Excruciating pain during menstrual periods, pain during sex, and pelvic pain when you’re not having a period are all signs of endometriosis. If you experience these symptoms, talk to your doctor about endometriosis. Some amount of menstrual cramping is considered normal. But extreme, debilitating pain signals that something is wrong. Here are some things you should know about endometriosis and available treatments.
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What Is Endometriosis?
Endometriosis is a disorder in which the cells that normally line the uterus implant elsewhere, usually in the ovaries, fallopian tubes, or the pelvic lining. This abnormal cell growth can interfere with fertility and cause pain during your period.
The disease is common, says Nicole Donnellan, MD, an obstetrician-gynecologist at UPMC Magee-Womens Hospital who specializes in diagnosing and treating endometriosis. “One out of 10 women of reproductive age has endometriosis. Among women who are experiencing fertility issues, the percentage can be as high as 30 to 70 percent,” she says.
Most women who show signs of endometriosis are between 18 and 45 years old. “It’s a hormonally driven disease, so it mostly occurs in women in their childbearing years,” says Dr. Donnellan.
What Are the Symptoms of Endometriosis?
The most common symptom of endometriosis is chronic abdominal and/or pelvic pain during menstruation. You may also feel pain during or after sex. Other symptoms of endometriosis include painful bowel movements or urination, and unusual fatigue, bloating, or nausea during your period.
Although you can have endometriosis and still get pregnant, the disorder usually lowers fertility.
It’s very common for women who suffer from endometriosis to develop anxiety and/or depression. According to Dr. Donnellan, “some studies report anxiety and depression in 80 to 90 percent of chronic pelvic pain patients.”
Why Do Doctors Sometimes Miss the Signs of Endometriosis?
For many of us, mentioning periods — even to a doctor — is still somewhat uncomfortable. And many women just assume that whatever they’re experiencing is normal, says Dr. Donnellan. “Everyone complains about their period, right? But if you can’t function for a week every month, that’s not normal,” she notes.
Endometriosis also often goes undiagnosed because the main symptom — chronic pelvic pain — is present with conditions such as pelvic inflammatory disease, irritable bowel syndrome, and ovarian cysts.
Talking to Your Doctor About Endometriosis
The exact cause of endometriosis is unclear and, unfortunately, the only way to get a definite diagnosis is with surgery and a tissue biopsy, says Dr. Donnellan. “There’s no imaging, no blood test for it. Diagnosing it is often a process of ruling out other things.”
If you’re experiencing pelvic pain, it’s important to be able to talk about it with your doctor. Dr. Donnellan offers these tips for effective communication:
- Be your own advocate. Don’t be afraid to discuss symptoms of endometriosis with your doctor, says Dr. Donnellan.
- Don’t downplay your pain. Women too often assume that period pain is something that must be endured.
- Be specific about your symptoms and how they affect your life. “If you’re missing several days of work or school each month because of painful periods, tell your doctor,” says Dr. Donnellan.
- Consider changing doctors. If you feel your ob-gyn isn’t taking your pain seriously, it may be time to look for someone else.
- Learn about treatments for endometriosis. The first step is often pain medicine and birth control to regulate hormones. Surgical removal of endometriosis may be required in more severe cases.
The Endometriosis and Chronic Pelvic Pain Center at UPMC treat endometriosis. To learn more or to make an appointment, call 412-641-4900.
Editor's Note: This article was originally published on , and was last reviewed on .
About UPMC Magee-Womens
Built upon our flagship, UPMC Magee-Womens Hospital in Pittsburgh, and its century-plus history of providing high-quality medical care for people at all stages of life, UPMC Magee-Womens is nationally renowned for its outstanding care for women and their families.
Our Magee-Womens network – from women’s imaging centers and specialty care to outpatient and hospital-based services – provides care throughout Pennsylvania, so the help you need is always close to home. More than 25,000 babies are born at our network hospitals each year, with 10,000 of those babies born at UPMC Magee in Pittsburgh, home to one of the largest NICUs in the country. The Department of Health and Human Services recognizes Magee in Pittsburgh as a National Center of Excellence in Women’s Health; U.S. News & World Report ranks Magee nationally in gynecology. The Magee-Womens Research Institute was the first and is the largest research institute in the U.S. devoted exclusively to women’s health and reproductive biology, with locations in Pittsburgh and Erie.