Abdominal cramps, mood swings, headaches…your monthly period is certainly no picnic. But it's especially hard for women with endometriosis, a condition where endometrial tissue, or uterine lining cells, is found outside of the uterus. During menstruation, the tissue breaks down and becomes trapped in the body, often forming lesions and causing severe pain. Here, 5 signs you could be dealing with endometriosis:
Abdominal pain, constipation, and diarrhea could all be signs of Irritable Bowel Syndrome, but if symptoms become worse during your menstrual cycle, they could be a sign of an endometrial growth somewhere in your gastrointestinal system, says Linda Griffith, PhD, director of the Center for Gynepathology Research at Massachusetts Institute of Technology. "Endometriosis can cause a lot of symptoms even gynecologists don't think of, and patients can be diagnosed with IBS when they really have endometriosis on the bowel," says Griffith. The only sure-fire way to differentiate between endometriosis and IBS—or really endometriosis and any condition—is to have a laparoscopy, which removes a tissue sample from the affected area and tests for endometrial cells.
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Upper body pain or painful breathing
The thing that baffles doctors most about endometriosis is the fact that endometrial cells can migrate to any part of the body. Beyond the usual placement in a woman's abdominal cavity, the cells can also be found in the arms, thighs, and even the diaphragm. For example, "women who get lesions on the diaphragm have terrible pain trying to breathe or move their upper arms or upper body during their period," says Griffith, who experienced those symptoms first-hand just before being diagnosed with endometriosis. "Who would think the inability to move your arm is related to your period? But that's what happens," she says.
When a woman's reproductive system is functioning properly, eggs released from the ovary travel down one of the fallopian tubes where they may meet up with a man's sperm. With endometriosis, however, endometrial lesions and scarring on the fallopian tubes can lead to difficulty conceiving, says Breton Barrier, MD, residency program director at University of Missouri's Department of OB/GYN and Women's Health. Even without fallopian tube scarring, endometriosis can delay conception. "A woman normally has a 20% chance of conception each month, but endometriosis might decrease that to a 10% chance," says Barrier. One hypothesis: endometriosis can cause resistance to the hormone progesterone, altering a woman's cycle and not preparing her uterine wall for the implantation of an embryo.
Similar to symptoms of a urinary tract infection, endometrial lesions on the bladder may cause frequent urination and feelings of bladder fullness during a woman's menstrual cycle, notes Griffith. "It can cause you to feel like you have to pee all the time, almost like a bladder infection," she says. Endometriosis has also been linked to a condition called interstitial cystitis, which is characterized by bladder pressure and pain, though the symptoms of this specific condition can occur any time, not just during a woman's cycle.
Imagine the mind-numbing, stabbing pain of appendicitis. Now imagine feeling that each month on top of your already annoying menstrual symptoms. It's called catamenial appendicitis, and it happens when endometriosis affects the appendix, according to Barrier, who believes the piercing pains result from inflammation of the appendix due to its placement in the lower pelvis—a prime spot for endometriosis. One way to differentiate catamenial appendicitis from typical appendicitis: catamenial appendicitis patients don't exhibit a heightened white blood cell count or signs of a fever.