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Monthly menstrual pain could indicate endometriosis

Monthly menstrual pain may signal more than just cramps. Monthly menstrual pain could indicate endometriosis, said Georgia Ragonetti-Zebell, a physician with Mountain View OB-GYN in Easley.

“Endometriosis is when the endometrium — the lining of the uterus — is found outside of the uterus,” she said. “It bleeds every month and responds to the normal hormone cycle.”

Endometriosis can cause scarring in the pelvis. The primary symptoms are pain, especially around the time of a women’s period, and infertility.

“They may have very heavy periods,” Ragonetti-Zebell said. “They may have pain associated with urination or bowel movements.”

Pain may also be associated with sexual intercourse.

Despite the fact that some women experience great discomfort from endometriosis, not everyone is aware that they have the condition.

“Many women with endometriosis don’t have any symptoms,” Ragonetti-Zebell said.

In some cases, women are unaware of it until they struggle to get pregnant. Ragonetti-Zebell said inflammation in the pelvis and scarring can block the fallopian tubes.

Risk factors for endometriosis include family history, being very young at the time of the first period or having very short menstrual cycles. Women who have many children or those who breast-feed longer tend to have less risk, according to Ragonetti-Zebell, as do those who exercise regularly. Any woman who is having periods can develop endometriosis, though Ragonetti-Zebell said it is most commonly diagnosed when a woman is in her 30s or 40s.

Treatment options are available.

“Since it’s hormonally stimulated, we can use hormonal therapy to suppress it,” Ragonetti-Zebell said.

That may be as simple as taking birth control pills. Pain can be managed with anti-inflammatory medications.

“Surgical options would be a laparoscopy where we go in and remove that tissue,” Ragonetti-Zebell said.

Laparoscopy is the only way to definitively diagnosis endometriosis, but it may be suggested by ultrasound.

“If someone has infertility or pain, we get an ultrasound,” Ragonetti-Zebell said. “Sometimes you can see some signs on ultrasound.”

If medications or laparoscopic surgery do not offer relief from the condition, Ragonetti-Zebell said a hysterectomy is also an option.

To determine a course of treatment, women first have to seek help from their doctor. Ragonetti-Zebell said if it is affecting a woman’s quality of life, she should not ignore it.

“Most women have some level of pain with their periods, some cramping,” Ragonetti-Zebell said. “If this is something that interferes with your life — if intercourse is painful or you are having infertility — we can often very much improve their lives with some medication.”

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