It’s Not just Period Pain, it’s Endometriosis!

Most women think that it's normal to have painful periods and never talk about it with their docors. Thats a mistake: in many cases, period pain derives from a serious condition called endometriosis.

Image Credit: Dusan Bartolovic / de.dreamstime.com

Invasion of endometric tissue

Up until several years ago, endometriosis was almost a taboo subject, and even doctors knew little about it. Luckily, the situation is changing: thanks to such celebrities as Lena Dunham, who suffer from endometriosis, this condition – which affects 10% of women – is now better-known. It can cause great pain and make a woman infertile; but what is it?

Endometrium is simply the lining of your uterus. Every month during your period, endometrium breaks down and comes out, resulting in bleeding. However, sometimes endometrium cells start growing outside the womb: in the ovaries, fallopian tubes, peritoneum, and other organs. During the period, this alien tissue will break down and bleed, but it has no way to leave the body. Eventually, masses of endometric tissue can form, adhering to other organs.

The danger of endometriosis

The main symptom of endometriosis is period pain, which can be very strong (so as normal painkillers don’t help anymore) or mild. 25% of women with endometriosis have no pain at all. Other symptoms include:

  • Heavy period bleeding
  • Long periods (7 days or more)
  • Pain during or after sex
  • Abdominal pain outside of periods
  • Constipation or diarrhea during periods
  • Infertility.

Since many of these symptoms can indicate other disorders (from polyovarian cysts to IBS – Irritable Bowel Syndrome), it takes a woman on average 7 years to get a diagnosis – by that time, the disease often spreads. The only way to securely diagnose endometriosis is via a laparoscopy, when a tiny incision is made near the belly button and a video camera is inserted.

Treatment methods

Let’s be honest: there is no true cure for endometriosis, and even after a surgery it can come back. Luckily, for most women the condition is manageable. The main treament strategies include:

  1. Conservative – with painkillers during periods, a better diet, exercise (such as yoga), and a healthy active lifestyle.
  2. Hormonal therapy – birth control pills often help, as well as gonatotropic hormone medicines, which induce a temporary menopause. Real menopause often ends the symptoms, and pregnancy provides a temporary relief, too.
  3. Surgical – endometric masses can be cleared via a laparoscopic procedure, which sometimes lasts for hours. Full recovery can take weeks, and endometriosis usually comes back, so this is a last-resort method.

Endometriosis and fertility

Unfortunately, endometriosis causes infertility in circa 50% of cases, though most of such women can still have children after treatment or with IVF. The reason for infertility is that endometric tissue often blocks the fallopian tubes, preventing an egg from meeting the sperm.

In many cases, clearing out the tubes helps women to get pregnant. However, if you have endometriosis, you are advised not to postpone having children too long, as the spread of the disease makes pregnancy more difficult.

The causes of endometriosis are not fully understood: perhaps endometric cells start flowing back into the body instead of out during periods, or maybe it is an autoimmune condition, or even genetic (see this study). Fortunately, good treatment options exist. Morale of the story: if your period is painful, talk to your doctor!

References:

Endometriosis – Ncbi.nlm.nih.gov
Endometriosis and Infertility – Ncbi.nlm.nih.gov
Laparoscopy – Keyhole Surgery – Nhs.uk

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