Painful periods
Shutterstock/Person in the photo is a model

Painful periods/unable to have sex – Could it be endometriosis?

By Nivarana Friday, May 26, 2023 - 15:56
Shradhha and Vikas walked into the infertility clinic after being married for eight years and unable to conceive. They told the doctor that having sex was so painful that they stopped trying for a baby after multiple unsuccessful attempts. Shraddha has informed the doctor that she has been having unbearably painful and heavy periods for many years. After conducting a few tests, the doctor found out that she was suffering from endometriosis.

What is endometriosis?

Endometriosis is a condition when a tissue from the uterus is found in other parts of the body instead of where it should be. It happens because of hormones, specifically estrogen - the female hormone. Women who have had higher levels of estrogen for a long time are more likely to have this problem. Some factors that increase the risk of endometriosis include starting periods early, not breastfeeding, or having a tumor that produces estrogen.

When a woman with endometriosis has her period, the body reacts strongly to the misplaced tissue, causing different levels of pain. This pain can be ongoing, make it hard to do daily activities, and have a long-lasting impact.

How common is endometriosis?

Endometriosis affects a large number of women worldwide, with more than 190 million women suffering from it. This makes up around 2-10% of all women. Many women who face infertility issues are also found to have endometriosis, accounting for more than half of the cases. 

In India alone, about 25 million women suffer from this condition, although experts believe that the actual numbers could be even higher because many cases go unreported.

Endometriosis can range from causing no symptoms to causing severe pain that greatly affects a woman's life. In severe cases, even surgery may not fully treat the disease. Unfortunately, it takes a long time for many women to receive a proper diagnosis of endometriosis, particularly if they have extreme period pains. 

It can take anywhere from 6 to 10 years for a woman to be correctly diagnosed. Sadly, doctors sometimes dismiss the pain as normal period cramps, making it even harder for women to get the right help. Multiple consultations with doctors are often necessary before receiving a proper diagnosis.

What are the symptoms of Endometriosis?

  • Pain in the lower abdomen or back that worsens during menstrual periods
  • Pain during or after sexual intercourse
  • Pain while urinating or having bowel movements during periods
  • Feeling nauseous or sick
  • Constipation or diarrhea during periods
  • Blood in urine or stools during periods
  • Difficulty getting pregnant (infertility)
  • Presence of cysts in the ovaries
  • Damaged fallopian tubes causing infertility
  • Severe pain during menstrual cycles
  • Chronic pelvic pain, requiring daily painkillers in severe cases

Endometriosis is a disease that can get worse over time. If left untreated, it can have a big impact on a woman's quality of life. Not just on the body but also in many different ways. 

It can make women feel hopeless, have low self-esteem, and feel very sad, anxious and some women can even think of ending their own life. These feelings are common in women with endometriosis, so it's important to pay attention to them and offer support.

What is the treatment of endometriosis?

Treating endometriosis involves using medications or having surgery, depending on how bad it is. In the early stages, taking painkillers can help manage the pain. For chronic pelvic pain, hormonal tablets may be prescribed to stop the monthly periods and reduce the growth of abnormal tissue. 

Some women might choose to use a special device placed inside the uterus that releases hormones, especially if they can't take hormonal pills due to other health conditions like problems with their liver.

In severe cases, surgery to remove the ovaries and uterus may be considered a way to relieve the pain. 

However, because the body changes due to the inflammation caused by endometriosis, it can make treatment and surgery more challenging for the doctor. That's why it's important to diagnose endometriosis early and start treatment as soon as possible to improve the chances of getting better.

Is pregnancy possible with endometriosis? 

While endometriosis can make it more challenging to conceive, it does not necessarily mean that pregnancy is impossible. The severity and location of endometriosis can vary among individuals, and it can impact fertility in different ways. Some people with endometriosis may have no trouble getting pregnant, while others may face difficulties or require medical assistance, such as fertility treatments. 

Barriers to Endometriosis diagnosis and treatment

Endometriosis can cause different symptoms, and it can be similar to other medical conditions, making it hard to diagnose. There are many reasons why it takes time to get a diagnosis of endometriosis. 

One reason is that not many people, including doctors, know much about it. Some people think that period pain is normal and don't take it seriously. There's also a stigma around talking about menstrual pain, which makes it harder to get help. Once diagnosed, the treatment for endometriosis can be expensive, which adds more stress and worries.

So it is important that women do not ignore unbearable or strong period pains and get them checked by doctors. It is important to spread awareness about endometriosis, so that women visit the doctor in time, get an early diagnosis and start treatment sooner. It's important to have open discussions about menstrual pain so the challenges of this disease can be addressed and its burden reduced.

This article was originally written by Evelina Jane Dsouza for Nivarana - a programme that works on public health issues in India and has been adapted by Love Matters India for its audience. 

To protect the identity, the person in the picture is a model and names have been changed. 

Have questions? Ask Love Matters (LM) on our Facebook page. We are also on Instagram, YouTube and Twitter. 

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