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Bleeding from the rectum only during menstruation can be commonly attributed to the presence of a condition called endometriosis.

What is Endometriosis?

It is a benign condition in which the tissue lining the uterus is found in areas other than the uterus. The endometrial lining is shed off by the body during menstruation, however, in some conditions, this lining can actually be found in other places like the rectum, bladder, intestines, ovaries or even some other areas of the body in rarer cases.

The endometrial lining may be present in an abnormal location, however, it attempts to behave in the same manner as that present in the uterus. As a result, the lining is affected by the hormonal cycle and shed during the menstruation period.

What is the cause behind Endometriosis?

The exact cause behind this occurrence is unknown although genetic factors, hormonal changes or a recent pelvic surgery are some of the suspected factors.

Symptoms of Endometriosis

The most common symptoms is that of heavy bleeding during menstruation often accompanied with pain and discomfort. Patients may also experience pain during sexual activity, difficulty in getting pregnant, infertility, bleeding from the rectum during menstruation and a feeling of nausea just before menstruation.


The diagnosis is arrived to by the help of a detailed medical history, physical pelvic examination, directly viewing the endometrial tissue and/or a biopsy of the abnormally placed endometrial tissue.

A lot of the times, a diagnosis of endometriosis is made during a laparoscopic procedure. The doctor can then remove the endometrial tissue during this procedure itself providing relief to the patient from the symptoms and increasing their chances of getting pregnant at the same time.


The treatment for endometriosis may be done surgically, through prescription hormones or a combination of the two.

The first step of treatment usually involves the use of contraceptive pills which contain low doses of hormones. These help to suppress the ovulation and menstruation which will, in turn, reduce the associated symptoms.

Research has also shown that just the use of these contraceptive pills may be enough for the extra uterine endometrial tissue to get destroyed over a period of time without any other intervention.

If, however, this low dose hormonal therapy does not work then a surgical procedure to remove the offending uterine tissue will have to be undertaken. It is rare but some doctors and their patients may also decide to straight away go for the surgical option rather than trying the hormonal therapy at all.

A combination of the patient's age, affordability as well as the severity of symptoms are taken into account before coming to a treatment plan. Ideally, a gynecologist, gastroenterologist, and anesthesiologist will be consulted during this time to get the complete picture.


Once a diagnosis of endometriosis has been reached, the patient should feel relieved that the cause of bleeding from the rectum or other areas of the body is not something more sinister. Endometriosis is treated successfully in most of the cases with precision and ease.

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