How to understand the symptoms of Endometriosis?
The month of March is dedicated to Endometriosis, a public health disorder characterised mainly by severe pain and cramps during menstruation, that often derails the life of the menstruating girl or woman, literally confining her to her house for those few days. The topic of pain during periods has led to a widespread conversation at the policy level with the supreme court passing on the decision to the Union Ministry for consideration. While this has sparked a media frenzy in national news channels, the real question is ‘what is the reason for such excruciating pain and what is the essentiality of such menstrual leave?’
Dr. Mukesh Gupta, Obstetrician & Gynaecologist, Le Nest Hospital, Malad, Mumbai says, “From a medical standpoint, Endometriosis is a gynaecological condition where the lining of the uterus also known as endometrium grows outside the uterus, on the ovaries, fallopian tubes, lining of the abdominal, intestines, bladder, and rectum as well. The reason for concern in this disease is the pain associated with endometriosis, as women suffering from this chronic inflammatory condition often complain of excruciating pain.”
Immediate and recurring symptoms:
Painful periods or dysmenorrhea:
Pain and cramps during menstruation is often considered as normal but if it impacts your life, your daily routine then it is definitely a red flag. Pain of such a high degree during menses or heavy bleeding and excessive clotting could very well indicate endometriosis and therefore must be checked by your gynaecologist.
Pelvic Pain:
The primary symptom of endometriosis is pelvic pain, often associated with menstrual periods. Due to this chronic condition, the surrounding tissues often get inflamed and scarred leading to adhesions. Thus, causing tissues lining the pelvis and the surrounding organs to stick together leading to high degrees of pain.
Painful intercourse or dyspareunia:
Pain during sex or post-coital (after) sex could be another symptom of this condition, but we cannot jump to conclusions without proper examination as painful intercourse could also be due to infections, lack of lubrication, vaginismus, structural problems, or psychological concerns.
Painful bowel movements:
If you experience pain while passing motions or urinating then one needs to rule out the reason for it. As the scar tissue and adhesions spread to the abdominal wall and bladder, it can cause pain at such times.
Abdominal bloating and nausea:
Digestive issues include diarrhoea, constipation, bloating, or nausea, especially during menstrual periods often causing confusion between a gastro or gynae issue.
Infertility
Dr. Gupta says, “Infertility is the lesser-known devil here, but endometriosis-associated infertility is affecting a large number of women and is only realised during family planning. The adhesions or scarring that affects the fallopian tubes could lead to blockage and therefore create issues for the sperm to reach the egg, reducing chances of pregnancy. Endometriosis can distort the pelvic anatomy and cause inflammation in the pelvic region, lead to endocrine and ovulatory disorders, disturb embryo implantation, impact sperm and egg quality, thus reducing chances of pregnancy. The condition also wreaks havoc with the hormonal balance of the body, interfering with multiple functions such as that of the peritoneal fluid, pituitary gland, endometrial function that may have a role to play in embryo development and fertility overall.”
The takeaway:
“The symptoms of endometriosis often overlap with other gynaecological conditions such as hormonal imbalance, STDs, dysmenorrhea, PCOS or infections. It is often said that pain during periods is normal and must be tolerated by women. Hence, many women ignore and not read into it too much,” adds Dr. Gupta.