Should periods be painful?
It is common for some women or adolescents to experience discomfort during part of their period. Period pain is not normal when:
- Pain starts before bleeding commences and/or extends past the first few days of your period
- The pain does not respond to pain medications or the contraceptive pill
- The pain is so debilitating it stops you from doing normal daily activities such as going to school or work.
What causes period pain?
Contributions to pain may include:
- Muscle cramps from the uterus and surrounding pelvic muscles
- Adenomyosis: when cells that normally line the uterus grow in the muscles of the uterus
- Endometriosis: when similar cells that line the uterus are found outside of the uterus
- A sensitised nervous system
How common is endometriosis
Endometriosis affects up to 1 in 10 women. It often takes several years to receive a diagnosis. Early management of endometriosis and the associated pain is important in reducing the impact of the condition on a woman’s quality of life as it often results in school, work and social absence and/or lost productivity. Early education in schools is essential to help girls understand when they should seek further help.
How is endometriosis diagnosed?
A laparoscopic procedure confirms endometriosis however specialist ultrasounds can also assist in confirming a suspicion of this diagnosis.
Is endometriosis always painful?
Endometriosis is not always painful and the severity of endometriosis does not predict how much pain is experienced. Some women have severe endometriosis with no pain and others have mild endometriosis and severe pain.
We do not fully understand why there is such variation in pain experienced in women with endometriosis but evidence is suggesting it depends on how the nervous system reacts to the endometriosis and pain experiences. Pain is a complex topic, but a pelvic physiotherapist, pain psychologist and medical specialists with a special interest in pain conditions can help you understand. These YouTube clips provide a good introduction to learning about pain:
Tame the beast – It’s time to rethink persistent pain
Understanding pain in less than 5 minutes, and what to do about it!
What can I do to manage endometriosis?
- Consult a gynaecological specialist who is familiar with endometriosis and other pelvic pain conditions who can guide you through medical management options such as the contraceptive pill, Mirena, pain relieving medications or laparoscopic surgery if required.
- Understanding your condition; your physiotherapist and health professional team can guide you towards the best options for research-based information on endometriosis and pelvic pain.
- Pelvic floor physiotherapy will differ for everyone based on their symptoms and individual goals, but commonly involves;
- Assisting your understanding of your pelvic pain condition
- Desensitisation of tissues
- Muscle release and relaxation
- Exercise and self management strategies
- Optimising your exercise, eating a balanced diet and living a healthy lifestyle with the help of a multidisciplinary team (a team of health professionals who work together to manage help treat your condition).
There is strong evidence to support the role of physiotherapists with additional training in women’s and pelvic health to treat a number of conditions across all life stages – from more commonly known pelvic health issues affecting women such as incontinence and prolapse, to pelvic and sexual pain concerns and also for helping children and adolescents with bed wetting or other bladder/bowel control concerns.
We hope the information in this blog has been useful and should always be considered in conjunction with an individual assessment with your physiotherapist and/or other health care provider skilled in the area such as a GP or gynaecologist.
We would love to help you manage your concerns and get you back achieving your goals worry –free!