Endometriosis & Autonomic Dysfunction: The Overlooked Connection

When most people think of endometriosis, they think of pelvic pain.

But for many patients, endometriosis affects far more than the reproductive system.

Increasingly, researchers and clinicians are recognizing a connection between endometriosis and autonomic dysfunction — a condition that affects how the body regulates essential functions like heart rate, blood pressure, digestion, and temperature.

What is autonomic dysfunction?

The autonomic nervous system (ANS) controls automatic functions we don’t consciously think about, including:

Heart rate and blood pressure

Digestion and bowel motility

Bladder control

Temperature regulation

Blood flow

When the ANS doesn’t regulate these functions properly, it’s called autonomic dysfunction, or dysautonomia.

Common forms include:

POTS (Postural Orthostatic Tachycardia Syndrome)

Orthostatic hypotension

Vasovagal syncope

How does this relate to endometriosis?

🔹 Chronic inflammation

Endometriosis is a chronic inflammatory disease. Persistent inflammation can irritate nerves and interfere with autonomic signaling over time.

🔹 Pelvic nerve involvement

Endometriosis can affect pelvic and autonomic nerve pathways, influencing:

Bladder and bowel function

Blood pressure regulation

Pain signaling beyond the pelvis

🔹 Central sensitization

Many people with endometriosis develop central sensitization, where the nervous system becomes hypersensitive. This is strongly linked to dysautonomia and chronic fatigue–type symptoms.

🔹 Overlap with related conditions

Endometriosis often overlaps with:

POTS

Hypermobile Ehlers-Danlos syndrome (hEDS)

Mast Cell Activation Syndrome (MCAS)

IBS and bladder pain syndromes

All of these conditions involve autonomic dysfunction.

🔹 Chronic pain keeps the body in “fight or flight”

Long-term pain can push the nervous system into a constant sympathetic (stress) state, disrupting vagal tone and autonomic balance.

Common autonomic symptoms reported by endometriosis patients:

Dizziness or fainting when standing

Rapid heart rate or palpitations

Temperature sensitivity

Digestive issues

Bladder urgency or difficulty emptying

Severe fatigue

Exercise intolerance

Why this matters

Understanding this connection helps explain why endometriosis:

Causes whole-body symptoms

Is often misdiagnosed or minimized

Requires multidisciplinary care, not just gynecology.

Endometriosis is not “just a period problem.”

It is a complex, systemic disease.