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Many people with endometriosis have painful, heavy periods and pelvic pain. Sometimes, endometriosis growths affect the nerves around the pelvis, which can cause pain in the legs, hips, and buttocks.

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Endometriosis is a chronic condition. It involves tissue similar to that which grows in the uterus growing anywhere else. A doctor may refer to this as “endometrial-like tissue.”

The tissue may grow around some of the many nerves that run through the pelvis and hips. This can cause leg pain. Endometriosis can also cause inflammation, scarring, pelvic pain, and infertility.

Explore this fully interactive 3D model that shows endometrial-like tissue growing outside the uterus.

Diagnosing endometriosis-related leg pain can be difficult because many other medical conditions that are better understood and easier to diagnose can also cause leg pain.

In this article, we give more detail about how endometriosis might cause leg pain and how to treat it — at home or with a doctor’s help.

A person with endometriosis may have pain in their lower body if the condition affects the nerves in or around the pelvis.

It is difficult to estimate how many people have endometriosis because the condition is often undiagnosed. By some calculations, at least 1 in 10 women in the United States have endometriosis.

Research on the prevalence of leg pain in people with endometriosis is relatively new. But a 2016 study found that as many as half of all people with endometriosis may have some degree of leg pain.

During regular menstruation, the lining of the uterus sheds and leaves the body through the vagina. This happens in response to changing hormone levels. When endometrial-like tissue grows outside the uterus, the cells of this tissue still shed, but they cannot leave the body.

This can cause a range of symptoms, and it can also put pressure on the pelvic nerves. This may lead to pain and numbness in the hips, buttocks, and legs.

Leg pain associated with endometriosis can involve endometrial-like growths on the sciatic nerve or one of its branches. This is known as sciatic endometriosis.

The sciatic nerve is the largest and longest nerve in the body. It begins in the lower back and runs through the pelvis and down the leg into the foot, branching into several smaller nerves along the way. Pressure on this nerve can cause pain in the lower body.

The sciatic nerve provides sensation to most of the lower body. Pressure on this nerve can cause a range of symptoms, but primarily pain, numbness, and tingling that radiates to the:

  • outside of the legs
  • back of the thighs and calves
  • knees
  • soles, heels, and tops of the feet
  • hips
  • buttocks

A person typically only has this pain during their period because the cause is endometrial-like tissue, tissue similar to that which lines the uterus.

In more severe cases, the pain may be more constant but worsen during periods.

Other symptoms of endometriosis

If a person has these growths on pelvic nerves, they may have growths elsewhere in the pelvic region, causing other symptoms.

Common symptoms of endometriosis include:

  • extremely painful, heavy periods
  • lasting pelvic, abdominal, and sometimes lower back cramps and pain
  • diarrhea or constipation
  • pain when using the bathroom during a period
  • blood in urine or stool during a period
  • migraine headaches
  • pain after or during sexual activity
  • nausea and vomiting
  • unexplained fatigue
  • frequent or lasting yeast infections

Some people with endometriosis have symptoms sporadically, such as when the growths are blocking or restraining a pelvic or abdominal organ.

Without treatment, endometriosis may eventually cause pelvic or abdominal pain most of the time.

Leg pain from endometriosis can be similar to leg pain from other causes. A doctor typically begins by asking questions to help identify the cause.

Next, they may ask about more typical endometriosis symptoms. In most cases, a person with leg pain from endometriosis also has other symptoms.

A doctor may be able to diagnose the condition with a pelvic exam. Rarely, though, a person may only have symptoms in the leg, so a pelvic exam may not help.

If the symptoms and the results of a pelvic exam point to endometriosis, a doctor needs to confirm that there are growths of endometrial-like tissue in the pelvic area or elsewhere. Usually, they do this with laparoscopy, a CT or MRI scan, or a transvaginal ultrasound.

Treating endometriosis generally helps relieve all pain associated with the condition.

Natural remedies

If a person’s pain is not interfering with their daily life, they may choose to manage it naturally.

