Could your period pain be endometriosis?

Living with endometriosis period pain

Laura, 36, from Birmingham first started developing symptoms of endometriosis when she was 27. Over time, her periods got heavier and more painful. It took over four years of doctor's appointments to receive an endometriosis diagnosis.

Initially, Laura's endometriosis symptoms were thought to be due to irritable bowel syndrome, but as things got worse, Laura knew there must be another reason.

"To start with, my periods just seemed a bit more painful than normal; then the pain started to take longer and longer to go away. I had to take time off work with my periods, and it seemed to worsen from there."

After numerous clinic appointments and investigations, Laura was diagnosed with endometriosis. By this time, she was missing up to a week of work every month because of her endometriosis period pain. Unfortunately, Laura's case is not unusual. It can take up to 7 or 8 years for some women with endometriosis to be diagnosed and receive help. This is something that charities such as Endometriosis UK and other campaigners are keen to change.

"Endometriosis has had a huge impact on my life. For the last four years, I have been in daily pain. This has affected my social life and my career too. I have had a lot of absence from work due to being unable to function properly due to the pain."

What is endometriosis?

Endometriosis occurs when cells normally found in the lining of the womb start to grow in other parts of the body. These cells are then shed every month in the same way as the womb sheds its lining causing a period. This shedding of endometriosis tissue causes pain. It can occur in places all over the body including the bowel, ovaries and even in a woman's lungs.

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Period pain

Most women have some pain during periods. The pain is often mild but, in about 1 in 10 women, the pain is severe enough to affect day-to-day activities. The pain can be so severe that they are unable to go to school or work. Doctors may call period pain 'dysmenorrhoea'. Period pain is one type of pelvic pain.

by Dr Doug McKechnie, MRCGP

When should I be concerned about my period pain?

As already mentioned, most women regularly experience some period pain, but it should not be severe. If your periods are becoming progressively more painful and heavy, it is a good idea to see your GP, especially if simple painkillers do not help in the way they used to.

Developing pain throughout your menstrual cycle that then worsens again during your period can be a sign of endometriosis. Other symptoms such as bleeding when going to the toilet or pain when having sex, especially a deep pain, may be an indication that endometriosis may be a problem.

One of the problems of diagnosing endometriosis is that it can cause a wide range of often vague signs and symptoms, depending on the location of the tissue. Endometriosis symptoms may include a sensation of heaviness in the pelvis if the endometrial tissue is located in that area.

Laura explains, "I suffer chronic pain in my pelvis, bleeding when I pass urine and extreme pain when I have sex. I also feel constantly bloated and tired. I have tried a range of treatments including the pill and have now had three surgeries. The last one has helped a little but I still have so many symptoms to deal with."

Laura is now trialling a different hormonal therapy to help control her symptoms, but is likely to require more surgery in the future. Her story is an extreme example of endometriosis and thankfully for most women, treatments are effective at controlling symptoms.

Getting an endometriosis diagnosis

It is important to remember that you are not alone. Currently, it's thought that up to 1 in 10 women have some degree of endometriosis, so it is more common than we think.

The first thing is to discuss things with your doctor. Explain your endometriosis symptoms and what you are concerned the problem may be. Awareness of endometriosis is growing, but it does remain a very under-diagnosed condition. One of the reasons for this is that pelvic examinations and ultrasound scans often may appear normal even in the presence of endometriosis. As such, it is important to ask for referral to a specialist should your symptoms not improve.

If you feel your problems are not being heard, it is worth taking information leaflets on the condition with you to the doctor or contacting Endometriosis UK for more advice and information. The charity has a helpline offering advice and support. It also runs online support groups so women experiencing endometriosis period pain can meet others in a similar situation.

Endometriosis treatment options

There are a range of treatments available that can help women suffering with endometriosis symptoms. These include painkillers, laxatives to help constipation and treatments to help bloating and tummy cramps. Your doctor may also suggest a hormonal treatment. Occasionally, surgery is required.

Keeping yourself active, having a healthy diet and maintaining a healthy weight can also be helpful. Endometriosis is a condition that can affect many different areas of a woman's life, so please do not be afraid to seek help.

If you are concerned about your painful periods or if they are are affecting your quality of life, seeing a doctor and receiving the treatment you need can make a big difference. Please remember you are not alone and make sure to ask for help.