Period pain is something that many of us just put up with, but that may be the worst thing to do. Endometriosis is a condition that up to 25% of women experience, yet most doctors and many gynecologists know nothing about it. If left untreated, it can render a woman infertile, yet the options are limited, and in most cases horrendous, if treatment is necessary.
It has long been accepted that periods and the agony that accompany them are a woman’s lot. However, this ain’t necessarily so. Pre-Menstrual Tension (PMT) in its more serious form can be crippling. If your PMT is driving you crazy, it may be endometriosis.
Endometriosis is a condition in which the tissue lining the uterus (womb) is found in places other than the uterus. It usually affects only women who are menstruating. Endometriosis can occur at any time between the onset of menstruation and the end of menopause.
What happens is fragments of endometrium (the mucus membrane lining the uterus) pass through the uterine tube (fallopian tube) and out into the pelvic area during normal menstruation. These fragments then implant themselves onto the surrounding pelvic tissue, and sometimes organs.
Symptoms of endometriosis are some or all of the following:
Pain which may be felt:
- with periods (mild, moderate or severe pain)
- during ovulation (mild, moderate or severe pain midway between periods)
- in the bowel during menstruation, or bowel movements or when passing wind
- when passing urine
- during sexual penetration (or after)
- during internal examination of vagina and/or bowel
- at other times
Other symptoms include:
- diarrhea or constipation
- heavy or irregular bleeding (sometimes involving the loss of large clots of blood or tissue)
- bleeding from the bowel before or during periods
- premenstrual tension (often for most of the month)
- depression and mood swings
- swollen abdomen
- low energy levels and constant tiredness
- low body temperature, low blood sugar
Pain is caused because the bleeding irritates other tissues in the pelvic area, and because some of the blood and tissue forms into cysts (fluid filled lumps). The continual release of blood contributes to the formation of scar tissue and adhesions (when organs become joined together) and the cumulative effect is more pain. The pain can become more severe over time as more blood and scar tissue builds up during subsequent periods.
The most common sites for built up tissue is usually limited to the pelvis affecting mainly the tissues near the uterus and fallopian tubes, including the bladder, ligaments and bowel. However, build up has been seen in the breast, lungs and lymph nodes.
Pain is the dominant symptom. It may be felt in different parts of the body at different times, and as various types of pain, some women experience it as sharp, stabbing pain; some feel it as a constant or intermittent dull ache, or as a severe cramping pain.
Some women feel the worst pain in the mornings and the evenings. Trying to manage the pain itself can lead to other complications such as nausea, the effects on the lining of the stomach and kidneys from the extended use of pain-killing drugs.
The most commonly reported symptom after period pain is diarrhea, painful bowel movements and intestinal upsets, yet these symptoms are rarely associated with endometriosis in the medical textbooks.
The bad news is (if it isn’t bad enough) you can’t know if you have it for sure without a minor operation called a laparoscopy where a small cut is made below the navel and another just above the line where pubic hair starts. A special light and viewer are then used to see if, and where the patches of endometrioses are. Without this procedure, it’s easy to confuse endometriosis with other conditions such as pelvic infections or fibroids.
But, endometriosis is one of the most common causes of infertility in women over the age of 25 and it has been estimated that between a third and half of all women with infertility experience some endometriosis. How it causes this is unclear, but it could be due to damage to the ovaries and/or fallopian tubes caused by build up.
If you do recognize this as you, or if you are unsure, it is important that you find a good, supportive doctor, as many doctors are ill-informed. Find one that is prepared to answer questions about the disease and describe treatment programs fully if you’re looking for a medical cure.
Treatment options are limited at present. Women are told they can:
- Use hormone therapy, including the pill, oral or injected hormones to try to shrivel up endometrial areas. There are many side effects to this treatment and for some it is worse than the original symptoms
- Have a baby. While this may (but may not) sort out the reproductive system, it is not usually a viable option for most women
- Have a hysterectomy – a great solution to period problems.
Alternatively, many women are choosing to be treated homeopathically which involves a restrictive diet and herbal medicines. See a naturopath to discuss this one.
Note: What must be remembered is that endometriosis is a serious, but largely ignored condition but it can be treated effectively. Your periods do not have to rule your life.