Can Endometriosis Cause Muscle Twitching and Fibroids: What to Know

September 13, 2025

Can Endometriosis Cause Muscle Twitching and Fibroids: What to Know

Endometriosis and uterine fibroids are two common, often confusing gynecologic conditions. Both can cause pelvic pain and menstrual changes, but they arise from different tissues and behave differently. Many readers also ask about less typical symptoms, such as muscle twitching, and whether endometriosis can lead to fibroids. Here’s what the evidence and expert sources from U.S. health agencies say.

Quick definitions

What is endometriosis?

Endometriosis occurs when tissue similar to the uterine lining grows outside the uterus (such as on the ovaries, fallopian tubes, bowel, or pelvic peritoneum). It is estrogen-responsive and can cause inflammation, scarring, and pain—especially around menstruation. Common symptoms include pelvic pain, painful periods, pain with sex, gastrointestinal discomfort, and infertility for some individuals. (Source: NIH/NICHD)

What are uterine fibroids?

Fibroids (leiomyomas) are noncancerous tumors of the muscular wall of the uterus. They are also influenced by estrogen and progesterone. Many people have no symptoms, while others experience heavy or prolonged menstrual bleeding, pelvic pressure, frequent urination, constipation, back pain, or reproductive issues. (Source: NIH/NICHD)

Can endometriosis cause muscle twitching?

Muscle twitching (also called fasciculations) refers to small, involuntary muscle contractions. Generalized muscle twitching is not considered a classic symptom of endometriosis. However, there are plausible pathways by which people with endometriosis and chronic pelvic pain may experience localized muscle spasms or twitch-like sensations.

Why twitching or spasm-like sensations can occur

Pelvic floor muscle spasm and myofascial pain: Chronic pelvic pain—common in endometriosis—can be associated with overactive or tender pelvic floor muscles. These muscles may spasm, causing aching, cramping, or twitch-like sensations in the pelvis, lower abdomen, or hips. Clinical research has linked chronic pelvic pain syndromes with pelvic floor myofascial dysfunction, which can coexist with endometriosis.
Nerve irritation and sensitization: Endometriosis can inflame or irritate nearby nerves, contributing to heightened pain signaling. Central sensitization (an amplified pain response within the nervous system) is reported in chronic pelvic pain and may make muscle tension or spasms feel more pronounced.
Whole-body factors: Anxiety, stress, caffeine, dehydration, and electrolyte imbalances (e.g., low magnesium) can all trigger muscle twitching in the general population, regardless of endometriosis. If you notice new, widespread twitching, think broadly about triggers and discuss them with a clinician. (Source: MedlinePlus)

Bottom line: Endometriosis does not typically cause generalized muscle twitching throughout the body. But in the pelvis, muscle spasm or twitch-like sensations can occur as part of chronic pelvic pain and pelvic floor dysfunction. If twitching is persistent, worsening, or occurs beyond the pelvic region, a clinician should evaluate for other neurologic or metabolic causes.

Does endometriosis cause fibroids?

No. Endometriosis does not cause fibroids, and fibroids do not cause endometriosis. They are distinct conditions:

Endometriosis: growth of endometrium-like tissue outside the uterus.
Fibroids: benign tumors of the uterine muscle (myometrium).

That said, the two conditions can co-occur in the same person. Both are influenced by estrogen, and both are common in reproductive-age individuals. Some studies report that people with one condition may be more likely to be diagnosed with the other, potentially due to shared hormonal and genetic factors or because clinicians look more closely once any gynecologic condition is found. But one does not directly cause the other. (Sources: NIH/NICHD)

How to tell them apart: key symptom patterns

Endometriosis: cyclical pelvic pain, painful periods, pain during or after sex, pain with bowel movements or urination (especially around menses), bloating, and sometimes infertility. Bleeding may be normal or heavy.
Fibroids: heavy or prolonged menstrual bleeding, pelvic pressure or bulk symptoms (bloating, urinary frequency), constipation, back or leg pain. Pain may be less cyclical and more related to size or location of fibroids.

