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Regular period cramps or endometriosis pain? Here’s how to distinguish | Health


Most of the women experience some kind of discomfort during their monthly menstrual cycle, commonly referred to as periods. Mild to moderate cramps, bloating, irritability are typical during this time and recover on their own after a couple of days. However, some women endure excruciating pain during this time of the month, making it difficult for them to go about their normal routine. If you’re experiencing severe pain, it’s important not to dismiss it as normal, as it could indicate either primary dysmenorrhea or endometriosis. Endometriosis is a condition where cells similar to the lining of the uterus, or endometrium, grow outside the uterus and cause severe pelvic pain. Here’s how to distinguish between regular period cramps and pain caused by endometriosis. (Also read: Is it PCOS or endometriosis? Know difference in symptoms)

Endometriosis is a commonly misunderstood condition that often gets mistaken for regular period pain. But there is a difference between both conditions that one needs to understand. (Freepik)
Endometriosis is a commonly misunderstood condition that often gets mistaken for regular period pain. But there is a difference between both conditions that one needs to understand. (Freepik)

How common are period cramps?

“More than 80% of women experience cramps during their menstrual cycles, with symptoms varying from person to person. While mild cramps are common, severe and prolonged cramps should not be ignored. Menstrual cramps occur as the uterus contracts to shed its lining, resulting in inflammation and abdominal pain,” says Dr Arpana Jain, Director – Obstetrics and Gynaecology, Fortis Hospital Shalimar Bagh.

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“Period cramps, also called dysmenorrhea, trouble up to 80% of women at some point in their lives. These cramps are typically considered a normal part of the menstrual cycle, especially during adolescence and early adulthood. These are abdominal or pelvic pains caused by prostaglandins that are released when the uterus contracts to shed its lining. Cramps can vary in intensity from mild to severe and may be accompanied lower back pain, nausea, diarrhoea, and headaches. Mild cramps are common and usually manageable with home remedies like heat therapy, gentle exercise or mild pain killers. However, sometimes the period cramps are severe or debilitating and can start affecting the quality of life. These could raise suspicion of an underlying condition such as endometriosis,” says Dr Astha Dayal, Lead Consultant, Obstetrics and Gynaecology, CK Birla Hospital, Gurugram.

Is endometriosis behind your severe period pain?

“Endometriosis is a chronic condition where tissue similar to the lining of the uterus grows outside the uterus. This is usually seen in the mid 30s and may affect around 10% women, although this number may be higher due to underdiagnosis or misdiagnosis. It can cause severe pelvic pain, often associated with menstruation, as well as other symptoms such as infertility, fatigue, and gastrointestinal issues,” says Dr Dayal.

Typically starting a few days before menstruation and lasting 1-2 days, mild to moderate cramps can be managed with pain relievers. However, persistent severe cramps that resist medication warrant medical attention.

“Endometriosis, characterised by consistent pelvic pain before and during menstruation, may also cause pain during intercourse and bowel movements. Unusual bleeding alongside pelvic pain could indicate endometriosis, requiring evaluation by a healthcare provider for proper diagnosis and management. Don’t endure severe menstrual cramps in silence; seek medical advice to address potential underlying conditions like endometriosis,” says Dr Jain.

“Endometriosis pain tends to be more severe and may not respond well to traditional pain management methods. If one has increasing period pain over time, general pain in the lower abdomen, or pain during sex, or while passing stools or urine, these could be signs of endometriosis. This can be confirmed by diagnostic tests like a pelvic examination by a gynaecologist, or imaging by ultrasound or MRI. Sometimes laparoscopy may be required to confirm the diagnosis. Endometriosis is a progressive disease and keeps increasing with every period. It is important to detect and treat it early to help manage symptoms and improve quality of life for these women. The treatment mainly includes pain management and hormonal therapy or surgical removal of endometriosis,” says Dr Dayal.

“Period cramps typically involve mild to moderate pelvic pain that usually subsides with over-the-counter pain medications. Endometriosis, on the other hand, often causes severe pelvic pain that may not respond well to standard pain relief methods. While period cramps usually last for a few days during menstruation, endometriosis-related pain can occur at any time during the menstrual cycle and may persist beyond the menstrual period,” says Dr Garima Sawhney, Senior Gynaecologist and Co-founder, Pristyn Care.

“Endometriosis may present with additional symptoms such as heavy menstrual bleeding, pain during intercourse, infertility, gastrointestinal issues, and fatigue. These symptoms are less commonly associated with typical period cramps. If you’re experiencing severe or debilitating pelvic pain, it’s crucial to consult with a gynaecologist to determine the cause and appropriate management. Ignoring symptoms could delay diagnosis and treatment of conditions like endometriosis, which may worsen over time if left untreated,” says Dr Sawhney.

Difference between regular period pain and endometriosis

Endometriosis is a commonly misunderstood condition that often gets mistaken for regular period pain. But there is a difference between both conditions that one needs to understand. While both can cause discomfort and cramping, the key difference lies in the severity and persistence of the symptoms. Dr Swati Gaikwad, Consultant Obstetrician & Gynaecologist, Motherhood Hospital, Pune on how to an distinguish between endometriosis and period pain.

  1. Endometriosis pain lasts for longer

Regular period pain is typically manageable with over-the-counter pain medication and usually subsides within a few days. On the other hand, endometriosis pain is often described as excruciating and may continue beyond the menstrual cycle. It’s important to pay attention to your body’s signals and seek medical advice if you suspect that your period pain may be more than just normal discomfort.

2. Endometriosis can cause chronic pelvic pain

Endometriosis can lead to serious complications if left untreated, including fertility issues and chronic pelvic pain. By understanding the differences between regular period pain and endometriosis, individuals can advocate for their health and work towards effective management strategies tailored to their needs.

3. Over-the-counter pain killers don’t work well with endometriosis pain

Period pain and endometriosis are often conflated, but they are distinct in their manifestations and impact on a person’s life. While period pain is a common discomfort experienced by many menstruating individuals, endometriosis goes beyond normal cramping. It can cause severe, debilitating pain that doesn’t go away with over-the-counter remedies. Those with endometriosis may also experience symptoms such as heavy bleeding, fatigue, gastrointestinal issues, and infertility that are not typically associated with regular menstrual cramps.

4. Diagnosis can be challenging for endometriosis

Furthermore, the diagnosis process for endometriosis can be challenging due to its varied symptoms and lack of definitive tests. Many individuals with the condition endure years of misdiagnosis or dismissal of their symptoms before receiving proper care. This delayed diagnosis can have significant consequences on their physical and mental health, highlighting the need for increased awareness and understanding of endometriosis.

“It is crucial to differentiate between period pain and endometriosis to ensure those suffering from this chronic condition get the support and treatment they need to manage their symptoms effectively. It is advisable to follow the instructions given by the treating doctor only. Don’t take any medication on your own as doing so can be risky for you,” says Dr Gaikwad.


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