Endometriosis is a common yet often misunderstood condition that affects approximately 1 in 10 women of reproductive age. For many, the most noticeable and distressing symptom is severe period pain, which can be debilitating and is often mistaken for just “normal” menstrual discomfort. However, while some level of pain during menstruation is common, excessive or unusual pain may indicate an underlying condition like endometriosis.
What Is Endometriosis and What Causes It?
Endometriosis is a medical condition where tissue similar to the lining of the uterus (the endometrium) begins to grow outside the uterus. This tissue often develops on the ovaries, fallopian tubes, and the tissue lining the pelvis. Like the tissue inside the uterus, this external tissue responds to hormonal changes during the menstrual cycle by thickening, breaking down, and bleeding. However, unlike the uterine lining, this tissue has no way to exit the body, leading to inflammation, pain, and sometimes the formation of scar tissue (adhesions).
While its exact cause remains unclear, factors such as retrograde menstruation, embryonic cell transformation, immune system dysfunction, genetic predisposition, and environmental influences like toxin exposure are believed to play a role.
Endometriosis is most commonly diagnosed in women in their 30s and 40s but can occur in women of any age, even teenagers. Early intervention and treatment can significantly improve quality of life, which is why recognising the signs early is so important.
Common Symptoms of Endometriosis
The symptoms of endometriosis can vary widely between individuals, with some women experiencing only mild symptoms and others dealing with debilitating pain. The most common symptoms include:
- Severe Menstrual Cramps: Painful menstrual cramps that don’t improve with over-the-counter pain relievers.
- Pain During or After Intercourse: Many women with endometriosis experience pain during or after sex, particularly deep penetration.
- Chronic Pelvic Pain: This can occur outside of your menstrual cycle, including pain during ovulation, pelvic fullness, or persistent aching.
- Heavy Menstrual Bleeding: Women with endometriosis often experience heavy or prolonged periods or bleeding between periods.
- Painful Bowel Movements or Urination: Especially during menstruation, endometriosis can affect the bowels and bladder, causing pain during bowel movements or urination.
- Gastrointestinal Issues: These may include nausea, bloating, constipation, or diarrhoea, often mistaken for irritable bowel syndrome (IBS).
- Fatigue and Other Symptoms: Women may also experience chronic fatigue, headaches, and lower back pain.
If you’re experiencing any of these symptoms regularly or they are worsening over time, it’s essential to consult with a healthcare provider for further evaluation.
When Should You See a Doctor?
It’s crucial to understand that not all period pain is indicative of endometriosis. Mild cramps during menstruation are common and can usually be managed with over-the-counter pain relief. However, there are certain signs that should prompt a visit to your doctor:
Severe Period Pain
If your menstrual pain is so severe that it prevents you from performing daily activities or is significantly worse than your usual cramps, it may indicate something more serious.
Pain That Doesn’t Respond to Over-the-Counter Medication
If you’re unable to alleviate your period pain with common painkillers like ibuprofen or paracetamol, this may be a sign of endometriosis or another underlying condition.
Chronic Pelvic Pain
Pain that extends beyond your menstrual cycle, such as during ovulation, bowel movements, or intercourse, is a common symptom of endometriosis.
Heavy Bleeding
Heavy or irregular menstrual bleeding, or bleeding between periods, may suggest endometriosis or another reproductive issue.
Fertility Problems
Endometriosis can impact fertility, causing difficulty in getting pregnant. If you’re struggling with infertility and suspect endometriosis, seeking a doctor’s advice is vital.
How Is Endometriosis Diagnosed?
Diagnosing endometriosis can be difficult, as many of its symptoms overlap with other conditions such as irritable bowel syndrome (IBS), pelvic inflammatory disease (PID), or even chronic fatigue syndrome. To reach a definitive diagnosis, your doctor will typically recommend:
- Medical History: Your doctor will ask about your symptoms, menstrual history, and any family history of endometriosis.
- Pelvic Examination: During this exam, your doctor may feel for any abnormal growths, cysts, or scarring in the pelvic area.
