Patients are often asymptomatic, sometimes feeling fatigue and weakness, and if they have had the condition for a long time they may experience neurological symptoms; if they have pelvic congestion or scarring adhesions, they may experience a feeling of lower abdominal cramping, pain or lower back pain, which often worsens around menstruation, after sexual intercourse or after exertion. In addition, some patients may have symptoms of menstrual disorders.