It is not okay to miss a part of your life because of cramps and discomfort during menstrual periods. It is not okay to be experiencing pain during sexual intercourse. It is not okay to be bed-ridden for two to three days every month. It is not okay if you are having difficulty in getting pregnant.
All of the above can place a heavy burden on a relationship. Living with chronic recurrent pain may lead to depression, fatigue and irritability, and can affect your daily activities.
Many women who experience these symptoms would eventually discover that they have endometriosis (period pain).
What are the Causes of Endometriosis (Painful Periods)?
Endometriosis or period pain is an incurable but manageable gynaecological condition.
It occurs when endometrial implants, comprised of tissue normally found within the uterus, are present in other areas of the body.
As the tissue continues to thicken, break down, respond to menstrual cycle hormones, and bleed during the menstrual cycle, endometriosis forms deep inside the body.
Scar tissue and adhesions form, and this can cause multiple anatomical changes and complications.
There is no known cure and, although endometriosis (period pain) can be treated effectively with drugs, most treatments are not suitable for long-term use due to side-effects.
Surgery can be effective to remove endometriosis lesions and scar tissue, but success rates are dependent on the extent of disease and the surgeon’s skills.
Hysterectomy, with surgical removal of all the disease at the same time, may relieve symptoms, but may not be a “definitive cure” either.
How Do You Know You Have Endometriosis (Periods Pain)?
Although endometriosis is typically diagnosed between the ages of 25 and 35 years, the condition probably begins about the time that regular menstruation begins.
Common signs and symptoms of endometriosis may include:
(Signs & Symptoms of the painful period)
Pelvic pain and cramping may begin before and extend several days into your period and may include lower back and abdominal pain.
Pain during or after sex is common with endometriosis.
Pain with bowel movements or urination
You’re most likely to experience these symptoms during your period.
You may experience occasional heavy periods or bleeding between periods.
Endometriosis is first diagnosed in some women who are seeking treatment for infertility.
You may also experience fatigue, diarrhoea, constipation, bloating or nausea, especially during menstrual periods
Endometriosis (period pain) or fibroids??
Endometriosis is one cause of severe menstrual pain. But the pain can be caused by another condition, such as fibroids, which are noncancerous growths of the muscle tissue of the uterus.
Fibroids can cause severe cramps and heavier bleeding during your period. The pain of endometriosis or fibroids can also flare up at other times of the month.
Get yourself diagnosed!
Endometriosis or painful period can be a challenging condition to manage. An early diagnosis, a multidisciplinary medical team and an understanding of your diagnosis may result in better management of your symptoms.
To diagnose endometriosis and other conditions that can cause pelvic pain, your doctor will ask you to describe your symptoms, including the location of your pain and when it occurs.
Tests to check for physical clues of endometriosis include:
During a pelvic exam, your doctor manually feels (palpates) areas in your pelvis for abnormalities, such as cysts on your reproductive organs or scars behind your uterus. Often it’s not possible to feel small areas of endometriosis unless they’ve caused a cyst to form.
This test uses high-frequency sound waves to create images of the inside of your body. To capture the images, a device called a transducer is either pressed against your abdomen or inserted into your vagina (transvaginal ultrasound).
Both types of ultrasound may be done to get the best view of the reproductive organs. A standard ultrasound imaging test won’t definitively tell your doctor whether you have endometriosis, but it can identify cysts associated with endometriosis (endometriomas).
Magnetic resonance imaging (MRI)
An MRI is an exam that uses a magnetic field and radio waves to create detailed images of the organs and tissues within your body. For some, an MRI helps with surgical planning, giving your surgeon detailed information about the location and size of endometrial implants.
In some cases, your doctor may refer you to a surgeon for a procedure that allows the surgeon to view inside your abdomen (laparoscopy). While you’re under general anaesthesia, your surgeon makes a tiny incision near your navel and inserts a slender viewing instrument (laparoscope), looking for signs of endometrial tissue outside the uterus.
A laparoscopy can provide information about the location, extent and size of the endometrial implants. Your surgeon may take a tissue sample (biopsy) for further testing. Often, with proper surgical planning, your surgeon can fully treat endometriosis during the laparoscopy so that you need only one surgery.
Treatment options you can consider to help you manage your symptoms
Pain medications such as acetaminophen, and nonsteroidal anti-inflammatory drugs (NSAIDs), like ibuprofen or naproxen, often help relieve the pain and cramping that comes with endometriosis. But these drugs only treat the symptoms and not the underlying endometriosis.
they manage levels of estrogen and progestin, which make your menstrual periods shorter and lighter. That often eases the pain of endometriosis. Your doctor may prescribe pills to be taken continuously, with no breaks for a menstrual period, or progestin-only therapy. Progestin-only therapy can also be given by injection. Endometriosis symptoms may return after you stop taking the pills.
These drugs such as gonadotropin-releasing antagonist and agonist (GnRH) mimic menopause, getting rid of periods along with endometriosis symptoms. They can cause hot flashes, vaginal dryness, fatigue, mood changes, and bone loss. Danocrine works mainly by lowering estrogen. Side effects can include weight gain, smaller breasts, acne, facial hair, voice and mood changes, and birth defects.
During a laparoscopy, the surgeon may remove visible endometrial growths or adhesions. Most women have immediate pain relief. A year after the surgery, though, about 45% of women will have a return of symptoms. The likelihood of symptoms returning rises over time. Hormone therapy started soon after surgery may improve the outcome.
Severe cases of endometriosis may require laparotomy, or open abdominal surgery, to remove growths, or a hysterectomy — removal of the uterus and possibly all or part of the ovaries. Although this treatment has a high success rate, endometriosis still recurs for about 15% of women who had their uterus and ovaries removed.
Lifestyle changes to help cope with endometriosis
Although there is no way to prevent endometriosis, you can make lifestyle choices that will help you feel better. Regular exercise may help relieve pain by improving your blood flow and boosting endorphins, the body’s natural pain relievers. Acupuncture, yoga, massage, and meditation also may help ease symptoms.
Getting pregnant with endometriosis
Having issues with fertility is a serious complication of endometriosis. Women with milder forms may be able to conceive and carry a baby to term.
Medications don’t improve fertility. Some women have been able to conceive after having endometrial tissue surgically removed. If this doesn’t work in your case, you may want to consider fertility treatments or in vitro fertilization to help improve your chances of having a baby.
You might want to consider having children sooner rather than later if you’ve been diagnosed with endometriosis and you want children. Your symptoms may worsen over time, which can make it difficult to conceive on your own. You’ll need to be assessed by your doctor before and during pregnancy. Talk to your doctor to understand your options.
Getting diagnosed with endometriosis may take some time. The symptoms of endometriosis are very similar to other common conditions. Because endometriosis manifests itself in a variety of ways and shares symptoms with other conditions, diagnosis can be difficult and often delayed. It’s important to share as much information with your doctor as possible.
Left undiagnosed or untreated, endometriosis can be a frustrating condition. To cope with the illness, it is important that you receive good medical care and support.
If you are facing period issues such as endometriosis (painful periods) and you would like to speak to us, please visit us at our women’s clinic in Malaysia.