Painful Periods? You Might Have Endometriosis—Here’s What to Know

Many women experience some pain during their period, but if your pain is so bad that you can't go about your day-to-day routine, it might be worth checking out the possibility of endometriosis. Endometriosis is a condition where the tissue that lines the inside of the uterus (endometrium) grows outside of the uterus. This can cause pain and other symptoms. Read on to find out if your period pain could be a sign of endometriosis, what else to be on the lookout for, and new developments for how functional medicine can help you navigate this complex health condition.

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Just a painful period, or something more?

One of the most common symptoms of endometriosis is unbearable period pain at the start of every menstrual cycle. Pain can range from mild to severe and may be accompanied by other symptoms such as fatigue, nausea, headaches, and lower back pain.

Pain can also extend to other activities not associated with a period, like sex, bowel movement, and urinating.

Pain is so bad with endometriosis because the endometrial tissue, which is normally confined to the uterine wall, has grown outside of it. The tissue reacts to hormones just like regular menstrual tissue does and can create lesions or cysts in other areas. This can cause pain when these lesions are stimulated during menstruation or other activities.

Early endometriosis symptoms

Endometriosis is tricky to spot, especially in its early stages, but the most common among those with endometriosis is pain: abdominal pain, menstrual pain that prevents you from normal daily tasks, pain with sex, and/or pain with urination.

Since many young girls begin birth control for pain or irregular periods, hormonal contraceptives likely mask the symptoms only to reappear much later when she discontinues birth control (1). Because of this, researchers believe many milder cases go unreported. One study reported that up to 70% of teenage girls with chronic pelvic pain will later be diagnosed with endometriosis (2).

If the pain you are experiencing is significantly impacting your day-to-day life, it's worth talking to a functional medicine doctor about testing for endometriosis.

5 Most common symptoms of endometriosis

Endo may affect as much as 11% of women between the ages of 15 and 44 in the U.S. (3) Here's what to look out for:

Painful periods. Cramping during a period is common, but with endometriosis cramps are often debilitating.
Chronic pelvic pain due to scarring and inflammation.
Painful intercourse, also known as dyspareunia. Women may experience pain that ranges from mild discomfort to intense pain.
Heavy menstrual bleeding or clotting. Endometriosis can cause heavy or prolonged periods, as well as the presence of larger clots.
Infertility. Endo is one of the leading causes of infertility because of scar tissue and inflammation in the fallopian tubes.

Painful periods and other menstrual symptoms don’t always mean endometriosis, and they can be due to another condition known as dysmenorrhea. If any symptom is severe, you should always consult a physician.

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Uncommon symptoms of endometriosis

In addition to the most common symptoms of endometriosis, there are some atypical symptoms you may experience, which include:

Fatigue or exhaustion. Many women with endometriosis report feeling worn out and exhausted during their menstrual cycles.
Digestive issues. Nausea, constipation, and diarrhea are all possible symptoms of endometriosis due to the inflammation that is occurring in the digestive tract.
Unexplained weight gain. Endometriosis can cause hormonal imbalances that can lead to weight gain, especially in the stomach area.
Mood swings and depression. Endometriosis can lead to hormonal imbalances that can affect mood and lead to depression.
Dizziness, light-headedness, or headaches with a period usually as a result of hormone imbalances related to endometriosis.

Increasing awareness of common and uncommon symptoms of endometriosis can help individuals seek a proper diagnosis and treatment earlier to minimize long term side effects such as infertility.

Risk factors

It is estimated about 10 to 15 percent of women of childbearing age suffer from endometriosis. It can take anywhere from 4 to 11 years to receive a proper diagnosis (4)

You could be at a higher risk for endometriosis if you (5,6):

Started your period before age 11
Have short monthly cycles—less than 27 days
Have heavy menstrual periods that last more than 7 days
Are infertile
Have a family history of endometriosis. If you have a female family member who has endometriosis, you’re up to seven times more likely to have endometriosis.

Diagnosis

If you think you might have endometriosis, the first step is to see your integrative doctor who specializes in women’s reproductive health.

Your health care provider will likely do a physical exam or a pelvic exam and may order one or more of the following tests:

Magnetic resonance imaging (MRI)
Pelvic exam
Transvaginal ultrasound
Blood tests (CA-125)
Laparoscopy

As of 2022, the European Society of Human Reproduction and Embryology (ESHRE) now recommends laparoscopy only if imaging results are negative and other treatments are unsuccessful (7).

Treatment of endometriosis with integrative medicine

Treatment decisions are incredibly individualized and will depend on factors such as your symptoms, stage of the disease, desire to have children, and any personal preferences. Treatment options for endometriosis include:

Pain management
Hormone therapy
Surgery – Laparoscopy to remove adhesions is effective to reduce pain.
Acupuncture or massage
Anti-inflammatory diet changes

Depending on your individual situation, your doctor may recommend excision to remove areas of endometriosis via a surgical procedure. Excision removes the buildup of scar tissue on the bladder, abdominal wall, uterus, and elsewhere. Somewhere between 20-50% of women need a second surgery within 2 to 5 years, but this type of intervention does result in long-term relief in up to 80% of patients (8).

Having endometriosis can feel overwhelming, but there are ways to cope with the symptoms. Proper treatment begins with a prompt diagnosis, which is why it’s important to familiarize yourself with the signs and symptoms of endometriosis. Talk to your doctor about the best treatment options for you, and find support from other women in the same situation. With proper management, endometriosis can be managed and symptoms can often be alleviated.

Get started with functional endometriosis treatment today.

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About
the author

CentreSpring MD, formerly known as Atlanta Center for Holistic and Integrative Medicine, provides the best medical care by using an integrative approach to find a patient’s centre—their core—empowering them to spring forth into health.

Blog Reviewed By:

Dr. Taz Bhatia, M.D.

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