Snuggling up with a hot water bottle, feeling moody, and inhaling chocolate like it’s going out of fashion? Yep, it’s that time of the month again. For some of us, periods are simply a part of life we have to deal with. But what happens when confectionery and comfort don’t help and you can tell that something’s a bit… off?
For Elizabeth Metz, 31, the red flag came when her periods began to affect her whole life. “I was missing work and had terrible back cramps that prevented me from sitting up – I knew this could not be normal.”
Common cause of painful periods: Endometriosis
Like an estimated 10% of women, Elizabeth had endometriosis, a condition in which the tissue that lines the uterus occurs outside the uterus, causing pain and potentially infertility.
Symptoms of endometriosis
Painful periods, pain with sex, and pain when peeing or doing a poo can all indicate endometriosis, explains gynaecologist Dr Elizabeth Farrell.
Claire Robertson, 24, suffered a huge amount of discomfort. “Two in every four weeks involve moderate to severe cramping, fatigue, digestive problems, low moods and anxiety,” Claire says.
What science says
Retrograde menstruation (when we bleed back along the fallopian tubes) is a normal process for most women, and the blood absorbs into the circulation. “But for those predisposed to endometriosis, the cells can stick on to other tissues and organs, and start to grow and multiply,” says Dr Farrell. Once outside the uterus, these cells still cycle and bleed monthly, but have nowhere to go. This causes inflammation and scar tissue to form.
Treatment for endometriosis
While there’s no cure, after the diagnosis is confirmed there are treatment options, from pain relief medication and hormonal therapy to reflexology and acupuncture. Surgical options include a laparoscopy, in which visible endometriosis is removed.
Endometriosis: did you know?
- Around one in 10 women suffer from endometriosis.
- If you have a first-degree relative with it, you’re at a higher risk.
- Symptoms include back, pelvic and thigh pain, bladder or bowel problems, nausea and lethargy.
- Endometriosis causes up to 30% of infertility problems.
- Endometriosis is a chronic illness.
Common cause of painful periods: Polycystic ovarian syndrome (PCOS)
When Lizzie Brent, 29, began suffering from cystic acne, she had no idea it was triggered by PCOS. “It wasn’t until a dermatologist suggested it could be PCOS and that I should have an ultrasound that I was diagnosed.”
Symptoms of Polycystic ovarian syndrome (PCOS)
Irregular, painful or non-existent periods; hair loss or increased hair in places not usual for women; dark skin patches, acne; fertility difficulties; easy weight gain.
What science says
PCOS is a complex hormonal disorder that develops when the body produces increased levels of male hormones (such as testosterone), insulin or both. This hormone overload messes with ovulation, and it’s likely that the higher testosterone levels are responsible for symptoms such as acne and excess hair.
Treatment for PCOS
PCOS is diagnosed with examination, ultrasound and blood tests. There’s no cure for PCOS, but it can and should be managed, as it is associated with an increased risk of diabetes and heart disease. Your GP may prescribe the Pill to help regulate your menstrual cycle.
“Over a few years, I lost 10kg and my cycle began to regulate. I still have PCOS, but I barely notice it,” says Lizzie.
PCOS: Did you know?
- Light and infrequent or heavy, frequent periods can be caused by thyroid problems.
- Harmless growths in the uterus, such as polyps and fibroids, can cause heavy periods.
- Exercise can help ease period pain by releasing endorphins (the body’s natural painkillers).
- Period pain can lessen with age.
- Certain bleeding disorders can trigger heavy periods.
- Stress, sudden weight loss or weight gain can cause periods to stop.
When to see your GP:
- Painful, heavy or irregular periods.
- Prolonged bleeding.
- Pain during or after sex.
- Abdominal, back and/or pelvic pain.
- Pain or difficulty when peeing or doing a poo.
- Premenstrual spotting.
- Infertility problems.
- Missing social or work activities due to pelvic or period pain.
Common cause of painful periods: Pelvic inflammatory disease (PID)
PID is an infection that can affect your uterus and fallopian tubes. Left untreated, it can cause blockages, scarring of the tubes and infertility.
Symptoms of Pelvic inflammatory disease (PID)
Symptoms can include pain during urination and/or sex; unusual periods; bleeding after sex or spotting between periods; fever, smelly or abnormal vaginal discharge (changes in colour or texture); abdominal and pelvic pain; or even no symptoms at all.
“Lots of people can have PID without many or any symptoms and the only way we find out is when they are trying to have a baby and find their fallopian tubes are scarred,” explains Dr Farah Kroman.
What science says
PID occurs when infection spreads from the vagina. Untreated sexually transmitted infections (STIS) such as chlamydia and gonorrhea can lead to PID, but you can have PID without an STI – for example, if you use an IUD or douche frequently, this can disturb the internal ‘good’ bacteria.
Treatment for Pelvic inflammatory disease (PID)
Diagnosis is confirmed with tests, an examination, ultrasound or laparoscopy. PID is treated with oral antibiotics and, if you have an abscess, surgery.