Do you know that most women are told to accept their period pain as normal, no matter how serious the symptoms? Even when it can be an actual menstrual disorder such as endometriosis? Time to address your pain with a doctor, here is all the information you can start with.

Endometriosis

Dr. Amodita Ahuja is a practicing consultant obstetrician and gynaecologist and laparoscopic surgeon. She is the co-founder of Project Pink Butterfly, which aims to educate patients about their reproductive health. She lives in Gurgaon.

Doctor please save me from the horror of periods, they are so painful that I can’t get up from my bed, can’t poop, my back hurts and the worst part is that all my meds have stopped working. I have been suffering from this pain since the day I got my periods but each time I fell down, felt blurry and yelled due to cramps they told me it’s normal so hushhhhhhh. 

This is every patient’s chronicle who suffers from endometriosis.

 

What is this horror and why are we so oblivious towards it?

Endometriosis is a condition in which the lining of the uterus grows outside of it, commonly on the ovaries, fallopian tubes and lining of the pelvis.

In this the aberrant endometrial tissue acts like uterine lining which — thickens, breaks down and bleeds with each menstrual cycle. This tissue has no exit from your body and gets trapped leading to scarring and adhesions — causing pelvic tissues and organs to stick to each other.

Due to this trapping of blood there is severe pain during periods which may start few days before their onset and may run few days into it, severe backache, pain during intercourse (severe enough which feels like losing virginity each time), while pooping and passing urine and eventually difficulty in conceiving. You feel nauseous and bloated all the time.

Although the exact cause is not known, few plausible theories are :

-Use of plastic pads that contain a chemical called dioxin which on entering into the body causes diffuse inflammation of pelvic tissues leading to endometriosis.

-Retrograde flow of menstrual blood – instead of flowing outside the body, it enters the tubes, ovaries and pelvis.

-Excessive estrogen in the body 

 

But if you got periods early, your weight is much less than ideal body weight, you never had babies, your mother or sister had a similar history then the chances of you having endometriosis increases much fold.

The stages of endometriosis are:

Category I: Peritoneal endometriosis

The most minimal form of endometriosis in which the peritoneum, the membrane that lines the abdomen, is infiltrated with endometriosis tissue.

Category II: Ovarian Endometriomas (Chocolate Cysts): Endometriosis that is already established within the ovaries. These forms of ovarian cysts are of particular concern due to their risk of breaking and spreading endometriosis within the pelvic cavity.

Category III: Deep Infiltrating Endometriosis I (DIE I)

The first form of deep infiltrating endometriosis involves organs within the pelvic cavity. This can include the ovaries, rectum, uterus, and can even lead to such drastic cases as “frozen pelvis.”

Category IV: Deep Infiltrating Endometriosis II (DIE II)

The other more extreme form of DIE involves organs both WITHIN and OUTSIDE the pelvic cavity. This can include the bowels, appendix, diaphragm, heart, lungs, and even the brain.

Any women who suffers from pelvic pain or period pain should meet a gynecologist irrespective of the intensity of pain. 

When you will meet your gynecologist, she might examine you and request an ultrasound or MRI including few blood tests like CA-125 and CA19.9 which are the markers of endometriosis and adenomyosis.

These tests can tentatively suggest that you have endometriosis or not but a complete and final diagnosis can only be made after seeing inside the abdomen with a telescope – also known as laparoscopy. Laparoscopy can provide information about the location, extent, and size of the endometrial implant. Often, with proper surgical planning, your surgeon can fully treat endometriosis during the laparoscopy so that you need only one surgery. 

The bottom line is if you have period pain or constant pain in the abdomen or pain during sex , please don’t sit over it and keep having pain medications, visit a gynecologist as soon as possible because the early you are diagnosed with endometriosis the better will be the outcome. Its a matter of your quality of life. You need not be quiet and suffer from it just because you are a woman. Be open about it because sometimes the things which are perceived as normal by the rest of the world might not be normal for you. Stop taking suggestions from goggle and non-specialist around you. It just takes a few extra minutes to talk to a specialist and you will be sorted for the rest of your life.

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