For most women, it is normal to experience pain usually called cramps just before the beginning of the menstruation or at during the first 2 days of menstruation, but it is quite unusual to experience pain after one’s menstruation and if experienced, it can be caused by some underlying conditions. One of these underlying conditions could be ENDOMETRIOSIS.
Endometriosis is caused when the inner lining of the uterus begins to grow on the outside. This means that inner lining of the uterus begins to grow outside and thus posing health issues and causing severe pain to the woman.
Most of the time, endometriosis is hardly diagnosed, and most people don’t know of the existence of this disease hence it’s the least treated for and mostly tested last during a routine monthly check. Here are some things you may need to know about this common but usually un-diagnosed disease.
Endometriosis occurs when the cells of the endometrium are found growing somewhere else in the body. Mostly these cells are found growing either in the pelvis, fallopian tubes or the ovaries. Some might even migrate farther down the pelvis into the bladder.
Now, when it is time for menstruation, the hormones produced by the ovary which responsible for menstruation will begin to act on the normally localized endometrial cells (i.e. the cells found within the endometrium), and also the abnormally migrated cells will likewise respond to these hormones as well.
When the endometrial cells within the endometrium begin to bleed, the endometrial cells which abnormally migrated also too will begin to bleed causing pain in the area where they are localized (i.e. pain within the pelvis, bladder or lower abdomen).
The exact cause of these is not known but some physicians believe that during the menstrual period, the cells are carried alongside the blood and they find some place to stick to hence not draining alongside the dead cells from the endometrium.
This thereby can cause cysts within the location where they lodge themselves in or likewise they can cause inflammation and severe pains due to the formation of scar tissue.
Most times, the woman will experience severe pains which will resist the effects of painkillers and sometimes, it may cause severely irregular periods and sometimes menorrhagia (heavy menstruation).
Other symptoms experienced may be pain sometimes during sex and sometimes immediately after sexual intercourse, severe pain and maybe bleeding during urination, traces of blood in the stool, and the feeling of severe weakness experienced usually most of the time. Most times, one may not experience any symptom at all although this occurs in rare cases.
This infertility is caused by the tendency of the scar tissue to catch and trap the egg while it’s coming down from the ovary thereby preventing it from getting into the fallopian tubes hence no fertilization can occur because there will be no egg for the sperm to fertilize.
Most women don’t know that endometriosis is a long term chronic condition that can have a long lasting physical effect as well as have severe effects in our emotional state. For some women, due to the severity of the pain, this disease might disturb their day-to-day activities and routine and can most likely cause depression as well.
Earlier, I said that endometriosis is one of the most under diagnosed disease and this is because symptoms can vary from person to person hence the difficulties in diagnosing the disease. Sometimes, this disease may even present as normal cramps and the woman may not even notice the abnormality of the pain.
Sometimes, this disease may also mimic the symptoms of pelvic inflammatory disease or abnormal bowel movements such as irritable bowel syndrome. On an average according to Mayo Clinic, it takes about 7 and a half years for this disease to be diagnosed.
Also, most women tend to suffer the pain in silence attributing the pain to normal menstrual cramps. As a woman, if you find out that the pain is more severe than the normal menstrual cramps which you usually have, please speak up and complain to your doctor.
You don’t have to suffer in silence when you can always get help and be treated adequately. Currently, treatments for endometriosis include painkillers such as Panadol and also NSAIDs although NSAIDs aren’t usually advisable due to the adverse effects it has on the liver.
Hormonal therapies could also be administered, and this would slow down the rate at which the hormones regulating menstruation are released hence slowing the growth of the endometrial tissue before a surgical operation carried out to remove the scar tissue. Treatment options is dependent largely on the following things;
- If the woman still wants to get pregnant or not
- Age of the woman
- Severity of her symptoms
For a woman who doesn’t want to get pregnant, usually birth control pills are usually prescribed as the first step of treatment.
This is because the birth control pills will stop the production of menstrual hormones by the ovary hence leading to the slowing down of the growth of the endometrial cells invariably helping to shrink the scar tissue.
While for women trying to get pregnant, a gonadotropin releasing hormone agonist treatment is administered. This will help to stop ovulation period.
Though it is advisable to go for surgery as an optimal relief but most times, for this disease, the symptoms usually return after 1 or 2 years because there is a regeneration of these endometrial cells even in the abnormal site of embedding. Most women are then therefore given pain relievers after surgery to help manage the pain.
But ultimately, if the symptoms keep persisting even after surgery, then it is advised that the women involved undergo hysterectomy (i.e. total removal of the uterus). This is mostly considered as the last option since other treatments have failed.
After the removal of the uterus, the condition is less likely almost at a 0.5% chance of coming back again.