Pelvic pain — especially during your period — is the most characteristic endometriosis symptom. This pain goes beyond the kind of aching cramps many women who don't have endometriosis encounter, and what's more, many patients report that it gradually gets worse. If you've got endometriosis, the period pain you endure may be so bad that you can't function and even have to take time off work.
Is your menstrual pain normal or extraordinary?
While it's not uncommon for women to feel crampy and achy during their periods, their discomfort should either be bearable on its own, or become so with the help of a simple over-the-counter painkiller. Women with endometriosis often go through periods that are heavier and longer than usual, and that frequently contain blood clots. The medical term for these heavy periods is menorrhagia.
Cramping doesn't always confine itself to "that time of the month" either, unfortunately, as endometriosis patients can also be struck by especially painful ovulation.
Signs that your menstrual pain isn't normal — and that you could have endometriosis, if you weren't diagnosed already — include:
- Potent menstrual pain that doesn't go away when you take a painkiller.
- Menstruation turns your pelvic pain up (more than) a few notches, but it actually bothers you throughout your cycle.
- Your pelvic region feels "heavy".
- You experience persistent pain in your lower back.
- Bowel movements, urination, and sexual intercourse can all be painful. There may even be blood in your stool and pee.
Is there anything you can do to alleviate endometriosis-related pelvic and period pain?
Yes, there is! Not all treatments and remedies that work for some women with endometriosis will offer you relief, however, so some experimentation is probably in order. Here's what you can try out.
Add some heat
You'll have heard that heat — in the form of a heating pad, a nice hot bath, or even just a shower — can alleviate pain, whether from hellish periods or sore muscles. Does it really work, though? You bet! Research shows that a heating pad applied to the pelvic region reduces your pain about as much as ibuprofen. An added bonus is that, unlike over the counter painkillers, heating pads don't cause any side effects.
Holding onto your crampy, painful belly might be natural, but the abdomen isn't a place we usually associate with massage. Nonetheless, there's research suggesting that massaging your pelvic area can offer real relief from period pain. It's helpful to have your back massaged as well as your sides and abdomen, so you may want to ask your partner, a friend, or turn to a professional. It's best if you get massaging just before your period starts. Because studies have shown that lavender oil has a calming effect, you will want to consider choosing that as your massage oil.
Less invasive than acupuncture, acupressure can provide a natural kind of relief for anything from headaches to nausea, and it can help for painful menstruation, too. The pressure point said to relieve period pain is found atop your foot, between your big toe and the one next to it. Since it's important to hit the right spot, we'd recommend getting onto Google Images for further instruction — the spot in question is called the "Bigger Rushing Point". The sacrum, located between your lumbar spine and your tailbone, is another good spot for women suffering from menstrual pain.
Before you dismiss acupressure as unscientific, know that the American Congress of Obstetricians and Gynecologists (ACOG) endorses it for period cramps and pain, because research shows that it does help reduce discomfort alongside painkillers.
Turmeric: Curcumin can soothe your pain
Turmeric, a member of the ginger family, has been shown to have anti-inflammatory effects, but it's been used for exactly that purpose in Ayurvedic medicine long before modern science could have proven that. Curcumin, the active ingredient in turmeric, is to thank for these properties. Research additionally indicates that turmeric can inhibit the form of estrogen called estradiol, and since endometriosis is estrogen-dependent, using it may reduce your symptoms. You can take turmeric as a supplement or drink it as tea, but you can also add it to your cooking.
Can you eat your way to symptom relief?
There's not yet any solid evidence that any one particular diet is great for women with endometriosis, but small studies, doctors' reports, and patient stories all suggest that the foods you consume do play a role in the severity of your symptoms. Because some people believe that certain foods — which vary from patient to patient — aggravate symptoms, you may consider an elimination diet.
Foods that may be linked to an inflammatory response, and which you may want to experiment with cutting out, include:
- Processed foods
- Red meat
- Too much sugar, including from eating too much fruit
Processed foods tend to contain the infamous omega-6 fats that you want to avoid to reduce pain and inflammation. You do need fats in your diet, however — but the good kind, and that means omega-3 fats that instead fight inflammation. These are found in fatty fish as well as extra virgin olive oil and some other plant oils, but you can also take a supplement.
What should be the painkiller of your choice?
No matter what lifestyle changes and complementary treatments you introduce to help reduce your painful periods, painkillers will realistically be part of your life, too. Non-steroidal anti-inflammatory medications (NSAIDs) have the double advantage of fighting inflammation as well as pain. These include:
- Acetaminophen (Tylenol®)
- Ibuprofen (Advil®, Motrin®)
- Naproxen (Aleve®)
Because these medications, all of which are available over the counter (though prescription NSAIDs exist too), do have the potential to lead to adverse effects when used over the longer term, do use them sparingly if you can, and talk to your doctor if you find yourself relying on them frequently. Frequent short-term side effects of NSAIDs gastroinestinal issues, while their long-term use can increase your risk of suffering a stroke or heart attack.
Consider hormonal treatments
Hormonal contraceptives have secondary benefits for which they are often prescribed to women with certain conditions, so long as they are not trying to get pregnant. Reducing menstruation-related pain is one of this reasons. Endometriosis patients can benefit from hormonal contraceptives as well as other hormone therapies:
- Combined hormonal contraceptives include the pill, vaginal rings, and patches. These regulate your hormone levels, and thus lessen the endometrial buildup during your cycle. There are also contraceptives that contain only progestin, including the Mirena IUD, Nexplanon, Depo-Provera, and progestin-only pills.
- Gonadotropin-releasing hormone (Gn-RH) agonists and antagonists and aromatase inhibitors.
Discuss the pros and cons of these treatments with your doctor in detail, particularly if you are considering having children in the future.
What about surgery?
Laparoscopic surgery can be carried out to remove endometriosis lesions, both to reduce painful menstruation and to increase your chances of getting pregnant with endometriosis.
If you're sure you do not want to have (anymore) children, a complete hysterectomy, including a salpingectomy and oophorectomy (removing the fallopian tubes and ovaries) can save you from disabling menstrual and pelvic pain. Considered a last resort only to be used after all other options have been explored, it can nonetheless offer great relief.