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Painful periods? 4 things you should know about endometriosis

Painful periods? 4 things you should know about endometriosis

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Periods aren't usually a pleasant experience to begin with, but certain signs and symptoms may point to a more serious condition called endometriosis. This condition has to do with the lining of the uterus, which thickens with blood every month before your period. However, when this special lining grows outside the uterus in other areas of your abdomen, it can cause extreme pain and discomfort.

Dr. Amber Bradshaw-Whitear of Ogden Clinic points out that this lining may grow on any structure in the abdomen, although it's usually contained to the pelvic area. While symptoms may begin as highly painful periods, they usually develop to a more consistent pain as endometriosis worsens. Other symptoms include pain during intercourse and problems with infertility.

Women with the condition ages 25-35 typically discover their endometriosis either due to infertility issues or escalated pelvic pain. Although genetics likely play a role in endometriosis, it's difficult to know exactly what causes this condition.

What causes endometriosis?

Although doctors aren't 100 percent sure what causes endometriosis, three theories as to the actual cause of endometriosis exist:

  • As blood menstruates, it moves backwards through the fallopian tubes and implants on an area of the abdomen.
  • Endometrial cells in the uterine lining travel through the lymphatic system to implant in other areas of the body.
  • Changeable cells in the abdomen transform into endometrial cells, causing endometriosis.

Because evidence of this condition comes from ensuring the presence of endometrial cells outside of the uterus, diagnosis only comes through a laparoscopic surgery. Once the surgeon removes suspicious tissue, they'll send it to the lab to confirm a diagnosis.

Is endometriosis a form of cancer?

Because of the changeable nature of endometrial cells, many have wondered about their relation to cancers of the abdomen. Note that endometriosis is not a cancer, but it may turn into cancer, just like any other cell in the body. If you have endometriosis, your risk of it turning into cancer is about 2.5 percent.

What treatments exist?

According to Bradshaw-Whitear, the first line of treatment for endometriosis can come even before an actual diagnosis is reached. "If we suspect endometriosis, we typically start hormonal therapy which will suppress the endometriosis from growing." Hormone suppression treatments and surgery are the two main solutions to endometriosis.

  • Birth control pills provide a treatment option by suppressing the menstrual cycle and reducing the progress of endometriosis. Certain intrauterine devices (IUDs) contain progesterone, which also suppresses endometriosis in a similar way to birth control.
  • Another treatment includes hormone-inhibiting shots. Many forms of treatment control or suppress hormones, which in turn reduces endometrial growth.

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Shutterstock

If a woman with endometriosis is attempting to get pregnant, none of the above treatments prove safe since they would all affect hormone levels. As an alternative, a doctor will perform surgery to remove the misplaced endometrial growth.

Surgical removal of endometriosis usually helps reduce pain and improves fertility, but is not a permanent solution. As long as the ovaries remain in a woman's body, she'll have to deal with the effects of endometriosis until she finishes menopause.

If women wish to prevent future endometriosis following this surgery, they will require additional hormone suppression.

Does surgery eliminate endometriosis pain?

If you are on hormone suppression therapies after surgery and are still experiencing pain, it likely originates from another source. It's not uncommon for women with endometriosis to have multifactorial pain, meaning that they may suffer from endometriosis and other pain-inducing conditions. For this reason, it's important to talk to your doctor early on if you are experiencing overly painful periods.

Some may wonder if a hysterectomy might cure endometriosis. Unfortunately, endometriosis grows in response to estrogen, which ovaries produce. Bradshaw-Whitear explains that only when the uterus and ovaries are removed will the patient be free of endometriosis unless they are given estrogen medication.


It's not uncommon for women with endometriosis to have multifactorial pain, meaning that they may suffer from endometriosis and other pain-inducing conditions. For this reason, it's important to talk to your doctor early on if you are experiencing overly painful periods.

Although surgery provides some relief for patients with endometriosis, Bradshaw-Whitear does not recommend ovary removal in women before menopause (unless the ovaries are diseased) and emphasizes that it should always be a last resort. "Ovary removal would send the patient into immediate menopause, which has its own set of challenges and health effects, especially when done too early."

If a surgery with a hysterectomy is required, it is best to leave the ovaries and place patients on hormones. "The goal is to find a medication that can help maintain quality of life," Bradshaw-Whitear says. Because endometriosis is a hormonally caused and regulated disease, hormone suppression treatments offer the best solution for long-term pain management.

If you're unsure whether your painful periods are just a routine part of womanhood or point to something more serious, talk to your doctor. Ogden Clinic offers a wide selection of doctors and medical professionals to put your health and happiness first.

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Dr. Amber Bradshaw-Whitear of Ogden Clinic

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