By Dr. Mukta Nadig, OBG Consultant, Columbia Asia Hospital, Hebbal 

Period pain is the nightmare for most women. The extreme pain, stomach cramps, fatigue, nausea during this time make most of them anxious about their periods. Many keep popping pain killer pills just to cope up with their day to day work during this time. Although mild stomach pain is common during periods, is it still okay to experience unbearable pain accompanied with heavy bleeding? Do you need to visit the gynecologist instead of taking the pain killers? The answer is yes. Severe stomach pain with heavy bleeding could be the symptom of endometriosis. 

The Endometriosis Society of India estimates that 25 million Indian women suffer from this condition but it is hardly discussed in the open. The lack of awareness, apprehensive nature, taboo associated with periods and the ignorance is making many women to bear the pain silently without proper treatment. It can occur as early as in pubertal age group but because of the taboo of gynaecologist consultation for young girls, there is delay in proper diagnosis and treatment.

What is endometriosis?

Endometriosis happens when the endometrium, the tissue that usually lines the inside of a woman’s uterus, grows outward from the uterus. Endometriosis most commonly involves ovaries, fallopian tubes and the tissue lining of the pelvis. Endometrial tissue may spread beyond pelvic organs as well in some conditions. These tissues thickens, breaks down and bleeds during every menstrual cycle but as they have grown outside the uterus, they don’t have any way to exit your body. When endometriosis involves the ovaries, cysts called endometriomas may also form.

Difference between menstrual pain and endometriosis pain?

Menstrual pain is usually experienced on day one or day two of the period cycle. In endometriosis, the pain persists up to three to four days and worsens by the day. Sometimes sexual activity, passage of stools can also become painful. This pain can also last over two to three weeks before or after the periods. 

How to identify endometriosis?

The symptoms of endometriosis may vary from person to person. The severity of the pain does not indicate the stage of endometriosis. Pelvic pain is most common during this condition. Many patients diagnosed with endometriosis may finally need IVF as the method of fertility. Other symptoms include

• Pain in the lower abdomen before and during menstruation
• Cramps around menstruation time
• Heavy menstrual bleeding or bleeding apart from menstrual cycle
• Lower back pain during menstrual cycle
• Discomfort during bowel movements and urination
• Pain during or after sex
• Infertility

If the symptoms are ignored, endometriosis can be sometimes mistaken to other illnesses such as irritable bowel syndrome or pelvic inflammatory disease. Therefore, it is important to visit the gynaecologists when you develop any signs of pain or heavy bleeding during periods. Self-medication or delaying the treatment can be more harmful. 

Though there is no particular reason for endometriosis, hormonal changes, surgical scar, immune system disorder, hereditary can be pointed out as the major causes. 

Complications:

Infertility: One of the major complications of endometriosis is infertility. It is observed that approximately 1/3 to ½ percentage of women with endometriosis have difficulty getting pregnant.

Cancer: Ovarian cancer is another condition due to endometriosis. Ovarian cancer can develop only in the later stage and if endometriosis is not treated properly.  

Endometriosis develops after several years from the onset of the menstruation. It can be managed with proper diagnosis and treatment at the right time. Change in lifestyle and following certain exercise is one of the major factor in the management of endometriosis. Women can practice exercise which will strengthen the pelvic muscles.  

Endometriosis is a long-term chronic condition that can impact on a woman’s physical health, emotional wellbeing and daily routine by leading to depression. Instead of shying away or ignoring the symptoms it is advised to visit the gynaecologist when you observe the signs. With hospitals taking all the necessary precautions, it is safe to visit the hospitals and consult the doctors physically for all the health-related queries.