SHARES
Abigail’s story
For 2 days a month, Abigail has been experiencing excruciating pain. She experienced very heavy periods, bloating and pain, along with a change in her bowel movements. She described the pain as constant severe pain around her pelvic and lower abdominal area. The pain was worse especially before and during a period, and it was happening for the past 10 months. Abigail took action and consulted a gynaecologist to determine the cause. Abigail was then diagnosed with endometriosis, a common gynaecological condition affecting reproductive-aged women.
Endometriosis is a painful disorder where the tissue that normally lines the wall of the uterus, also known as endometrium, grows outside of the uterus. Besides that, it can involve the ovaries, fallopian tubes and the tissue lining the pelvis.
Period Pain and Endometriosis
So, why is endometriosis associated with painful periods? A possible cause is that when a woman has her period, besides bleeding from the cells and tissue inside the uterus, some of these tissues travel out of the uterus. Displaced endometrial tissue continues to act normally, where it thickens, breaks down and bleeds during menstruation. Consequently, when blood gets in contact with other organs such as inside the abdomen, it causes inflammation and irritation which can contribute to pain. Moreover, the scar tissue developed can cause pain.
Infertility and Endometriosis
Findings has shown that between 20% and 40% of women with infertility suffer from endometriosis. There are two possible theories behind inability to conceive in such cases. Firstly, endometriosis may cause distortion to the fallopian tubes. Subsequently, it impairs the release of the egg from the ovary and pickup by the fallopian tube during ovulation. Another theory involves the presence of inflammation which can adversely affect the function of ovaries, egg, fallopian tubes or the uterus.
Symptoms of Endometriosis
Besides painful pelvic pain often associated with menstrual period, some other common signs and symptoms may include:
- Pain with intercourse
- Pain with bowel movements or urination especially during menstruation
- Excessive bleeding
- Fertility issues
- Fatigue, diarrhoea, bloating especially during menstrual periods
One should be aware that the severity of the pain may not necessarily be a reliable indicator to diagnose the condition. Endometriosis is sometimes mistaken for other conditions such as pelvic inflammatory disease, irritable bowel syndrome or ovarian cysts.
Diagnosing Endometriosis
Endometriosis can be challenging to diagnose due to the varying symptoms which can mimic other conditions. On average, it takes approximately 7.5 years for a woman to be diagnosed. Endometriosis can only be truly diagnosed with a laparoscopy (a surgery where a doctor looks into the abdomen with a camera through a small incision) and a biopsy of any suspicious tissue. Examination of the tissue under a microscope will then confirm the diagnosis. Other examinations which can aid in diagnosing the condition include CT scan, MRI scan and ultrasound.
Treatment of Endometriosis
Treatment can involve medication, hormone therapy or surgery. The approach usually depends on how severe the signs and symptoms are and the future need for pregnancy. There are also lifestyle and home remedies which may help to relieve the discomfort. For instance, warm baths and heating pad to relax the pelvic muscles, over-the-counter analgesics as well as regular exercises.
Data from studies seem to indicate that early diagnosis and complete excision is one of the best way to improve quality of life, and perhaps to prevent progression of endometriosis and thereby benefit long-term fertility. However further studies with more data are needed to confirm this theory.
Conclusion
Pain is never pleasant. But for women with endometriosis, it can become unbearable. It is important for you to recognise and understand the condition, voice concerns about such issues and to consult a healthcare professional to improve your health.
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by Soh May Leng
Born and raised in Malaysia, May Leng obtained her Bachelor of Dental Surgery from the University of Otago, New Zealand. She has joined the GetDoc team to relay valuable health information to the public. Staying active plays a big part in her daily life especially through outdoor sports such as running and swimming. She also enjoys travelling and has a passion for photography. View all articles by Soh May Leng.
