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Endometriosis and Menstruation – A Challenging Cycle

By EmpowHER May 4, 2011 - 5:08am

A woman’s ovaries produce hormones each month that stimulate cells from the uterus lining to multiply and prepare for a fertilized egg. This lining, called the endometrium, swells and gets thicker. These cells are shed during menstruation and the swelling shrinks at the start of each cycle.

Endometriosis occurs when these cells also find their way to and grow in areas outside the uterus, such as in the ovaries, pelvis or fallopian tubes. These cells thicken, grow, break down and produce menstrual blood every month, just as they do in the uterus. But because this blood is not in the uterus, it cannot flow easily out of the body and may get trapped forming cysts and scar tissue. The actual causes of endometriosis are unknown.

Several studies have shown that women with endometriosis begin their menstrual cycle at a much younger age than women without the condition. Endometriosis is more prevalent in women who have a regular cycle than in women who have an irregular cycle, and that cycle may be shorter than average (less than 27 days).

Women with endometriosis have a particularly challenging time during menstruation. Heavy bleeding, severe cramps and longer menstrual flow are associated with endometriosis.

During menstruation, some women with endometriosis opt for menstrual cups rather than tampons or pads. Menstrual cups collect rather than absorb menstrual fluid and are often able to support heavier menstrual flows. In addition, menstrual cups are safe to wear for up to 12 hours, which means that women are changing their protection less frequently, reducing any irritation that may be caused by repeated tampon insertions.

Women who have severe or chronic discomfort or pain during menstruation or at other times during their cycle should consult a physician to discuss options for managing their symptoms. Beyond medication, many women also find relief during their period by taking warm baths and applying a heated pad to help relax pelvic muscles and reducing cramping and pain.

Endometriosis: Characteristic Symptoms and Signs
Endometriosis can be difficult to diagnose because of variation in symptoms from woman to woman and the association of these symptoms with other conditions. In addition to severe cramps, heavy bleeding during menstruation, and longer menstrual flow, other symptoms and signs of endometriosis include:

• Pain associated with intercourse
• Nausea/vomiting, gastrointestinal cramping, or diarrhea/constipation, particularly associated with periods
• Rectal pain
• Blood in the urine; urinary frequency, retention, or urgency
• Chronic or intermittent pelvic pain
• Painful menstruation
• Irregular bleeding
• Irregular vaginal clotting
• Large, painful ovarian cysts called endometriomas (also known as "chocolate cysts")
• Infertility, miscarriage, ectopic (tubal) pregnancy

Fatigue, chronic pain, allergies and other immune-related issues are also commonly reported complaints in those with endometriosis.

As always, it is best to consult a healthcare provider with questions about any symptoms or health problems.

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