Endometriosis – When Painful Periods Could Be Something More

Most women experience some kind of mild cramping or discomfort just before, or during, their menstrual period. This is perfectly normal and can be effectively dealt with simply by taking a couple of paracetemol tablets. Some women, however, experience such painful periods that the pain is actually debilitating, and they find it impossible to carry out their normal daily tasks.

Heavy periods, accompanied by severe cramping, could be a symptom of endometriosis, a chronic disease that affects millions of women around the world to a greater or lesser degree. It occurs when endometrium tissue (usually only found lining the womb) starts growing outside the uterus – commonly in the fallopian tubes, on the ovaries, on the lining of the pelvic cavity and on the ligaments that support the uterus.

This misplaced tissue develops into lesions or growths, which behave in the same way as the uterus lining does during menstruation – building up, breaking down and shedding. The problem is, that unlike uterine tissue which is expelled naturally from the body through the vagina, tissue shed from endometrial growths has nowhere to go, and can cause internal bleeding and inflammation. This causes pain, bowel problems, infertility, adhesions and the formation of scar tissue.


Symptoms of endometriosis usually develop in women between the ages of 25 and 40, and can include:

  • Painful periods
  • Pain during or after sex
  • Fatigue
  • Inability to conceive
  • Painful urination and bowel movements during menstruation
  • Frequent yeast infections
  • Gastrointestinal upsets such as nausea, diarrhoea or constipation

Endometriosis can affect any woman, although it is more prevalent in those who are close blood relatives of other sufferers, as it is known to run in families. It is rare in post-menopausal women.

A definitive diagnosis can usually only be made by performing a laparoscopy, which will show the size, location and extent of the growths.


The exact cause of endometriosis is unknown. Some experts believe that during menstruation, some of the menstrual tissue backs up through the fallopian tubes, implants in the abdomen and grows. Another theory is that this happens to all women, but only those with a hormonal or immune system problem will develop endometriosis.


Treatment can be as simple as painkillers, or as complex as surgery, and many options in between. Factors determining which treatment will be the most effective include the woman’s age, whether or not she wants to become pregnant in the future, and how severe her symptoms are.

Hormone treatments are often prescribed, especially if the patient has no wish to become pregnant. The endometrium, and, likewise the endometrial cells outside of the uterus, need oestrogen to survive. Reducing the amount of oestrogen in your body can cause the patches of endometriosis to shrink and fade away.

Dr Alain Sanua is a qualified Medical Doctor who is a passionate practitioner of Integrated Medicine. He is particularly interested in treating persistent conditions, including Endometriosis. To make an appointment to discuss your symptoms with him, please phone our Bryanston practice on (011) 463 1614, or our Dunkeld practice on (011) 447 0525.


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