Yes, severe menstrual pain can be a symptom of endometriosis. Pain associated with endometriosis typically appears at a later stage rather than from the first menstrual period. Menstrual pain experienced from the first period is termed primary dysmenorrhea and usually has different underlying causes. Unfortunately, many women normalize menstrual pain, leading to delayed medical attention. This can negatively impact women's quality of life and, in advanced stages, may adversely affect reproductive health.