What is Causing Painful Periods and painful sex?

September 17, 2019 | Yesmom

Yes Mom

All you need to know about endometriosis

Top Things to Know:

  • Endometriosis is not just a ‘bad’ period
  • It is a painful condition characterized by the growth of cells, similar to those found lining your womb or uterus, on other nearby organs like the bladder, kidneys etc.,
  • It is classified into four grades based on the severity of symptoms
  • There is no exact cause of endometriosis
  • Endometriosis is a very common condition, though most of the time it is not reported
  • Each woman suffers from one or more symptoms, and each symptom severely impacts her quality of life
  • There is no cure or treatment for endometriosis but medication and surgery are recommended for managing the symptoms

What is Endometriosis?

Every girl and woman has experienced some degree of pain during her periods. It is very common for teenage girls to have excessive pain right around their first period. This continues for a few months before fading away into what most women describe as ‘mild to moderate’ discomfort.

However, the story isn’t the same for all women, is it? One of the more common causes of excessive pain during periods and at the time of ovulation is a condition called as endometriosis. And no, endometriosis is not just a ‘bad’ period which you may have been told umpteen number of times, if you suffer from it.

So, what exactly is endometriosis? Don’t get worried about the complicated medical term as it simply means a condition where cells, similar to the ones lining your uterus or womb, grow outside of it on other organs, and follow the same pattern of growth and shedding as the uterine lining cells do during menstruation. 

During periods, the lining of the woman’s womb or uterus is shed off, along with blood, mucous and some cells. The same happens with these cells that are growing on other organs. They break down, causing bleeding, inflammation and excruciating pain in the abdominal region of the woman’s body. Infact, endometriosis can occur even after a woman has reached menopause, in the absence of periods.

There are four stages of endometriosis – grades 1 to 4 and are classified as mild, moderate and severe, where grades 3 and 4 show severe growth of scarring tissue.

How Does Endometriosis Occur?

“Why do I suffer from endometriosis?”, is quite commonly asked by women who suffer from the condition. Well, there is no exact known cause for endometriosis. However, there are multiple speculations that can be probable causes of this painful condition Some of these are:

  • Presence of primitive cells on pelvic organs that develop into the endometrium or womb-lining cells
  • Altered immune response of the body
  • Remnants or scar tissue that are found post surgery in the region
  • Retrograde menstruation where blood is deposited via fallopian tubes directly into the abdomen
  • Even genetics has been blamed for this condition

But, there is no evidence to prove any one of the above reasons as the cause of endometriosis.

How common is Endometriosis?

Endometriosis is a condition that occurs in women who are in the reproductive years. The condition is commonly seen in the 25-35 yrs age group and has been diagnosed even in girls as young as 11 yrs. A whopping 25 million Indian women suffer from endometriosis. About 20-50% women who are being treated for infertility suffer from it.

What are the Symptoms of Endometriosis?

While endometriosis is very common, not all women have symptoms. But, most women with this condition suffer from one or more of the following symptoms:

  • Pelvic pain before the start of your period
  • Pain in the lower abdomen
  • Painful sex
  • Cramping during emptying of bowels and while having sex
  • Painful urination
  • Difficulty in conceiving

How Does Endometriosis Affect Fertility?

As you know now, most women with endometriosis often do not have any signs or symptoms. However, one common complaint most women, who accidentally get diagnosed with endometriosis, have is that they are finding it difficult to conceive.

When the gynecologist performs an abdominal scan or a laparoscopic examination, these uterine lining- like tissues are found on some organs in the abdomen. These are basically the scar tissue that is formed as a result of endometriosis. 

If this involves the ovaries or the fallopian tubes, the transfer of the egg to the uterus may be altered or blocked. In such scenarios, it can cause infertility or difficulty for the woman to conceive.

How is Endometriosis Diagnosed?

Apart from symptoms, how does one get diagnosed with endometriosis? Well, if you feel you have one or more symptoms of endometriosis, it is advised to visit your obstetrician-gynecologist or OB-GYN. 

He/she will perform a pelvic examination that might include a recto-vaginal examination. Other scans such as ultrasound imaging can also be used to get a clearer picture of the uterus, ovaries and the surrounding areas. Some hormonal tests like Anti-Muellerian Hormone(AMH) level tests are also performed for diagnosing endometriosis. It has been observed that endometriosis is linked with decrease in the AMH levels.

However, the best way to diagnose endometriosis is by performing a laparoscopy. Laprascopy involves a minor operation wherein, a small camera is inserted into the pelvis of the woman via a small cut that is made near the belly button or navel. This is a routine diagnostic test for endometriosis, which is performed under general anaesthesia as an out-patient procedure. This means you don’t have to stay the night at the hospital and can go about your daily activities from the next day.

What Treatment Options Do I Have?

Once the diagnosis has been confirmed by the OB-GYN, the next logical step in the management of endometriosis is treatment. Today, there is no complete cure for endometriosis. The treatments available currently are those that are aimed at reducing the symptoms, improve the quality of life of the woman affected and improve her chances of conception.

In order to manage the symptoms of endometriosis, there are primarily two ways to go about it: Medications and surgery. 

The decision is based on your doctor’s diagnosis and severity of your condition.

Commonly used medications are: 

  • NSAIDs or Non-Steroidal Anti-Inflammatory Drugs that help in reducing pain and cramping
  • Hormonal medications 
  • Birth control pills
  • Other pain controlling medicines


Surgical method of treatment for endometriosis is commonly preferred when the symptoms are severe or the woman’s condition hasn’t improved much after medications. However, endometriosis has a high recurrence rate of 40% and a woman gets maximum amount of relief once she reaches menopause. Most doctors advise their patients to continue medications before and after the surgery.