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Examiner
  • Is it just a painful period, or is it endometriosis?

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  • Some pain and cramping during menstruation is expected by many women; however for some, that time of the month can be something close to an ordeal. Sadly, many of these women accept this as normal, or feel societal pressure to believe it is just "par for the course" during menstruation.
    Severe pain, excessive bleeding and nausea could be signs of endometriosis. As March is Endometriosis Awareness Month, I thought it might be a good time to ask women to pay attention to their doctors’ opinion on this matter.
    Often misunderstood, endometriosis is a painful illness affecting an estimated 176 million women and girls around the world. According to the World Endometriosis Research Foundation (WERF) endometriosis negatively impacts society to the tune of an estimated $119 billion annually in healthcare and other costs.
    It's estimated that one in every 10 women have endometriosis during their reproductive years, and yet studies also indicate a seven to 12-year delay is typical in the diagnosis of endometriosis. Discovering the problem early may help you avoid unnecessary complications and pain.
    About 97 percent of cases involving my patients are due to a process called retrograde menstruation. In retrograde menstruation, menstrual blood containing endometrial cells flows back through the fallopian tubes and into the pelvic cavity instead of out of the body. These dislodged endometrial cells land onto the walls and surfaces of pelvic organs, like the ovaries, where they re-establish themselves, grow and continue to bleed over the course of the menstrual cycle.
    Endometriosis usually develops several years after the onset of menstruation. It affects women and girls from all races or socioeconomic backgrounds, with signs and symptoms of endometriosis ending temporarily with pregnancy and permanently with menopause.
    Though definitive causes remain under debate, the condition may develop when one or more small areas of the abdominal lining turn into endometrial tissue. This is possible because the cells lining the abdominal and pelvic cavities come from embryonic cells with the potential to assume the structure and function of endometrial cells. What causes it to activate remains unknown.
    Until relatively recently, even diagnosing endometriosis has been difficult, as there are other conditions with similar symptoms. Laparoscopy (operation performed in the abdomen or pelvis through small incisions with the aid of a camera) is the only way of truly diagnosing the disease.
    What is known are the risk factors for this disease:
    • Never giving birth.
    • One or more relatives (mother, aunt or sister) with endometriosis.
    • Menstrual cycles shorter than 27 days with bleeding lasting longer than eight days.
    • Any medical condition that prevents the normal passage of menstrual flow.
    • A history of pelvic infection.
    If you are suffering from any of the following, I urge you to speak to a doctor to determine the right treatment for you. This could include hormonal therapy, oral contraceptives or surgery:
    Page 2 of 2 - • Pelvic pain and cramping that begins before and extends several days into your period which may include lower back and abdominal pain.
    • Pain with intercourse.
    • Pain with bowel movements or urination.
    • Excessive bleeding.
    • Infertility (endometriosis is first diagnosed in some women who are seeking treatment for infertility).
    • Other symptoms such as fatigue, diarrhea, constipation, bloating or nausea.
    It’s imperative that early and effective intervention is offered to any girl or woman who may be suffering in order to prevent long-term effects and negative impacts.
    Dr. Kenneth Adams practices obstetrics and gynecology at St. Mary's Medical Center and can be reached at 816-350-1200.
     
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