Fact-Checked By : Dr. Tara Scott, OB-GYN
When it comes to your health, knowledge is power. Becoming an advocate for your health is a great way to get the education and tools you need to make a positive difference in your life — this is especially true for those who are experiencing chronic pain.
If you’re “used to” having a heavy, painful, or irregular period, making an appointment with your gynecologist is the smartest thing you can do. While some cramping is expected during your period, heavy bleeding and pelvic pain aren’t normal and should be addressed ASAP. Why? Because these symptoms are telltale signs of endometriosis.
Endometriosis (en-doe-me-tree-O-sis) is a painful and incurable condition in which endometrial-like tissue grows outside of the uterus. According to the Endometriosis Foundation of America, endometriosis affects 1 in 10 reproductive-aged individuals — an estimated 200 million individuals worldwide.
Although endometriosis is commonly found within the pelvic cavity, endometriosis can grow anywhere, including but not limited to, reproductive organs, the outside of the uterus, fallopian tubes, ovaries, and uterosacral ligaments. Endometriosis can also attach itself to the large and small bowel, appendix, diaphragm, lungs, and rectum. In rare cases, endometriosis can be found in the kidneys, liver, eyes, brain (cerebral endometriosis), bone, heart, and skin.
This abnormal tissue, which is not endometrial tissue but endometrial-like tissue, thickens, breaks down and bleeds each month during the body’s menstrual cycle. Because the tissue has nowhere to go, it becomes trapped — which, as you can probably imagine, causes trouble. If the endometriosis is on the ovaries, for example, cysts (endometriomas) may form. In addition, surrounding tissue may become irritated (regardless of where the endometriosis is located), which can cause scar tissue and adhesions.
Endometriosis is often described as a “whole-body disease.” This is because endometriosis has both physical, emotional, and mental side effects. Endometriosis can impact every single aspect of a person’s life.
Physical symptoms of endometriosis include:
- Painful periods (dysmenorrhea)
- Chronic fatigue
- Pain during or after sex
- Heavy or irregular bleeding
- Pain with bowel movements or urination
- Lower back pain
- Pelvic pain
- Diarrhea and constipation
- Difficulty getting pregnant (infertility)
- Psychological stress
- Poor quality of life
Psychiatric symptoms of endometriosis include:
Note: This is not an exhaustive list. Endometriosis is an individualized condition and symptoms may vary from person to person. Pain is not related to the severity of the disease. Some individuals with severe endometriosis may experience no pain, while others with a milder form may have severe pain.
There is only one way to definitely diagnose endometriosis is through surgery, typically laparoscopic surgery. During laparoscopic surgery, a camera is used to look inside the abdomen and pelvis through a small incision. Laparoscopic surgery can be used to determine the location, extent (stage), and size of endometriosis.
Endometriosis is classified into one of four stages:
- Stage I: Minimal endometriosis
- Stage II: Mild endometriosis
- Stage III: Moderate endometriosis
- Stage IV: Severe endometriosis
These stages are determined by the location, amount, depth, and size of the lesions. Again, it’s important to note that the stage of endometriosis doesn’t correlate with an individual’s pain level. This means that it’s possible for an individual with Stage I to have excruciating pain while another individual with Stage IV may be asymptomatic — 20 to 25 percent of people with endometriosis are asymptomatic.
Although there’s no known cure for endometriosis, there are ways to manage the pain and other symptoms.
Some treatment options for endometriosis include:
Heat therapy: Using heat therapy (i.e. a heating pad, castor oil packs, warm water bottle, or a hot bath, etc.) may help to relax the pelvic muscles, reducing cramping and pain.
OTC painkillers: OTC painkillers such as ibuprofen and other NSAIDs (non-steroidal anti-inflammatory drugs) may provide pain relief for individuals with endometriosis.
Anti-inflammatory foods: To fight inflammation, some individuals with endometriosis choose to go on an anti-inflammatory diet (also known as the endometriosis diet or “endo diet” for short), as consuming inflammatory foods and/or beverages, such as red meat, gluten, alcohol, and caffeine, may promote inflammation and lead to pain and progression of the condition. While anti-inflammatory foods won’t provide immediate relief, sticking to an anti-inflammatory diet (i.e. eating more green leafy veggies, salmon, ginger, and blueberries, among other foods) may help to manage endometriosis in the long term.
The Bottom Line
Endometriosis is an individualized condition and should be treated as such. This means your pain management plan may look different than what’s listed above and that’s OK! To ensure that you’re getting the help you need, make an appointment to discuss pain management options with your gynecologist.