When it comes to a competition between girls with the most severe form of menstrual pain, we all have in mind, that one girl from our high school days. For the guys, you cannot but cast your mind back to those college days when some two or more other boys would have to put a girl on their back(s) and scurry to the sickbay, all in the name of menstrual pain. Even in higher institutions, we still sometimes see and hear the groaning and moaning some sweet female who harbors this severe, intense cyclical pain; while many other females welcome their visitors with such calmness and tranquility. No one wants pain in the neck. As some would say, a normal period is not so funny, not to mention a stressful one.
Not all severe menstrual pain is ordinary or without cause. A dangerous medical condition called, Endometriosis, is mostly responsible for these cases. Although a short narration and examination by the doctor might do, a special procedure known as ‘Laparoscopy’ is needed to make a diagnosis.
What is Endometriosis?
Endometriosis occurs when bits of the tissue (endometrium) that lines the womb (uterus), grow outside the womb. These locations could be on the pelvic organs; ovaries or fallopian tubes, the covering of the abdominal organs (peritoneum); the pelvic ligaments; the umbilicus, the airways; the covering of the lungs.
The Why’s and How’s
The lining of the womb is called the endometrium. Endometrial tissue consists of glands, blood cells and connective tissue. Normally, this tissue should be found in the uterus only, and it thickens after menses, to prepare the womb for ovulation. However, when this tissue is found outside the uterus, it is called Endometriosis. As discussed above, it can be found anywhere in the body, but usually in the pelvis area. During menstruation, the endometrial tissue is expelled from the body, but the endometriotic tissue is not expelled. As a result, there is pain and other life-threatening symptoms which could affect various areas of life including school, work, relationships and even medical bills. Also, infertility could result from the blockage of the fallopian tubes, as the lesions grow larger.
Fast Facts on Endometriosis
- It is the most common benign gynecological condition
- It occurs in approximately 6-10% of women of reproductive age worldwide
- The symptoms are generally present during a woman’s reproductive years
- The estrogen levels during puberty are thought to trigger the symptoms
- These symptoms resolve after menopause or when treatment is directed towards pseudo-menopause
Tell-Tale Signs of Endometriosis
If it affects the female genital tract, there could be:
- Severe menstrual cramps
- Long lasting lower back and lower abdominal pain
- Periods lasting longer than 7 days
- Pain during sexual intercourse
If it affects the urinary tract, there could be:
- Cyclical bleeding during urination
- Obstruction of the urinary passage
In the gastrointestinal tract, there could be:
- Cyclical pain and bleeding during defecation
- Obstruction to the tract
In the lungs, there could be:
- Cyclical coughing out blood
- Blood and air in the rib cage
Other symptoms depend on the location of the endometriotic tissue or the organ affected. These symptoms occur with the normal menstrual flow
How is this Condition Managed?
As has been earlier said, endometriosis is not curable but it is manageable. Apart from physical treatment, psychological therapy is essential as well;
- Painkillers like Ibuprofen, can be used for the relief of the painful menses. As much as possible, avoid the use of codeine/opiates as these can worsen pre-existing bowel symptoms
- Hormones like birth control pills, IUDs, Gonadotropin-releasing hormone(GnRH) agonists and antagonists, Danazol, etc, can be used as prescribed by a doctor.
- Surgery: temporarily, the areas of the endometriotic tissue can be removed, using an instrument known as the laparoscope. A permanent solution entails the removal of the womb, ovaries and fallopian tubes, in women who have completed their families.
- Fertility treatment: pregnancy may be recommended via in-vitro fertilization (IVF)
Also, some other interventions can be done at home and they include:
- avoiding caffeine as this can worsen symptoms
- exercises like walking, to slow down the pain and progress of the condition by reducing estrogen levels
- intolerable pain or unexpected bleeding should be promptly reported to a doctor
Complications of Unmanaged Endometriosis
It is always best to monitor the symptoms, to avert the long term complications of the disease. Otherwise, the following could result:
- Infertility in up to 50% of affected women
- Increased risk of developing ovarian cancer
- Ovarian cysts (fluid-filled sacs within the ovaries)
- Fusion of the pelvic organs
- Intestinal and bladder complications