Are you wondering why you are having such painful periods? You may have the chronic condition endometriosis.
Why is endometriosis so painful?
Endometriosis is a disorder where tissue that is inside the uterus – the endometrium – grows outside of the uterus. Endometriosis most commonly involves the ovaries, fallopian tubes and tissues lining the pelvis. It is possible, however, for endometrial tissue to spread beyond pelvic organs.
Endometriosis is usually described as being painful but not constant. It flares with the menstrual cycle. This is because the endometrial-like tissue that is outside of the uterus acts like the endometrial tissue in the uterus. It follows the menstrual cycle: it thickens, breaks down and then bleeds with each cycle.
What causes endometriosis?
There are several theories about how endometriosis develops, but the exact cause is unknown. Genetics plays a role, and those with parent, sibling or child with endometriosis are more likely to develop the condition. It’s important to talk with your health care provider to thoroughly review your medical and family history, which can help identify other risk factors.
What are the common symptoms of endometriosis?
Common symptoms of endometriosis include:
- Painful periods, including pain before and after a menstrual period.
- Lower back and abdominal pain
- Pain during intercourse
- Painful bowel movements or urination - especially during a menstrual period
- Heavy menstrual bleeding or bleeding between periods
- Infertility
- Fatigue
- Diarrhea or constipation
- Bloating or nausea
Some women may not have any symptoms. A high amount of pain does not mean the person has a lot of endometriosis tissue.
What happens to fertility if a person has endometriosis?
A main complication of endometriosis is infertility. Endometriosis may obstruct the fallopian tube and keep the egg and sperm from coming together. Endometriosis may also damage sperm or eggs.
Even with mild to moderate endometriosis, a person can still conceive and carry a pregnancy to term. A primary OB/GYN provider may refer a patient to fertility specialists to assist with conception.
How is endometriosis diagnosed?
When meeting with your provider, they will ask you questions to better understand your symptoms and thoroughly review your personal and family medical history. While surgery remains the only way to definitively diagnose endometriosis, a clinical diagnosis can be made based on your symptoms and health history. A surgical diagnosis is most often reserved for those that do not respond to first-line medical treatments for endometriosis
What is the treatment for endometriosis?
There are various treatment options for endometriosis. Before embarking on any treatment plan, it's important to discuss with your primary provider to choose the plan best for you.
- Pain relief medicine: anti-inflammatory medicine like ibuprofen (Advil or Motrin), naproxen sodium (Aleve) or aspirin
- Hormone therapy: hormone pills, patches, etc. control the menstrual cycle and managing can result in lighter and shorter menstrual flow; this may reduce or even eliminate pain.
- Surgical procedure: there are various surgeries including the removal of endometrial tissues – to help relieve pain and improve fertility – or the removal of the uterus and possibly the ovaries.
Alternative/complementary therapies for endometriosis
Some patients who have reported feeling pain relief following acupuncture treatment. There is little research available on any type of alternative treatment for endometriosis. If acupuncture is of interest, ask your provider if they can recommend a reputable acupuncturist.
Exercise, support groups and fish oil supplements may also be options. As always, discuss any supplements with your provider to ensure there are no interactions with medications you may be taking.
Who do I talk to about an endometriosis diagnosis?
Did you know you can see a certified nurse-midwife for concerns you have regarding your menstrual cycle? This includes pain, irregular bleeding or other concerns. Did you also know that CNMs are also nurse practitioners? You can also see a midwife for all your well-woman needs and annual exams.
Any time you have concerns about your health it is a good time to see your provider at MercyOne or MercyOne Genesis.
This blog was reviewed by a MercyOne medical provider.