Some strategies include:

  • gentle stretching that focuses on the muscles of the buttocks, thighs, calves, and feet
  • gentle exercise, such as yoga, swimming, or walking
  • taking over-the-counter pain medications, some of which are available for purchase online, including aspirin, acetaminophen, and ibuprofen
  • using pain-relieving creams, gels, or ointments, some of which are available for purchase online, including tiger balm
  • staying hydrated, as dehydration can intensify inflammation and pain throughout the body
  • wrapping an ice pack in a cloth and applying it to the painful area for 15-minute periods several times a day
  • applying heat to the affected area using a heating pad or hot water bottle several times a day
  • minimize stress, especially during or after a period, or when symptoms are at their worst
  • talking with a mental health professional to get help managing the stress of living with chronic pain
  • learning and practicing mindful exercises, such as meditation and guided visualization, to help distract from pain and stress
  • trying alternative therapies, such as acupuncture and massage therapy

A person may also find that taking natural supplements that contain antioxidants and anti-inflammatory compounds can help with symptoms. A person can incorporate more of these compounds into their diet by eating more fruits and vegetables rich in fiber and antioxidants, such as leafy green vegetables, berries, and citrus fruits.

Some lean meats and nuts, including fish, walnuts, almonds, and sesame seeds, also contain anti-inflammatory compounds, such as omega-3 fatty acids.

A person should limit foods linked with inflammation, such as red meats, alcohol, and heavily refined or preserved foods.

Other foods, compounds, and drinks with components that may provide some relief include:

  • celery juice
  • chamomile tea
  • green tea
  • soy
  • citrus fruits
  • grapes
  • garlic
  • magnesium glycinate
  • omega-3 fatty acids
  • ginger
  • curcumin
  • turmeric

Preliminary research has shown that probiotics may help treat endometriosis symptoms. Other research has shown that vitamins C and E may reduce the severity of endometrial pain.

Medical treatments

If home care strategies are not effective, a doctor may recommend medication to reduce the production of hormones that regulate ovulation and menstruation. The treatment might involve hormonal birth control or other hormonal medications.

When other approaches do not help reduce endometriosis-related leg pain, a person may need surgery, which is usually laparoscopic.

Among other complications, endometriosis can cause chronic pain, discomfort, and infertility. Around 30–40% of people with endometriosis cannot conceive, because of internal scarring.

The severity of the complications usually depends on the location, size, and thickness of the growths.

When endometriosis involves leg pain, additional complications may include:

  • difficulty sitting, especially for long periods or on hard surfaces
  • difficulty walking
  • limping
  • inactivity
  • loss of muscle mass in the buttocks, thighs, and calves
  • altered sensation in the legs and feet
  • trouble falling and staying asleep
  • restless leg syndrome
  • missing work due to the pain
  • being unable to do day-to-day tasks because of the pain, especially before and during menstruation
  • depression or anxiety

Very rarely, a person with leg, hip, and buttock pain caused by untreated endometriosis loses some sensation in their legs or feet.

A person with any of the above symptoms should see a doctor as soon as possible.

Below are answers to some common questions about pain from endometriosis.

How do I explain endometriosis pain?

Anyone with unusually severe pelvic pain, or pain elsewhere, that seems to align with their menstrual cycle may have endometriosis. This pain may feel as if something is pushing or pulling down on the affected area. A person may also have stabbing pain, abdominal bloating, and other digestive symptoms. Overall, each person with endometriosis may experience the pain differently.

Can endometriosis cause leg pain before or during your period?

When endometrial-like tissue grows outside the uterus, it can cause pain in the affected area. This typically happens when the person has a period. However, endometriosis can also cause pain throughout a person’s cycle.

Can endometriosis cause upper or lower leg pain?

Usually, endometrial-like tissue grows and causes pain in the pelvic area or abdominal cavity, but it can grow in other parts of the body. Endometriosis pain in the upper leg, near the buttocks, may mean that the condition is affecting the sciatic nerve.

Endometriosis can affect a range of pelvic and abdominal organs and structures, including the pelvic nerves that supply sensation to the legs. If the growths that characterize endometriosis develop on these nerves, a person may have leg pain.

Speak with a doctor about frequent or lasting leg pain, especially if it gets much worse during a period. Without treatment, endometriosis growth on a nerve may cause serious complications.