- Imaging Tests: Ultrasound or MRI scans can help detect ovarian cysts that may be linked to endometriosis, though these imaging tests might not identify smaller lesions.
- Laparoscopy: This is the gold standard for diagnosing endometriosis. During this minimally invasive procedure, the doctor can directly view the pelvic organs, take tissue samples, and verify the presence of tissue similar to the lining of the uterus outside of it.
Managing Endometriosis
While there is no cure for endometriosis, there are effective treatments that can help manage symptoms and improve quality of life. With early diagnosis, you can better manage pain, reduce complications, and improve fertility outcomes.
Pain Management Options
- Over-the-Counter Medications: Nonsteroidal anti-inflammatory drugs (NSAIDs) such as ibuprofen can help reduce inflammation and alleviate pain.
- Prescription Medications: Stronger pain relievers or muscle relaxants may be prescribed for more severe cases.
- Hormonal Therapy: Hormonal treatments such as birth control pills, hormone injections, or an IUD can help regulate the menstrual cycle and reduce endometriosis symptoms.
- Surgical Options: In severe cases, surgery may be required to remove the tissue, especially if it’s causing infertility or significant pain. Laparoscopic surgery can remove or destroy the endometrial-like tissue.
Lifestyle Changes
- Exercise: Regular physical activity can help reduce inflammation, improve mood, and manage pain.
- Dietary Adjustments: Some women find relief from endometriosis symptoms by avoiding inflammatory foods such as processed sugars and trans fats, while increasing their intake of anti-inflammatory foods like omega-3 fatty acids and fresh fruits and vegetables.
- Stress Management: Techniques such as yoga, meditation, and deep breathing can help manage stress and reduce the severity of symptoms.
Importance of Early Diagnosis and Ongoing Care
Early diagnosis and treatment of endometriosis can significantly improve your quality of life, reduce pain, and help maintain reproductive health. If left untreated, endometriosis can lead to chronic pain, infertility, and adhesions, which can cause long-term damage.
Common Questions About Endometriosis
Yes, one of the most common symptoms of endometriosis is severe period pain, which often goes beyond the usual discomfort of a normal menstrual cycle. While cramping during periods is common, women with endometriosis experience intense pain that can interfere with daily activities. The pain may begin before menstruation and last for several days. It’s typically much more intense than regular cramps, and pain relief may not be effective.
Endometriosis can affect fertility in several ways, with about 40% of women with the condition experiencing difficulty conceiving. The tissue growth can cause scarring, block the fallopian tubes, and disrupt the normal function of the ovaries and uterus, making it harder to get pregnant. If you’re struggling with infertility and have endometriosis, it’s important to speak with your doctor to explore possible treatments.
Yes, digestive issues are common for many women with endometriosis. Symptoms such as bloating, constipation, diarrhoea, and nausea can occur, particularly around menstruation. This is because the endometrial tissue can affect the bowels when it grows outside the uterus, causing irritation and inflammation.
Yes, endometriosis is considered a chronic condition. It occurs when tissue similar to the uterine lining grows outside the uterus, causing ongoing symptoms such as pain, heavy bleeding, and sometimes fertility issues. While there is no cure for endometriosis, early diagnosis and appropriate treatment can help manage the condition effectively, reduce pain, and improve quality of life.
Some individuals experience symptom relief after childbirth, possibly due to hormonal changes associated with pregnancy and breastfeeding. However, this relief varies, and symptoms may return postpartum.
Get a Comprehensive Women's Health Check Today
If you’re experiencing symptoms of endometriosis or have concerns about your menstrual health, it’s essential to seek medical advice as soon as possible. Early intervention can improve symptom management and prevent the condition from worsening.
At Sirona Women’s Health Clinic, we provide compassionate care to women dealing with endometriosis. Our all-female GP team is dedicated to providing thorough evaluations, personalised care, and tailored treatment plans to help you manage endometriosis effectively.
Whether you’ve been living with the pain for years or have just started noticing symptoms, our team is here to help. Contact us today for an appointment. We proudly serve women across Brisbane, including Annerley, Woolloongabba, Greenslopes, Coorparoo, and the Greater Brisbane area.