Extreme period pain could be a sign of endometriosis - experts

Extremely painful menstrual period cramps could be a sign of endometriosis, experts have warned.

Endometriosis is a chronic inflammatory disease that is exhibited by growth of endometrial glands and layer outside the uterine cavity.

It occurs when bits of the tissue that lines the uterus (endometrium) grow on other pelvic organs, such as the ovaries or fallopian tubes.

Outside the uterus, endometrial tissue thickens and bleeds, just as the normal endometrium does during the menstrual cycle.

Local researchers have been doing endometriosis research for more than 15 years.

They include Dr Ezekiel Onyonka Mecha from the University of Nairobi, Department of Biochemistry, Prof Charles Omwandho from Kirinyaga University in collaboration with Prof Lutz Konrad and Prof Hans-Rudolf Tinneberg.

Konrad and Tinneberg are scientists from Justus-Liebig-University Giessen Germany, Department of Obstetrics and Gynaecology.

“If you feel like your periods are more painful than other people’s, or if you experience pain during your period in all different parts of your body, it is advisable to see your doctor. This may be a possible sign of endometriosis,” Mecha said.

The aim was to try and find the correlation of endometriosis and other gynecologic disorders causing pain to women of reproductive age and try to find out earlier diagnostic markers for endometriosis and effective therapeutic interventions.

Mecha and other scientists found that endometriosis pain is similar to adenomyosis pain and the two conditions may be the main course of extremely painful periods.

Adenomyosis is a condition in which endometrial tissue exists within and grows into the uterine wall.

In most cases it occurs late in childbearing years and typically disappears after menopause.

Sometimes, adenomyosis may cause heavy or prolonged menstrual bleeding, severe cramping, and pain during intercourse or blood clots that pass during a period.

Prevalence of endometriosis in Kenya and to a large extent in Africa is unknown and this has been attributed to lack of clinical and scientific research in the area of endometriosis.

However, studies put the approximate cost of treatment at Sh355,000 per woman per year.

In Kenya, many women are suffering in silence since many of them don’t know that they are suffering from this condition due to its symptomatic similarity with other diseases which most of them take as ‘normal’. 

“There is need for more endometriosis awareness and research in the country. This needs a multi-sectoral approach including all stakeholders who include the researchers, doctors, patients, public and private partners,” Mecha emphasized.

The medic also notes that the government needs to increase and provide financial support towards endometriosis research and awareness, while the media needs to play a great role in educating the public about the endometriosis and associated pain.

“In addition, the government needs to come up with policies geared towards protection of endometriosis patients.”

Ten per cent of the world women populations in their reproductive age are affected by endometriosis.

Mecha outlines abdominopelvic pain, dysmenorrhea, heavy menstrual bleeding, infertility, painful sexual intercourse and/or post-coital bleeding as some of the main symptoms of endometriosis.

“Ovarian cyst, irritable bowel syndrome and pelvic inflammatory disease are predictive of the diagnosis of endometriosis among patients seeking help. Moreover it has a significant socioeconomic impact, both individually and globally.”

The medic notes that despite the significant effect of this disease, the gold standard for diagnosis of this disease still remains laparoscopy.

A general lack of awareness by both women and healthcare providers due to a “normalization” of symptoms also results in a significant delay from when a woman first experiences symptoms until when she eventually is diagnosed and treated.

Moreover there exists inadequate diagnostic tools, when a patient elicits the symptoms associated with endometriosis such as pelvic pain, usually ultrasound scans are performed and in most cases reports indicates a false negative hence delaying the diagnosis of endometriosis, he adds.

In addition, ultrasound scans are not sensitive unless the endometrioma is large.

Mecha also notes that hormonal treatments provide just but temporary relieve, blanketing the symptoms, this ultimately would delay the diagnosis of the disease.

These, he says, are just but some of the main contributing factors that hinder the diagnosis and management of the disease, underscoring the urgent need for a proper tool to eliminate such delays.

Although endometriosis pain may feel different for every person that experiences it, there are usually a couple of common factors that distinguish it from menstrual pain.

First, in endometriosis, the pain is chronic. It happens repeatedly prior to and during the menstrual period and sometimes during other times of the month.

Secondly, the pain is severe to a point that over the counter pain relievers such as ibuprofen or aspirin will not provide pain relief. 

In addition, the pain is consistent. It happens often enough that someone can anticipate it, and recognize what it feels like. Other symptoms of endometriosis includes bleeding or spotting in between periods,  excessive bloating,  cramping, diarrhea, constipation, nausea and  difficulty getting pregnant.

Endometriosis can also lead to heavy bleeding which may result to anemia, frequent headaches, and difficulty focusing and food intolerances.