Which of the following are common overt signs of endometriosis?

Premenstrual pelvic pain is a common overt sign of endometriosis. This condition is characterized by the presence of endometrial-like tissue outside the uterus, which often responds to hormonal changes throughout the menstrual cycle. As a result, many women with endometriosis experience significant pain in the days leading up to their menstrual period. This pain is typically due to inflammation and the effects of menstruation itself on the ectopic endometrial tissue.

Many women report this specific type of pain, which can vary in intensity but is often severe enough to interfere with daily activities. The timing of this symptom—occurring before menstruation—aligns closely with the pathophysiology of endometriosis, where the ectopic tissue grows and sheds in synchronization with the menstrual cycle, leading to pain that is notably premenstrual.

When considering other potential signs of endometriosis, heavy menstrual bleeding can occur but is not as specific or universally present as pelvic pain. Atypical leg pain can be associated with various conditions and is not a classic symptom of endometriosis. Infertility can be a consequence of endometriosis, but it is not typically categorized as an overt sign of the disease in the same way that pelvic pain is.