While extremely painful periods might be accepted as part of being a woman, it shouldn’t be. Pelvic pain could be a sign of endometriosis and there are several treatment options available.

Lourdes Waller had always had painful periods. But it wasn’t until she turned 20 that the pain became unbearable. A keen university student, practiser of jiu-jitsu and active volunteer in her community, Waller found herself increasingly confined to her bedroom. “During my period, I’m dealing with this excruciating pain,” she explains. “I can’t stand up straight.”

Waller went to her family doctor, which launched a three year-long journey through testing, imaging, and rounds of medications, including iron supplements, multiple birth control pills, and intrauterine devices. But the pain persisted and she had difficulty finding a health care provider to acknowledge her pain and suffering. That was until she was finally referred to Dr. Sony S. Singh of the Women’s Health Centre at The Ottawa Hospital, who gave Waller a diagnosis of endometriosis.

“Endometriosis is a condition affecting women who are of reproductive age,” explains Dr. Singh. “It’s when the tissue of the lining of the uterus grows outside of the uterus and places itself onto the ovaries, pelvis, or abdominal structures.”

Signs of endometriosis include painful periods, chronic pelvic pain,  and pain during intercourse, bowel movements, and urination. The disease can also lead to problems conceiving. “Among women who have difficulty getting pregnant, endometriosis is found in quite high numbers, between 40–50 percent,” Dr. Singh says.

Treatment options for endometriosis

While endometriosis is a life-long disease, there are several non-invasive treatments available to help manage the symptoms, including lifestyle changes like exercise and maintaining a balance diet. There are also effective medications available to manage the pain associated with endometriosis and others that help to suppress the growth of the disease. Women suffering from severe pain, or who are having difficulty getting pregnant, may want to consider a laparoscopic or keyhole surgery to remove the growths.

Among reproductive-aged women, the occurrence rate of endometriosis is about 10 percent. But Dr. Singh thinks the actual rate is higher due to difficulty in diagnosing the disease and stigmas surrounding acceptability of menstrual pain. “Women perhaps believe themselves or are told that their painful  periods are normal,” says Dr. Singh.

Often, patients with endometriosis like Lourdes Waller will suffer for years, resulting in a delayed diagnosis — an average of seven years, according to Dr. Singh. “Patients are frustrated because they’ve seen so many physicians or care providers before they finally get the pain relief, acknowledgement, and treatment that they need.”

Encouraging conversations about menstrual pain

Dr. Singh suggests that women who think they may have endometriosis should be persistent with their health care providers. “For women who don’t feel as though they’ve been heard or can’t find access to the care they need, I’d encourage them to advocate for
themselves by doing research, by making phone calls, and getting referrals to those who can help them.”

Even if you aren’t suffering from endometriosis or severe pelvic pain, having conversations with your doctor, friends, and family about menstrual pain is important. “We’ve normalized painful periods and discomfort. But when it affects your quality of life and if you can’t go to school or work, that to me is not normal,” says Dr. Singh. “People don’t talk about endometriosis or painful periods. So we have to be open to talk about these reproductive issues.”