

Final reminder

Bladder symptoms can be linked with endometriosis, but they can also have other causes. They deserve proper assessment, especially if symptoms are cyclical, severe, recurring or affecting life.