Imaging can help identify fibroids (ultrasound, MRI). Endometriosis often requires laparoscopy for definitive diagnosis, though imaging can suggest certain lesions (e.g., endometriomas on the ovaries).

When to seek medical care

See a clinician if you experience:

Severe or worsening pelvic pain
Heavy bleeding (soaking pads/tampons every 1–2 hours)
Painful periods that interfere with work or daily life
Unexplained muscle twitching that persists, spreads, or is accompanied by weakness, numbness, or other neurological symptoms
Difficulty becoming pregnant

Primary care clinicians, OB-GYNs, and pelvic pain specialists can help determine whether symptoms stem from endometriosis, fibroids, pelvic floor dysfunction, or other conditions.

Treatment options

Endometriosis

Nonsteroidal anti-inflammatory drugs (NSAIDs) for pain.
Hormonal therapies: combined hormonal contraceptives; progestins; and GnRH modulators. The FDA has approved elagolix for moderate to severe pain associated with endometriosis; combination therapies containing relugolix are also FDA-approved for endometriosis-related pain. Discuss benefits, risks, and bone health monitoring with your clinician.
Pelvic floor physical therapy: For patients with pelvic floor spasm or myofascial pain, targeted physical therapy can reduce pain and improve function.
Surgery: Laparoscopic excision or ablation of lesions can relieve pain and improve fertility in selected patients.

Uterine fibroids

Watchful waiting for small, asymptomatic fibroids.
Medical therapy: hormonal contraceptives or progestins to reduce bleeding; tranexamic acid for heavy menses; GnRH agonists/antagonists to shrink fibroids short term. The FDA has approved a relugolix/estradiol/norethindrone acetate combination to treat heavy menstrual bleeding due to fibroids.
Procedures: uterine artery embolization, MRI-guided focused ultrasound, myomectomy (surgical removal), or hysterectomy, depending on symptoms, size, location, and fertility goals.

Because treatments can affect bone density, fertility, and symptoms differently, personalized care with a clinician familiar with both conditions is important.

Practical tips for muscle twitching with pelvic pain

Track triggers: caffeine, dehydration, stress, and sleep loss can increase twitching.
Hydrate and maintain balanced electrolytes through diet; ask your clinician before taking supplements.
Consider pelvic floor physical therapy if exam suggests muscle spasm.
Use heat, gentle stretching, and relaxation techniques (diaphragmatic breathing, biofeedback) to reduce muscle tension.
Review medications with your clinician if new twitching began after a change in therapy; consult FDA Medication Guides when available.

The takeaway

Endometriosis does not cause fibroids, but the two conditions can coexist and share hormonal influences. Generalized muscle twitching is not a hallmark of endometriosis; however, pelvic floor muscle spasms and heightened pain sensitivity can create twitch-like or cramping sensations in people with chronic pelvic pain. If you’re experiencing these symptoms—especially alongside heavy bleeding, severe pain, or new neurological signs—seek a thorough evaluation. Evidence-based treatments exist for both endometriosis and fibroids, and adding pelvic floor care when appropriate can meaningfully improve quality of life.

Sources and further reading

NIH/NICHD – Endometriosis: https://www.nichd.nih.gov/health/topics/endometri
NIH/NICHD – Uterine Fibroids: https://www.nichd.nih.gov/health/topics/uterine/conditioninfo/fibroids
U.S. Office on Women’s Health – Endometriosis: https://www.womenshealth.gov/a-z-topics/endometriosis
U.S. Office on Women’s Health – Uterine Fibroids: https://www.womenshealth.gov/a-z-topics/uterine-fibroids
MedlinePlus (NLM/NIH) – Muscle twitching: https://medlineplus.gov/ency/article/003296.htm
FDA – Endometriosis treatments (e.g., elagolix) and Medication Guides: https://www.fda.gov/drugs
FDA – Myfembree (relugolix/estradiol/norethindrone acetate) for heavy menstrual bleeding due to fibroids and for endometriosis pain: https://www.fda.gov/drugs