Pelvic Pain During Menstruation? It Might Be Endometriosis

What Is Endometriosis?

If you are experiencing pelvic pain during menstruation, it may be indicative of a condition called endometriosis. The endometrium is the layer of tissue that lines the uterus. If the endometrium grows outside the uterus (often on the ovaries, fallopian tubes, or other parts of the pelvis), it can cause inflammation, pain, and often, scarring. This painful condition is called endometriosis.

If left untreated, endometriosis can lead to various consequences including:

• Infertility: Endometriosis can cause scarring in the reproductive organs, making conception difficult or impossible.
• Chronic pain: The patient can suffer severe pelvic pain, especially during menstruation.
• Ovarian cysts: Endometriosis can cause cysts to form on the ovaries. This may cause further pain and discomfort.
• Bowel and bladder problems: Endometriosis can cause pain during bowel movements and urination. It may also cause gastrointestinal issues such as bloating, constipation and diarrhoea.
• Depression and anxiety: The chronic pain and uncertainty of living with endometriosis can lead to the patient suffering depression, anxiety, and other mental health issues.

Endometriosis is not uterine cancer. The exact cause of endometriosis is unknown, but a widely accepted theory is it is caused when menstrual blood flows backwards into the pelvis through the fallopian tubes during menses. There are some endometrial cells in the menstrual fluid which then gets implanted on the reproductive organs or other areas in the pelvis, thereby causing endometriosis.

How Common Is Endometriosis In Singapore?

Endometriosis affects an estimated 10% of women worldwide, and it is similarly prevalent in Singapore as well. A further estimate is that it affects 20-30% of women who are of reproductive age. However, there is possibility of under-reporting of the disease. Due to the lack of awareness and possible stigma surrounding menstruation and women’s health, some women may suffer in silence and not seek treatment.

Symptoms Of Endometriosis

The most common symptom of endometriosis is pelvic pain, particularly during menstruation. The pain can be severe and may also occur during sex, bowel movements, or urination. Other symptoms include heavy or irregular periods, fatigue, bloating, and infertility. However, it’s essential to note that some women may not experience any symptoms, or their symptoms may be mild.

Screening And Diagnosis Of Endometriosis

There is currently no routine screening for endometriosis. Research suggests that the tumour marker CA125 (often included in health screening packages in Singapore for ovarian cancer screening) may potentially be a suitable test for endometriosis. The evidence suggests that patients with symptoms of endometriosis have elevated levels of CA125 in most instances. However, there is the possibility of “false-negative” errors, whereby a patient who does have endometriosis does not exhibit elevated CA125.

Diagnosing endometriosis can be challenging as it shares similar symptoms (such as the aforementioned pelvic pain during menstruation) with other gynaecological conditions. A doctor may suspect endometriosis based on a woman’s symptoms and medical history. They may also perform a pelvic exam or an ultrasound to check for any abnormal growths.

The only definitive way to diagnose endometriosis is through a laparoscopy. This is a minimally invasive surgical procedure where a thin tube with a camera is inserted through a small incision in the abdomen to view the pelvic organs. If endometriosis is found, the doctor may also remove any visible growths during the procedure.

Treatment For Endometriosis

There’s currently no cure for endometriosis, but treatment options are available to manage symptoms and improve quality of life. The type of treatment to be used will depend on factors such as the patient’s age, how severe her symptoms are, and she desires for future childbearing.

Options for treatment include pain relief medication such as nonsteroidal anti-inflammatory drugs to alleviate pain and inflammation. Hormonal therapy such as birth control pills, hormonal intrauterine devices (IUDs), or gonadotropin-releasing hormone (GnRH) agonists may also be used to suppress ovulation and reduce the growth of endometrial tissue.

For severe cases, surgery may be necessary to remove endometrial growths, scar tissue, or even the uterus and ovaries. However, surgery is typically reserved for cases where conservative treatment options have failed, or when a woman’s fertility is at risk.

How To Prevent Endometriosis

Unfortunately, there is no guaranteed way to prevent endometriosis. However, certain lifestyle changes may reduce the risk of developing the condition. These include regular exercise and a healthy diet to help maintain hormonal balance and reduce inflammation. The risk of developing endometriosis may also be lowered by avoiding alcohol and tobacco.

Where To Get Endometriosis Treatment In Singapore

Early detection and treatment are key to managing endometriosis and preventing complications such as infertility. Women who experience pelvic pain during menstruation, or suspect they may have endometriosis, should seek medical advice from a gynaecologist.

Fortunately, women in Singapore have access to various treatment options for endometriosis. Public hospitals such as the Singapore General Hospital, National University Hospital and KK Women’s And Children’s Hospital offer comprehensive Obstetrics & Gynaecology departments that provide diagnosis, treatment, and management of endometriosis. Other private gynaecology clinics such as Thomson Women’s Clinic and Raffles Women’s Centre also offer endometriosis treatment.

Further Reading That Might Interest You