Recognising the symptoms:
Endometriosis is a condition where cells like those that line the inside of the uterus are found elsewhere in the pelvis such as the ovaries, Fallopian tubes, and even the bladder. This tissue that is outside the uterus behaves the same way as the tissue on the inside of the uterus. This means that every month (under the influence of hormones) the tissue outside of the uterus builds up, then breaks down and bleeds. Unlike the cells in the womb that leave the body as a period, this blood has no way to escape and so bleeds into the pelvis. Bleeding into the pelvis triggers inflammation which causes pain. Inflammation also leads to the development of scar tissue and bands of tissue that cause organs in the pelvic to stick together.
Common signs and symptoms of endometriosis include:
- Painful periods (called ‘dysmenorrhea’). Pelvic pain can start before a period, continue for several days during and even after a period. Some may also experience lower back and abdominal pain during this time
- Pain during or after sex is common with endometriosis
- During your period, you may noticed pain with bowel movements or when passing urine
- Irregular bleeding pattern: Some may experience episodes of heavy menstrual periods or bleeding between periods
- Endometriosis my present as failure to conceive and may be first diagnosed during investigations for infertility
- If the rectum/bowels or the bladder/urinary tract are involved other symptoms can be: Periods-related or cyclical gastrointestinal symptoms in particular painful bowel movements as well as nausea, constipation, diarrhoea, bloating abdomen. Periods related or cyclical urinary symptoms, in particular blood in urine or pain when passing urine (with no urine infection).
Endometriosis is sometimes mistaken for other conditions that can cause pelvic pain, such as pelvic inflammatory disease (PID), ovarian cysts, and irritable bowel syndrome (IBS), as there are similarities or overlap in the pattern of symptoms. Many are often diagnosed with ‘bad period pain’. It is not uncommon to hear that women have made several trips to the GP, Accident and Emergency, and even Hospital Outpatient departments. While it is certainly imperative to carry out investigations to rule in or rule out other conditions that can cause pelvic pain, it is important to consider endometriosis as a possible differential, to prevent unnecessary delays in diagnosis and the associated negative impact on quality of life.
We encourage you to speak to your doctor if you are experiencing period pain that is impacting your quality of life.