Painful periods & Endometriosis

More than half of women regularly experience menstrual cramps, with one in five experiencing severe pain. More than 10% of them suffer from endometriosis or adenomyosis, a similar percentage is affected by Polycystic Ovary Syndrome (PCOS), while one in three is affected by Pelvic Congestion Syndrome (PCS).

Not forgetting those who endure the inconveniences related to polyps, fibroids, and other dystrophies.

Beyond the chronic pelvic pain induced by menstrual cycles, many also experience ovulatory pain (40%), or the woes of Pre-Menstrual Syndrome (PMS), which affects 40% of women.

In the most severe cases, this syndrome can develop into Premenstrual Dysphoric Disorder (PMDD), affecting between 3 and 8% of the female population.

The symptoms frequently associated with menstrual pain include lower back and vulvar pain, particularly heavy menstruation, mood swings, migraines, pronounced fatigue, as well as various digestive and urinary disorders, not to mention heightened breast sensitivity…

When to worry about menstrual pain?

The menstrual cycle is divided into four main phases, which are supposed to occur without pain:

• Follicular phase: maturation of the follicle for optimal ovulation, strengthening the uterine wall.
• Ovulatory phase: fertility period during which the oocyte is released, stimulated by a peak of progesterone.
• Luteal phase: follows ovulation until the last day of the ovarian cycle.
• Menstrual phase: shedding of the thickened endometrium through menstrual bleeding in the absence of fertilization.

Hormonal balance is regulated by the fluctuations of two main hormones: estrogens, which promote oocyte maturation at the beginning of the cycle, and progesterone, which develops the endometrium for potential embryonic implantation.

A disruption of this balance, particularly an excessive production of estrogens or a deficiency of progesterone, can cause pain, often exacerbated in women suffering from endometriosis due to a tendency towards hyperestrogenism.

These hormonal imbalances, conducive to inflammation or a reduced anti-inflammatory effect, are warning signs of internal dysfunctions that should not be ignored.

No!! it's not normal to … Suffer from menstrual cramps

Absolutely not, enduring painful periods should never be perceived as a normal aspect of women's health.

Regular and pain-free menstruation is a reflection of hormonal and general well-being. All too often, these pains, whether or not related to endometriosis, are mistakenly accepted as a normal reality. However, they indicate a deep imbalance within our body.

During the menstrual cycle, our body secretes prostaglandins, essential hormones that facilitate uterine contraction for the expulsion of the endometrium.

Although these contractions are natural, excessive menstrual pain, to the point of disrupting daily life or causing nausea, should raise the alarm. They require a medical consultation to rule out the possibility of endometriosis or other medical conditions.

The excess of prostaglandins, often the result of inflammation, can lead to overly intense uterine contractions, gradually depriving the uterine muscle of oxygen and exacerbating the pain.

This inflammatory imbalance also disrupts the hormonal balance and communication between the brain and the ovaries, resulting either in a decrease in progesterone, which has anti-inflammatory properties, or an increase in estrogens, promoting inflammation.

This is a clear warning: if your menstruation becomes a torment, it is imperative to seek medical support to identify any underlying condition and restore the balance of your health.

Is a single medication enough to ease your pain?

Menstrual pain, especially when it is a symptom of endometriosis or other conditions, often resists the effect of a simple analgesic. This pain can become so debilitating that it hinders the ability to perform normal daily activities. Its impact goes beyond the personal, causing repeated absences from school or work.

Any other associated symptoms?

Menstrual pains can also be related to symptoms that make them even more handicapping such as:

• of exhaustion
• very painful breasts
• irritability
• bloating, digestive disorders
• urinary troubles
• migraines
• nausea or even vomiting
• discomforts… 

Endometriosis, is it primarily responsible for menstrual pain?

This condition causes inflammation, oxidative stress, immune failure, and hormonal imbalance, thus triggering symptoms such as menstrual pain, heavy and irregular menstruation, among other symptoms: 9 symptoms in total, found here.

It affects more than 1 in 8 women worldwide. 

Menstrual Pain: Not Just During Periods 

The menstrual experience is not limited to those few visible days; it extends far beyond, in a continuum of sensations and symptoms that transcend the bleeding week.

According to data reported by Le Monde, approximately 370 million people endure acute menstrual pain, while 186 million suffer from endometriosis.

Moreover, a study by Règles Elémentaires shows that half of the population is unaware of menstrual pathologies, and a majority has never received formal education on the subject. Yet, a large majority of the French population is in favor of widespread education on menstruation, especially among young people.

The Lab de l’Endo, through a survey of more than 450 women, highlights that pain is not limited to just the days of menstruation. Indeed, 28% of respondents identify ovulation as the most painful phase, 26% point to Pre-Menstrual Syndrome (PMS), and 46% to menstruation itself.

This is therefore a call to recognize and talk about menstrual pain not only during periods but throughout the menstrual cycle. A call to action for a better understanding and management of this pain that profoundly affects the lives of millions.

Menstrual Pain: Beyond Endometriosis

Let's address not only the pain related to menstruation and endometriosis but also broaden our discussion to other disorders that can cause painful, heavy, and irregular menstruation.

What is Pelvic Congestion Syndrome?

Pelvic Congestion Syndrome, often overshadowed by endometriosis although it accounts for 30% of chronic pelvic pain cases in women, is characterized by the presence of pelvic varicose veins. These, resulting from poor blood circulation in the pelvis, can also affect the legs, disrupt digestion, the urinary system, and cause fatigue and irritability. The preferred treatment, varicose vein embolization, attests to the complexity of this condition which spans multiple medical disciplines and remains difficult to diagnose.

What is PCOS?

As for the Polycystic Ovary Syndrome (PCOS), it causes heavy and irregular menstruation in a significant proportion of women, affecting more than 10% of them – a prevalence comparable to that of endometriosis. Despite its frequency, PCOS receives less attention and resources for its understanding and treatment.

The management of PCOS, just like that of Pelvic Congestion Syndrome, often requires a multidisciplinary approach. It is essential to explore complementary treatments, whether medical or natural, to alleviate symptoms on a daily basis. These pathologies highlight the importance of a holistic approach in the diagnosis and treatment of menstrual disorders, calling for greater awareness and recognition of the various conditions that can impact menstrual health.