With all the health information available at our fingertips, its hard to determine what is normal and when we have to seek medical attention.
Painful menstrual cycles (known formally as dysmenorrhea) can be common.
It can occur from the very first time we get our periods or develop later on in life. Unfortunately, a quick internet search may lead us down a path with very scary sounding diagnoses, such as chronic pelvic pain or endometriosis.
The facts can be daunting:
- dysmenorrhea can impact 16-91% of reproductive age women
- 10-20% of US girls miss some school because of dysmenorrhea
- though medications like Ibuprofen and Motrin are supposed to help, 18% of women with painful periods still have pain despite these treatments
- greater than 70% of patients with pelvic pain have endometriosis
Ok, that being said, let’s all take a quick 10 seconds to do some yoga breathing and realize that the facts above do not doom us to a life of chronic pain.
Yes, there is a condition called endometriosis and yes it can have some serious repercussions for our lives but painful periods do not equal endometriosis.
Endometriosis effects up to 10-12% of women in their reproductive years
- First, there are no set symptoms that make you a ‘slam dunk’ endometriosis patient. Meaning, even if you have dysmenorrhea, painful intercourse (dyspareunia) and/or painful ovulation (wait for it. . .known as Mittelschmerz) you are not necessarily going to have endometriosis.
- Secondly, no matter how convincing a set of symptoms may be, neither you nor your doctor can be 100% sure you have endometriosis. Only surgery can defintively determine the presence of endometriosis. This may seem like a huge step. Most of us would like to avoid surgery unless it is absolutely necessary, however, to have a concrete diagnosis of endometriosis surgery is necessary.
- There are new developments on the horizon which will hopefully help us make the diagnosis of endometriosis without surgery but currently the standard of care states that surgical diagnosis is needed.
- Third, (and this is good news) we can start treatment without having surgery. Meaning, we can try to treat dysmenorrhea without knowing for sure if endometriosis is present.
Hormonal contraceptives have long been known to both decrease menstrual related pain, ovulatory pain and diminish blood loss during menses. These options include birth control pills, birth control patches or vaginal rings, injectable birth control methods and hormone-imbedded IUDs.
These choices may not be right for everybody but it is important to know that there are medical options available before we have to consider surgery.
Let’s take a moment to realize that painful periods are not going to define us and we have options (prior to surgery) that may give us relief.
However, if your dysmenorrhea has started to impact your life negatively please do seek care with your Ob/Gyn and discuss your options in detail.
Stay tuned for more information on who gets endometriosis, what happens if hormonal therapies do not work and what surgery can offer.
I am a Ob/Gyn practicing in Orange County, California. My area of focus since completing my training at USC has been Minimally Invasive Surgery and pelvic pain. My goals as a physician have included educating and being transparent with my patients about their diagnosis and treatment options. A team approach to pelvic pain and endometriosis has been proven to be most effective therefore, empowering my patients with accurate and evidence based information is essential to demystifying this often misunderstood condition.