Do You Get Endometriosis As Soon As You Get Your Period?

Did you know that endometriosis can start as early as your first period? For years, it was believed that endometriosis only developed after many menstrual cycles, but newer research tells a different story. Endometriosis can actually begin before your first period or within the first 1-6 months after it starts.

According to the Endometriosis Association, 66% of women with endometriosis report experiencing symptoms before the age of 20. Despite this early onset, most go undiagnosed for years — with the average delay in diagnosis ranging from 6 to 12 years globally, and 15 years in North America.

But, prompt diagnosis is crucial. Not only does it help people receive care they really need, but it also helps them understand long-term health risks, and helps to make informed choices around safeguarding future fertility (if this is a goal).

What is Endometriosis?

Endometriosis is a chronic and debilitating condition which presents as extremely painful, and often unbearable periods. We don’t fully understand why endometriosis occurs, or how it develops. At this time, likely causes include immune dysfunction, pelvic inflammation, abnormal hormone production, hormone resistance, imbalanced microbiome, and genetics. Endometriosis affects 1 in 10 women of reproductive age. It’s diagnosed in 5 in 10 women experiencing infertility, and 5 in 10 women experiencing chronic pelvic pain.

If you’d like to better understand what endometriosis is, you can read more about that here.

When Does Endometriosis Start?

As mentioned above, endometriosis can start as early as the first period, with 66% of those affected experiencing symptoms before age 20. However, for many, symptoms become more severe over time due to increased exposure to estrogen throughout their reproductive years.

For some, the pain and pelvic symptoms are intense from the very beginning. For others, symptoms gradually worsen with age, and in some cases, they don’t become severe until early perimenopause, a stage often marked by higher estrogen levels that can intensify pelvic pain.

Despite these patterns, endometriosis is often diagnosed late — an average of 15 years after symptoms begin in North America. Diagnosis is usually only explored once symptoms become unmanageable or when unexplained infertility arises, leading many to receive a diagnosis in their 30s or 40s.

Why Prompt Diagnosis Matters for Fertility

If you suspect you have endometriosis and want to conceive in the future, getting an early diagnosis is crucial. There are effective treatment options — including medication and integrative approaches — that can slow the progression of endometriosis. While any stage of endometriosis can impact fertility, the earlier it’s addressed, the better your chances of conceiving without major interventions or surgery.

If you’re struggling with infertility or have been diagnosed with unexplained infertility, getting properly assessed for endometriosis is essential. In fact, it’s estimated that 44-50% of women with infertility actually have endometriosis. Identifying it early can help you choose the most effective fertility treatments, potentially saving you years of heartache, financial stress, and unsuccessful interventions.

Standard IUI or IVF protocols aren’t comprehensive enough for those with endometriosis. They don’t address the chronic inflammation in the pelvic cavity that can impair egg quality, reduce egg quantity, and increase the risk of implantation failure. A more targeted, integrative approach is key.

Next Steps: What To Do If You Suspect Endometriosis

If you are concerned or suspect you may have endometriosis, it’s really important to start closely tracking your symptoms. When you start advocating for assessment, having this data on hand is key and may help expedite a referral to a specialist. Essential signs and symptoms to look out for include:

Extremely painful periods (even if it’s only lasting for 1 day)
Chronic pelvic pain, even outside of periods
Chronic abdominal pain, low back pain, or hip pain
Painful intercourse
Painful urination or bowel movements
Digestive symptoms including nausea, vomiting, bloating, diarrhea, or constipation
Excessive menstrual bleeding and clots

Working with a Naturopathic Doctor is also incredibly important. Not only can we help provide a clinical assessment for endometriosis, but we can also set you up with integrative strategies to help minimize period pain, improve quality of life, and optimize fertility while you wait for more advanced interventions (if they are required).

A Final Word

Ultimately, endometriosis can start with your very first period. Early diagnosis is critical, as it can help preserve fertility and prevent long-term complications of endometriosis.

At The Clara Clinic, we take a proactive, integrative approach to endometriosis—helping you understand the likelihood of endometriosis earlier, and creating a personalized naturopathic plan to support your reproductive health and quality of life.

Ready to take control of your reproductive health? Book a complimentary 15-minute consult to discuss your concerns, ask questions, and explore the best next steps for you.