Endometriosis affects over 5 million women in North America. The disease is caused by the endometrial cells, or the cells of the uterus, abnormally growing in inappropriate areas of the body. The tissue acts just like the normal uterus, shedding the lining every month. Depending on the location of the abnormal tissue, this can cause massive scarring and bleeding through the body.
Endometrial tissue is commonly found in the reproductive organs, such as on the outside of the uterus, the fallopian tubes, and the ovaries. It can spread to other internal organs, such as the intestines and bladder. If the tissue affects the lymphatic system, it can grow across the entire body. The only definitive test to confirm a diagnosis of endometriosis is through laparoscopy and treatment includes hormonal medications like birth control, pain killers, and surgery.
Let’s take a closer look at 15 of the most common symptoms of endometriosis…
1. Painful Menstruation
One of the most common symptoms of endometriosis is painful menstruation. This pain can start one week before ovulation and continue until one week after the end of menstruation. The pain may be a constant discomfort, or it can cause cramping. This cramping pain may radiate and come in waves. According to the U.S. Department of Health and Human Services, this pain occurs when the endometrial tissue bleeds and has no where to exit the body which causes inflammation and pain. Over the counter pain medication is a good treatment option for painful menstruation. There are specialty medications specifically made for menstruation pain that include a mild muscle relaxant. In more severe cases, women can develop blood-filled cysts called endometriomas, explains SELF. If these cysts rupture in the body, they’ll cause extreme pain and heavy bleeding.
However some women can suffer from endometriosis and only experience a very mild level of pain so they’ll never seek help and might not realize they suffer from this condition for a long time. Self points out that this is one of the reasons this condition is so under-diagnosed. Also, many women just associate their period with bad cramps, so they don’t know how to differentiate when something more is wrong. “There are some who either suppress or don’t articulate their symptoms because they don’t want to admit they have a problem until it really interferes with their life,” says Tamer Seckin, M.D., an NYC-based gynaecologist when talking to SELF.
2. Excessive Bleeding During Menstruation
One dangerous symptom of endometriosis is excessive bleeding during menstruation. Someone who’s suffering from this condition might also experience unusually long periods that last longer than the average 7-days. Excessive bleeding can cause low levels of iron which leads to fatigue, hair loss, and anemia. For women who experience heavy or long menstruation, iron supplements or iron intravenous injections may be necessary.
“When you get your period, the endometrial growths react to menstrual hormones from your ovaries the same way the lining of your uterus does, so they grow and bleed, too. As endometrial growths get bigger over time, they can bleed even more,” writes Self. The Mayo Clinic points out that endometriosis can develop early on in a woman’s reproductive stages so she might not know her period is unusually heavy because that’s all she’s used to.
3. Back Pain
Back pain for endometriosis can be caused by a variety of conditions. Before, during, and immediately after menstruation, back pain may be a painful symptom. This can be caused by the uterus contracting and cramping. Back pain may also be caused by scar tissue that forms around the internal organs after endometriosis damage. While the damage is internal, the pain may radiate to the back or chest. A warm, relaxing bath can help relax tense back muscles. Along with pain medication, this symptom can be controlled with the help of your doctor.
4. Painful Penetrative Sex
As endometriosis damages the reproductive organs, sexual intercourse may become very painful. The act of penetration can push against scar tissue, damaging the muscles. Tamer Seckin, M.D., an NYC-based gynaecologist who specializes in treating women with endometriosis told Self that this pain can occur during sex, afterwards, or even continue on in the days following. “Pain with orgasm is common, but people don’t usually articulate it.” Going slowly with open communication can help when achieving penetrative sex. A woman’s body may also tense up, not allowing for penetration if there has been pain during sex in the past.
It’s important to note that there could be other reasons behind pain during sex. For example if there’s not enough lubrication or there’s a hidden STD, it could be the culprit. But if this symptom is experienced along with painful menstruation, it could be due to endometriosis. “If someone is having painful periods and bowel movements, and pain during sexual intimacy, it’s a very prognostic sign and highly implies endometriosis,” says Seckin to Self.
One devastating side effect of endometriosis is infertility. It is estimated that up to 50-percent of women suffering from endometriosis will be unable to get pregnant, according to Self. This is caused by scar tissue damaging the ovaries and the walls of the womb. Many women might not even realize they have endometriosis until they begin trying to conceive and are unable to. Getting pregnant is not the only problem. Carrying a child to term may also be difficult.
Some studies have shown that women with endometriosis have a higher change of miscarriage. This can be caused by hormonal imbalance and scar formations. Some studies have found a link between the body’s immune response and miscarriage, leading to the hypothesis that the body may not recognize the embryo unlike it does with healthy women.
