Period Pain: Could It Be Endometriosis?

Melissa Ann Delgado, MD, FACOG, is board-certified in obstetrics and gynecology. She specializes in robotic laser surgery for endometriosis and sees patients at the Chronic Pelvic Pain Center of Northern Virginia.

You probably expect your monthly cycle to arrive with uncomfortable cramps and bloating. But if you (or your teen daughter) experience significant pain each month, it could be something more.

Endometriosis is a painful condition that affects more than 1 in 10 women between ages 15 and 44. It strikes when cells that normally line the uterus migrate to other parts of the body. Most often, those cells end up on the ovaries, fallopian tubes or the outside of the uterus. But sometimes they can travel further, to the bowel, bladder or even the lungs.

We don’t know why it happens, but we know the outcome: persistent pain that arrives every month like clockwork. Over time, endometriosis can also interfere with fertility. But take heart — we have a number of tools to manage this frustrating condition.

Endometriosis Symptoms

The impossible-to-miss symptom of endometriosis is intense pain during periods. It usually starts shortly after a young woman’s first cycle and gets worse over time. The pain can strike before, during and after your period, making it feel like you’re out of commission most of the month.

Many women also experience deep pain with intercourse or when they insert a tampon. It’s also common to have stomach problems like bloating, nausea and diarrhea. 

Endometriosis Treatment Options

In generations past, many women felt like they had to suck it up and deal with the pain of endometriosis. They got used to missing school or work and spending days in bed with their heating pads.

Now, doctors are better at recognizing the symptoms of endometriosis — and we have several options to help you deal with the pain:

• Hormonal birth control. Using contraceptives such as birth control pills, NuvaRing® and the Mirena® intrauterine device (IUD), we can temporarily stop a woman’s menstrual cycle. For many women, stopping periods means stopping the pain.
• Orilissa® (elagolix). This medication stops the ovaries from making estrogen and progesterone. It can cause side effects similar to menopause, including hot flashes and night sweats. But for women who can’t tolerate hormonal birth control, it can be an effective way to manage endometriosis.
• Alternative medicine. Some women aren’t comfortable with hormonal treatment. We can work with these patients to address endometriosis pain using acupuncture and herbs.
• Surgery. When other treatments aren’t effective, surgery can help. In extreme cases, we might consider a hysterectomy to remove a woman’s uterus. But that’s a last resort. Often, we can use a tool, such as a robotic laser, to remove the patches of wayward cells. This type of surgery is often a good choice for women who are hoping to get pregnant.

Unfortunately, several other conditions can cause chronic pelvic pain in women. And those conditions often go hand-in-hand with endometriosis. But intense pain during your period isn’t something you have to accept. Talk to your doctor. A proper diagnosis is the first step to living without pain.

Learn more about the Chronic Pelvic Pain Center of Northern Virginia, or call 703-448-6070 to schedule an appointment.