Written by Mr Jayanta Chatterjee for Doctify
Painful periods are something many women suffer through every month. Whether you find relief from ibuprofen or yoga, applied heat or the coil, the pain can be a life-disrupting burden.
But have you ever wondered if what you’re going through is normal? Or could it be something more serious? One of Doctify’s leading Gynaecologists, Mr Jayanta Chatterjee is here to help you tell the difference between a bad period and endometriosis.
What is endometriosis?
Endometriosis is a chronic condition seen in women of child bearing age due to ectopic presence of bits of the lining of the womb. Put simply, parts of the womb’s lining start to grow outside it.
If it is found in the muscles of the womb it is called Adenomyosis. It can be commonly found in the lining of the pelvis, the ligaments that support the uterus, the lining of the bladder. It can also infiltrate the lining of the rectum, the space between the rectum and the vagina and the bowel.
When present in the ovaries, it can give rise to cysts that are classically called “chocolate cysts” of the ovary due the altered blood present in them. Endometriosis is rarely seen in post-menopausal women.
How can I tell the difference between severe period pain and endometriosis? What are the other symptoms?
The symptoms associated with endometriosis are:
- Painful periods that aren’t usually relieved with painkillers
- Persistent pelvic pain which gets worse during periods
- A sense of heaviness in your pelvis – this is specifically associated with pelvic endometriosis
- Lower backache
- Pain during and after having sex
- Pain while passing urine and moving your bowels. On rare occasions, blood in your stool and urine is associated with endometriosis
Some of the words used to describe pelvic and period pain associated with endometriosis are: stabbing, spasmodic, dull aching, constant throbbing, sharp agonising, shooting and cramping. Some women describe their period as being so painful that it results in them feeling faint and nauseous.
When should I go to the doctor?
A combination of the above symptoms should prompt you to seek the help of a doctor.
Does it have a cure?
Endometriosis is generally a chronic condition with a variable course and progression pathway. The best way to diagnose pelvic and abdominal endometriosis is by doing a diagnostic laparoscopy, using this you can examine the pelvis and look inside the uterus using a telescope.
Managing symptoms is the mainstay of treating endometriosis. Controlling pain with painkillers and suppressing the ovaries from producing hormones that exacerbate the symptoms with hormonal preparations can also be effective.
Doctors can do surgical ablation or resection using minimal access approach to remove endometriotic deposits from the organs affected. Often this can result in improved fertility outcomes.
Using the Mirena intra-uterine system can also help in managing period pain.
In women who have already had children family, and who have exhausted medical and conservative surgical approaches, performing a hysterectomy and removing the ovaries and tubes may be the last resort in managing this profoundly debilitating condition.
How does it affect fertility?
Endometriosis can have significant impact on a women’s fertility. The present of endometriotic implants in the pelvis can result in scarring, adhesions and cause tubal damage. When affected by “chocolate cysts”, the ovaries may not ovulate regularly, resulting in anovulatory cycles. Surgical treatment often results in better fertility outcomes in women with endometriosis. However, some women will need to seek the help of fertility specialist to achieve a pregnancy.
