How can you seek a solution if you don’t acknowledge the problem? You can’t. 

Painful periods should not be the norm. Many women remain undiagnosed for various menstrual related disorders because of their misconceptions surrounding period pain. They assume their pelvic pain and severe menstrual cramps are normal period related issues. Alas, the dearth of open conversation surrounding menstruation has resulted in a general lack of understanding regarding the reasons for menstrual pain and discomfort. 

Endometriosis is a common, but infrequently spoken about, women’s health disorder. It affects approximately 1 in 10 women during their reproductive age and The Endometriosis Foundation of India estimates that there are 25 million women in India who suffer from this condition. In an average menstrual cycle, the tissue lining inside the uterus (endometrium) will build up and then proceed to shed. However, in patients with endometriosis, the tissue lining grows outside the uterus and around the ovaries.  

As research surrounding women’s health is still an underdeveloped field in need of more rigorous findings, medications, and resources. The causes for endometriosis are unknown. Some theories that scientists and researchers believe could contribute to the disorder:

• Retrograde Menstruation: Occurs when there is back flow of menstrual blood into the pelvic cavity.

• Metaplasia: The transformation of extrauterine cells (outside the uterus) lining to endometrial cells. 

• Hormonal interactions: Estrogen and progesterone are two sex hormones. They are mainly produced in the ovaries and contribute to regulating endometrial tissue. Some research suggests that an increase in the ratio of estrogen to progesterone, leading to estrogen dominance, can play a role in the onset and sustenance of endometriosis. 

There are many symptoms associated with endometriosis. Most common symptoms include heavy menstrual bleeding, dysmenorrhea (menstrual cramps), fatigue, tiredness, chronic lower back pain, pelvic pain, painful bowel movements, painful urination, painful intercourse, and bloating. 

Traditionally, the most conservative treatments for endometriosis treat the associated pain. Painkillers and hormonal medications, such as oral contraceptive pills, can help alleviate some of the symptoms of endometriosis. According to the National Institute of Child Health and Development (NIH), oral contraceptive pills can have certain mild side effects such as, “weight gain, bloating, and bleeding between periods.” Similarly, other hormonal alternatives can lead to  depression, irregular vaginal bleeding, joint and muscle stiffness, bone loss, and sleep related issues. In the literature review, “Patient Education: Endometriosis (Beyond the Basics)”, Dr. Schenken from The University of Texas Health Science Center at San Antonio, states that “kidney problems, upset stomach, and worsened blood pressure” can be the unintended side effects of painkillers. He writes that while traditional painkillers may not alleviate all the symptoms of endometriosis, a combination of painkillers and hormonal therapies may be a more optimal treatment. The best way to find a treatment plan that is suitable to your body is to consult a licensed doctor or gynecologist. 

Formal diagnosis of endometriosis involves a laparoscopy, a surgical procedure in which an instrument is inserted into the abdomen through a small incision made in the navel. Laparoscopies can confirm endometriosis in the presence of cysts and suspected endometrial lesions. Other diagnoses methods include transvaginal ultrasounds, MRIs, and clinical examinations focusing on the pelvic and vaginal region. The Endometriosis Society of India emphasizes that while “removal of uterus and ovaries is required for permanent cure”, it is not an effective solution for women who desire to conceive. 

Various lifestyle and diet changes can help tackle symptoms of endometriosis. These often include warm baths, use of heating pads, regular exercise and de stressing, and intake of more vitamins and minerals. As per diet changes, some physicians recommend consumption of less anti inflammatory food, less refined sugars, and even a gluten free or low gluten diet. 

The best way for you to take charge of your menstrual health would be to contact a physician! Menstrual wellness is vital to women’s reproductive, psychological, and sexual health.  Do not ignore your symptoms out of shame or ignorance. Speak up for your body by seeking proper and timely clinical advice. 

Source: Meghana Sukthandar

Meghana is a biomedical researcher based in San Francisco, CA. She is a UC Berkeley graduate,with a degree in Molecular and Cellular Biology, and is actively involved in cancer research and health/educational policy reform.

To follow for latest updates and questions: @meghanasukt