Endometriosis is a notoriously difficult condition to diagnose. While part of that is because doctors sometimes fail to take symptoms as seriously as they perhaps should, it's also compounded by the fact that, often, women dismiss their own symptoms as "normal."
Many symptoms of endometriosis might be passed off as "just another annoying by-product of being a woman," but it may be the case that there's a serious gynecological issue at hand.
In a bid to demystify female health conditions, Dr. Anita Mitra—gynecologist and author of women's health issues book The Gynae Geek—talks us through the endometriosis symptoms most easy to miss. If any of the following ring true for you and you're suffering them fairly consistently, make sure you get yourself checked out:
While a painful period is perhaps the symptom most widely associated with endometriosis, because "period pain" is something we're almost taught to accept as part of menstruation, it can sometimes be dismissed despite its severity. "Painful periods happen because the endometriosis deposits inside your pelvis also bleed in the same way as the uterine lining does," explains Dr. Anita. "But it doesn't have anywhere to go and so it causes irritation of the pain fibres in your pelvis, leading to the searing pain that can be so bad some women may vomit or be unable to stand.
"Not all painful periods are endometriosis," the doctor reminds us, "but it's important to be aware that it's not a symptom that you have to put up with."
"This is the one that women are scared to talk about," says Dr. Anita, adding: "It amazes me the number of women who think that sex is supposed to be painful. Sure, it can be uncomfortable at times, but if it's so painful you have to stop on a regular basis, that's a sign something may be wrong."
The gynecologist explains that painful sex can occur as a result of endometriosis "because of inflammation inside your pelvis. In some women, there can be scar tissue that sticks your internal organs together. Your uterus is normally mobile, so it should move slightly when you're having sex, but if scar tissue is freezing everything together it will hurt."
"You've given up wheat, you've ditched the dairy, but you're still bloated...why? It could be endometriosis," suggests Dr. Anita. But because bloating is such a common symptom for people who have irritable bowel syndrome or other digestion-related conditions, it might not be one that's obviously associated with endometriosis."
If the deposits are near or on your bowel, it can cause it to become inflamed, leading to bloating which can even make you look 6 months pregnant," explains the gynecologist.
Pain While Pooping
Relieving your bowels shouldn't be a painful experience, but for those who suffer it, it's not something they might automatically link to endometriosis. "This happens if you have scarring around your bowels," says Dr. Anita. "It needs to move to function normally and if it's stuck down with scar tissue, it will be really uncomfortable when you're going to the toilet, or even just when your bowel is squeezing all the contents along."
This intense discomfort, the doctor notes, can cause constipation "because your bowel won't move in the same way."
Blood in your poop? Don't ignore it, however embarrassing you think it is. "It's estimated 10 percent of women with endometriosis also have cyclical rectal bleeding," explains Dr. Anita. "That's blood in your stools or from your [rectum] during your period due to the presence of endometriotic deposits in your bowel."
Pain When Peeing/Constant Cystitis
"Again, if you have deposits or scar tissue involving the bladder it will hurt when you pee. If you're constantly going to the GP for a suspected urine infection but nothing grows on the urine culture, it could also be a sign of underlying endometriosis," notes the gynecologist.
"Between 25 to 50 percent of women who go for infertility investigations have underlying endometriosis," says the doctor, adding: "What always upsets me is that many of these women clearly describe symptoms of endometriosis—particularly painful periods or painful sex—that they've 'put up' with for many years."
Dr. Anita reassures that "not all women with endometriosis will struggle to conceive." But in those that do, it's due to "scar tissue tethering your pelvic organs so that your fallopian tubes can't move around to pick up eggs, or because the scar tissue is blocking off the tubes.
"This is one of the biggest reasons why you shouldn't ignore the symptoms, because it takes time to treat endometriosis, so you don't want to be trying to do it urgently at the point where you're desperate to get pregnant."
How to get your doctor to start paying attention to these symptoms:
- Emphasize the impact the symptoms are having on your life, mentioning things like how often you're taking painkillers, whether you have to take time off from work/college/school or cancel social engagements, whether you can look after your kids etc.
- Emphasize the cyclical nature of your symptoms. Tracking your symptoms according to your cycle with a period tracking app is a really good way of getting this information across during the consultation when time may be short and you're feeling overwhelmed or nervous.
- Go to another doctor if you feel you were ignored. You can go to see any GP at your practice, not just your named doctor.
This article originally appeared on Cosmopolitan.com/uk. Minor edits have been made by the Cosmo.ph editors.