Painful Periods and Sex: What Is Endometriosis?

A diagram of a female reproductive system.

If there’s one thing on which most women agree, it’s that your period is pretty uncomfortable. The cramping, the bloating, the general discomfort…we wouldn’t wish it on our worst enemies. But for some women, period pain is more than just “uncomfortable;” it’s intense, debilitating, and completely unbearable.

These women suffer from a disorder known as endometriosis—a painful condition that can affect every part of their lives. Endometriosis causes painful periods, makes sex terribly uncomfortable, and even contribute to infertility.

Endometriosis is a fairly common condition, affecting 10-20% of women between the ages of 15 and 44. But like many conditions that don’t have visible symptoms, most people are woefully under-informed about the nature of this disorder.

Today, let’s try to change that. Here is everything you need to know about endometriosis.

What Is Endometriosis?

A woman laying down with her hands on her lower abdomen in pain.

Endometriosis occurs when uterine lining (endometrium) grows outside the uterus. In most cases, this tissue grows on the ovaries, fallopian tubes, and pelvis, but it can spread even farther in the body; for example, actor and dancer Julianne Hough was rushed to the hospital in 2008 due to endometrium that had spread to her appendix.

Endometrial tissue is meant to grow and thicken in the uterus, before being shed during your period. When this tissue grows outside your uterus, however, it has nowhere to go—which means it becomes trapped inside your body. This can result in scar tissue, inflammation, adhesions, and other complications that make this condition so terribly painful.

Signs and Symptoms

A woman in pain sitting on the edge of her bed with her husband stting on the opposite side.

One of the most difficult things about endometriosis is the fact that it’s an “invisible illness.” You can’t tell someone has endometriosis just by looking at them. In fact, the only way to get a conclusive diagnosis is to undergo a laparoscopy (a low-risk surgery that inserts fiber optic tools into your abdomen) so your doctor can see the endometriosis lesions.

Until that surgery, you and your doctors can only guess about the nature of your condition—that is, if you realize that there’s a problem at all. Many women with endometriosis have reported that, while the pain they experienced was violent and severe, they simply assumed it was a normal part of being a woman! Thankfully, endo awareness has been on the rise in recent years, and more and more women are learning to recognize the signs that something could be wrong.

So, what are the signs of endometriosis? According to the Mayo Clinic, the most common symptoms are:

  • Severe pelvic pain and cramping during your menstrual period (or even a few days before)
  • Pain during or after sex
  • Pain during bowel movements or urination, particularly during your period
  • Regular bleeding or spotting in between periods
  • An increase in digestive problems, such as constipation, diarrhea, bloating, or nausea during your period
  • Infertility

If you suffer from these symptoms, you should talk with your doctor and investigate further to determine if you’re dealing with this condition.

Treatment Options

A woman having an appointment with her female doctor.

Unfortunately, the medical community has yet to find a cure for endometriosis. However, there are some treatment options that can lessen a woman’s symptoms and make the condition more bearable. Most doctors will suggest some kind of hormonal medication, as endometriosis symptoms have been known to decrease when a woman’s hormone levels are lower. Common treatments include hormonal birth control, an IUD, or aromatase inhibitors (medication that reduces the estrogen in the body).

There are also surgical treatments that can be effective for women with endometriosis, particularly women who are trying to get pregnant. A doctor can perform laparoscopic surgery to clear away any endometriosis growths while preserving a woman’s uterus and ovaries and not affecting her hormones. This can increase a woman’s success of getting pregnant—but it is important to note that her symptoms will likely return when her period does after birth.

Finally, the most extreme treatment option for women with endometriosis is a complete hysterectomy, including removal of the ovaries. This method is less popular than it was in decades past as doctors favor other less invasive options, but it is an available option for women whose symptoms are too severe to manage through other treatments.

Living with Endometriosis

These days, more and more women are opening up about their struggles with endometriosis. This increased awareness has been life-changing for those who have lived with this difficult condition, and it has also led to a greater understanding from the general public. As more people learn about this condition, it is possible that more people will get tested, diagnosed, and treated early—preventing many more women and girls from suffering in silence.

If you suffer from severely painful periods, pain during sex, or any of the other symptoms of endometriosis, don’t feel like you have to deal with it alone! Talk to your doctor, or visit sites like the Endometriosis Association to find resources that can help you.

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