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Why is My Period So Painful?

Com­mon symp­toms of endometrio­sis and when it’s time to talk to your gynecologist

Endometrio­sis is a com­mon con­di­tion that impacts up to one in every ten women in the Unit­ed States. Endometrio­sis devel­ops when the tis­sue lin­ing your uterus, called your endometri­um, grows out­side of your uterus, most com­mon­ly in your ovaries, fal­lop­i­an tubes and/​or peri­toneum. These abnor­mal tis­sue growths are called implants and although not as com­mon, they can also devel­op in areas out­side of your pelvic organs.

As endometrio­sis pro­gress­es, it can affect your body in a vari­ety of ways. Implants may grow and can bleed each month dur­ing your men­stru­al cycle, which may cause the sur­round­ing tis­sue to become inflamed or irri­tat­ed. As the implants break down each month, scar tis­sue can form and cause pain before and/​or dur­ing your men­stru­al cycle.

Symp­toms

Pelvic pain, often just before and dur­ing your men­stru­al peri­od, is the most com­mon symp­tom of endometrio­sis. You may expe­ri­ence no pain, but still have sig­nif­i­cant scar tis­sue growth from mul­ti­ple implants, while oth­er women may expe­ri­ence more pain with less implants and scar­ring. Oth­er com­mon symp­toms include pain dur­ing sex­u­al inter­course, uri­nary symp­toms, blad­der pain, gen­er­al­ized or local pelvic pain and pain dur­ing bow­el movements.

Diag­no­sis and Treatment

At the onset of your symp­toms, a pelvic exam may be per­formed, and is some­times fol­lowed by a laparoscopy to diag­nose the con­di­tion. The laparoscopy allows your doc­tor to con­firm the diag­no­sis and deter­mine the sever­i­ty of your endometrio­sis based on the amount of endome­tri­al tis­sue found out­side of your uterus. Dur­ing the pro­ce­dure, a thin instru­ment (laparo­scope) is insert­ed though a small inci­sion in your abdomen to allow your doc­tor to view your pelvic area. In some cas­es, a small amount of tis­sue may be tak­en for addi­tion­al testing.

Your doc­tor will con­sid­er sev­er­al fac­tors when devel­op­ing your treat­ment plan includ­ing the sever­i­ty and symp­toms of your endometrio­sis, and whether or not you want to have chil­dren in the future. Treat­ment options may include med­ica­tion, surgery or both.

Med­ica­tion Treatment

Med­ica­tions to treat endometrio­sis include pain reliev­ers, such as non-steroidal anti-inflam­ma­to­ry drugs (NSAIDs) and hor­mon­al treat­ments. The hor­mon­al treat­ments include oral pills, injectable med­ica­tions and intrauter­ine devices. Although med­ica­tions will not remove endometrio­sis tis­sue, hor­mone ther­a­py slows the growth of new tissue.

Sur­gi­cal Treatment

Surgery is often used to remove implants and pro­vide symp­tom relief. In some cas­es, when only a por­tion of the endometrio­sis tis­sue can be removed, your symp­toms may still be present. After surgery, you may be pre­scribed med­ica­tions to lessen your pain and slow the growth of new endometrio­sis. If you’re expe­ri­enc­ing severe endometrio­sis with sig­nif­i­cant, chron­ic pain, a hys­terec­to­my may be recommended.

Risk Fac­tors

Endometrio­sis is not pre­ventable. Begin­ning men­stru­a­tion at a young age, enter­ing menopause lat­er in life and low body mass index (BMI) can increase your risk of devel­op­ing endometrio­sis. Endometrio­sis also tends to run in fam­i­lies and is more com­mon in Cau­casian and Asian women.

Com­pli­ca­tions

Many women who expe­ri­ence fer­til­i­ty issues are sub­se­quent­ly found to have endometrio­sis. It is impor­tant to know that while fer­til­i­ty issues are a com­mon com­pli­ca­tion asso­ci­at­ed with endometrio­sis, many women do not expe­ri­ence any dif­fi­cul­ty becom­ing preg­nant. Your fer­til­i­ty may be impact­ed if the inflam­ma­tion asso­ci­at­ed with your endometrio­sis dam­ages the fal­lop­i­an tubes and thus restricts the move­ment of sperm or eggs.

If you’re expe­ri­enc­ing any symp­toms asso­ci­at­ed with endometrio­sis, con­sult with your gyne­col­o­gist. Although there is no cure for the con­di­tion, ear­ly diag­no­sis can help you man­age your symp­toms and slow the growth of implants. Sched­ule an appoint­ment with a DuPage Med­ical Group gynecologist.

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