Fibroids and Endometriosis Navel Pain: Why It Happens and What Helps

September 13, 2025

Fibroids and Endometriosis Navel Pain: Why It Happens and What Helps

Navel (belly button) pain isn’t the first symptom most people associate with fibroids or endometriosis, but it can happen. Whether the pain is a dull ache around the umbilicus, a sharp twinge that worsens around your period, or a tender spot at the belly button itself, understanding why it occurs can point you to relief. This guide explains how fibroids and endometriosis can cause navel pain, what else to consider, how clinicians diagnose the problem, and which treatments have evidence behind them.

Why fibroids or endometriosis can cause navel pain

Fibroids: referred pain and pressure

Uterine fibroids are noncancerous growths of the muscle wall of the uterus. They commonly cause heavy menstrual bleeding, pelvic pressure, and lower back pain. Less commonly, fibroids contribute to pain felt near the belly button. Reasons include:

Referred pain along nerve pathways: The skin around the umbilicus corresponds to the T10 dermatome. Pelvic organs share nerve pathways with abdominal wall areas, so uterine pain can be perceived higher in the abdomen.
Mass effect and stretching: Large or multiple fibroids can enlarge the uterus, stretching ligaments and peritoneum. This can create a sense of fullness, bloating, or discomfort that is felt centrally, including at or near the navel.
Constipation and bloating: Fibroids can press on the bowel, worsening constipation, which itself can cause periumbilical pain.

Navel pain from fibroids is more likely when fibroids are large, subserosal (on the outer surface of the uterus), or when there’s significant abdominal distension.

Endometriosis: cyclic pain and, rarely, umbilical lesions

Endometriosis occurs when tissue similar to the uterine lining grows outside the uterus. It can inflame, bleed, and irritate nearby nerves, especially around menstruation. Navel pain related to endometriosis can arise via:

Referred pain: Pelvic endometriosis can sensitize nerves so pain is “mapped” to the central abdomen.
Umbilical (cutaneous) endometriosis: Rarely, endometrial-like tissue implants in the belly button (sometimes called Villar’s nodule). Signs include a tender, sometimes bluish-brown spot at the navel that may swell or even bleed around periods.
Abdominal wall endometriosis: Endometriosis can occur in surgical scars (for example, after a C-section or laparoscopy), occasionally near the umbilicus, causing focal, cyclical pain.

Clues that endometriosis is involved include pain that peaks just before or during menstruation, dyspareunia (pain with sex), painful bowel movements during periods, or a visible navel lesion that changes with the cycle.

Other causes of belly button pain to rule out

Navel pain isn’t always gynecologic. It’s important to consider:

Umbilical or ventral hernia: A bulge that may hurt with coughing, lifting, or straining.
Appendicitis: Classically begins as periumbilical pain then shifts to the lower right abdomen; often accompanied by fever or nausea.
Gastrointestinal issues: Constipation, gastritis, irritable bowel syndrome, or inflammatory bowel disease can cause periumbilical discomfort.
Skin and soft-tissue conditions: Infection, cysts, or irritation in the navel.
Pregnancy-related changes: Rapid stretching or umbilical hernia development.

Seek urgent care if you have severe or worsening pain, fever, persistent vomiting, a hard abdominal bulge, bloody stools, fainting, a positive pregnancy test with acute pain, or inability to pass stool or gas.

How clinicians figure it out

History and exam: Your clinician will ask about timing (relation to menstrual cycle), associated symptoms (bleeding patterns, bowel or bladder changes), prior surgeries, and whether a navel lump or color change is present. They’ll examine the abdomen, umbilicus, and pelvis.
Imaging: Pelvic ultrasound is first-line to detect and map fibroids and assess other pelvic structures. MRI can better characterize fibroids, abdominal wall masses, or suspected umbilical endometriosis. If there’s a focal umbilical lesion, targeted ultrasound can help.
Diagnostic laparoscopy: Endometriosis is definitively diagnosed by surgical visualization and (ideally) biopsy, though many patients are treated based on symptoms and imaging without immediate surgery.
Pathology for umbilical lesions: If an umbilical nodule is removed, a pathology exam confirms endometriosis and rules out other rare conditions.

What helps: evidence-based options

Self-care and symptom control

NSAIDs: Over-the-counter ibuprofen or naproxen can reduce inflammatory pain. Use the lowest effective dose for the shortest time and follow label directions; talk to a clinician if you have heart, kidney, stomach, or bleeding risks.
Heat and gentle movement: Heat packs and low-impact exercise may ease cramping and referred pain.
Bowel care: Hydration, fiber, and, if needed, short-term stool softeners can reduce constipation-related periumbilical pain.

Medications that treat the condition

Your clinician may suggest one or more of the following, tailored to symptoms, goals, and medical history:

Combined hormonal contraceptives (pill, patch, ring): Can lessen endometriosis-related pain and fibroid-related bleeding for many.
Progestin-only options: Oral progestins, the injection, or a levonorgestrel-releasing IUD can suppress endometrial growth and reduce pain/bleeding.
Tranexamic acid: A non-hormonal option taken during menses that reduces heavy bleeding from fibroids.
GnRH agonists/antagonists with add-back therapy: Medicines that lower estrogen to shrink fibroids and suppress endometriosis activity. FDA-approved examples include elagolix for endometriosis pain and combination therapies (elagolix+estradiol+norethindrone; relugolix+estradiol+norethindrone) for heavy bleeding from fibroids and for endometriosis pain. Because low estrogen can cause hot flashes and bone loss, “add-back” hormones are used to protect bone and reduce side effects.

Procedures and surgery

For fibroids: Options include myomectomy (surgical removal of fibroids), uterine artery embolization (blocking blood supply to shrink fibroids), MRI-guided focused ultrasound, and hysterectomy (uterus removal). Choice depends on size, number, location, symptoms, and fertility goals.
For endometriosis: Laparoscopic excision or ablation of endometriosis lesions can improve pain and, for some, fertility.
For umbilical endometriosis: Local surgical excision of the navel lesion is typically recommended, often curative, with pathology confirmation.

Discuss fertility plans with your clinician before any treatment; some approaches are better for those wishing to preserve or pursue pregnancy.

When to see a clinician

Pain that is persistent, worsens over time, or disrupts daily life
Navel discoloration, swelling, or bleeding—especially if cyclical
Heavy menstrual bleeding (soaking pads/tampons hourly, passing large clots, or anemia symptoms like fatigue or shortness of breath)
New abdominal bulge or suspected hernia

For urgent symptoms (sudden severe pain, fever, vomiting, fainting, pregnancy with pain, inability to pass stool/gas), seek emergency care.

What to track before your appointment

When the pain occurs and how it relates to your cycle
Any visible changes at the belly button (color, swelling, drainage)
Prior surgeries (C-section, laparoscopy) and family history of fibroids/endometriosis
Meds you’ve tried and their effects
Pregnancy goals in the next 1–2 years

This article is for general information and does not replace personalized medical advice. A healthcare professional can help determine the cause of your navel pain and the safest, most effective treatment.