6. Painful Urination
A symptom of endometriosis is painful urination. The entire urinary tract my become affected, including the bladder, kidneys, and urethra. Painful urination can be caused by the endometrial tissue implanting along any of these organs. It can also be affected by the tissue rubbing from implants on other organs, such as the uterus. Endometriosis can also cause blood to appear in the urine, as well as frequent urination and urgency, says Very Well Family. The source goes on to say, “In severe cases of endometriosis, endometrial tissue may grow around or even inside the bladder, leading to pain and bleeding.” Contact your doctor immediately if you notice that you urine is bloody.
7. Painful Bowel Movements
Issues affecting the entire gastro-intestinal tract are common with women suffering from endometriosis. This can start simply with painful bowel movements, but can affect other areas as well. These symptoms are commonly caused by the endometrial tissue rubbing the intestines from implants on the back of the uterus. The tissue can also attach itself to the bowels themselves, causing scarring. Other gastro-intestinal symptoms include bloating, bowel pain, cramping, and bloody bowel movements. If you experience blood in the water or stool after a bowel movement, contact your doctor. Bowel obstructions are a possible corresponding condition, as the tissue may implant on the inside of the intestines.
8. Feeling Of Insides Being Pulled Down
When endometriosis has progressed the pain can become so bad that it’s often described as feeling like the internal and reproductive organs are being pulled down. As the endometrial tissue adheres to the organs, the resulting scar tissues may fuse multiple organs together. As more scarring takes place, the organs may be unable to shift freely within the body. This may result in the feeling of the organs being pulled down to the pelvic bone. The only treatment for this advanced scarring is surgery to separate the organs. Correlated symptoms to this feeling include bladder and bowel issues and painful sexual penetration.
As a woman’s body reacts to the disease, fatigue may become a symptom. The implanted tissues and scarring can be taxing to the body, as it struggles to preform its regular functions. The endometrial tissues can also create hormonal imbalances. Many women experience this fatigue around their monthly menstruation. Fatigue may be one of the most underreported symptoms of endometriosis as it can be related to other illnesses or forgotten about. Chronic fatigue is not something you should have to battle with every day. If you suffer from chronic fatigue, talk to your doctor about the possible causes and treatment options.
10. Inability To Exercise
Pain in the pelvic region can make it difficult for women to exercise. The foreign tissue and scarring can bind organs together, causing pulling and tearing with certain movements. Pelvic pain can be caused by exercises involving the abdominal muscles. The pain can also be caused by running, walking, and even from standing for too long. In rare cases, endometrial cells can find there way into the lungs. This can cause bloody coughing and shortness of breath. This may feel like asthma, causing an inability to exercise. Hip and leg pain are also possible is the sciatic nerve is affected by nodules.
11. Constipation or Diarrhea
Women who are affected by endometriosis have a higher risk for irritable bowel syndrome (IBS). In fact, Self points out that endometriosis is sometimes confused with IBS or a food intolerance because it can present signs of intestinal pain, diarrhea, or constipation. “Many women with endometriosis go for intense bowel workups and colonoscopies, and they’re given special diets,” says Tamer Seckin, M.D., an NYC-based gynaecologist to Self. These tests are done because they believe they have some kind of gastrointestinal problem, but the root cause could be endometriosis because this disease can cause IBS.
12. Spotting and Bleeding Between Periods
In addition to heavy bleeding during menstruation, women who suffer from endometriosis might also suffer from spotting or bleeding between periods. Excessive bleeding between periods is a condition called Menometrorrhagia, according to the Mayo Clinic.
13. Nausea and Vomiting
In addition to suffering from gastrointestinal issues like diarrhea or constipation, it’s not uncommon for women with endometriosis to experience an upset stomach like nausea and/or vomiting during their period. The nausea could even stem from the other pain they’re experiencing due to this disease.
14. Pelvic Pain
As we’ve previously discussed there’s a lot of pain associated with endometriosis. From painful menstruation, to bowel movements, urination, back pain, and even pain during sex. We’re about to add one more to this list! About 20-percent of women who suffer from this condition will also experience general pelvic pain, says Very Well Family. This pain will present itself not only during menstruation, but throughout their entire cycle.
The amount of pain that a patient experiences doesn’t not attest to how severe their condition is. “You can have mild endometriosis and suffer from severe pelvic pain or have severe endometriosis and have little or no pelvic pain,” writes Very Well Family.
Depression and anxiety are an unfortunate part of endometriosis that can develop as a result of all the other symptoms a woman will experience like painful sex, infertility, and just an overall constant suffering of pain. “You may feel exhausted and depressed from dealing with pain throughout your cycle or period. Infertility and a difficult sex life (from painful intercourse) can lead to depression and anxiety,” explains Very Well Family.
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