WOMEN’S BODIES: ENDOMETRIOSIS. WHAT ARE THE SYMPTOMS?
Endometriosis can cause a wide range of symptoms, which may be quite differed from one sufferer to the next. Some women have no symptoms at all, and the condition is discovered by chance during surgery for some unrelated condition (including sterilisation, showing that endometriosis isn’t always associated with subfertility). Other women have few or no symptoms except subfertility. Unfortunately some affected women suffer many symptoms such as period pain, painful sex, pelvic pain, bleeding problems, bowel problems and subfertility.
• Period pain (dysmenorrhea) is the most common symptom. The pain may be mild, moderate or severe and described as nagging or sharp, constant, throbbing, deep or gnawing. It may be in the centre or on either side of the lower abdomen, and may spread out of the genitals, groin, inner thighs, lower back, rectum and buttocks. It differs from period cramps by usually starting a day or so before the onset of bleeding and continuing throughout the period.
• Painful sex (dyspareunia) can have a devastating effect on a woman’s self-esteem and sexual relationship. It may be felt as sharp jabbing during sex and deep aching afterwards.
• Pelvic pain may be unrelated to periods or sex. It may be sharp or dull and can occur in attacks or be more or less constant. It may be made worse by certain movements and postures, a bowel movement or passing urine.
• Bleeding problems include heavy, prolonged periods with clotting, spotting before periods, irregular periods and sometimes bleeding between periods. Many women with endometriosis ovulate irregularly or not at all, and it is believed that the bleeding problems result from the hormonal state associated with disturbed ovulation. Repeated heavy periods can cause anaemia.
• Bowel symptoms such as diarrhoea, constipation, painful bowel movements, rectal pain, wind pain and abdominal bloating seem to be more common than was thought in the past, perhaps because some sufferers, unless asked, haven’t mentioned these symptoms to gynaecologists.
• About four out of ten women with endometriosis will have problems with conception, but eventually at least half of these will become pregnant. The subfertility may result from failure to ovulate, adhesions that block the release of the egg or its passage along the tube, hormonal imbalances and perhaps less intercourse because sex is painful.
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