7 main symptoms of endometriosis and how to relieve them

Endometriosis can cause severe, debilitating pain and lead to infertility. Understand what the main signs are.

Having very intense menstrual colic, having heavy menstrual flow and feeling pain during penetrative sex are some of the main symptoms of endometriosis. Although they seem common, these signs indicate that something is wrong with menstruation and sexual and reproductive health.

Endometriosis is a disease characterized by the presence of endometrial tissue that lines the internal cavity of the uterus, in the region of the pelvis and abdomen. A the disease affects one in 10 women in Brazilaccording to the Ministry of Health, and about 180 million women worldwide, according to the World Health Organization (WHO).

But, after all, how do you identify the first signs of endometriosis and when should you see a doctor to investigate and treat the problem? “The presence of one or more of these symptoms justifies going to the doctor to identify whether endometriosis exists or not”, explains Alexandre Pupo, gynecologist and obstetrician, doctor of the clinical staff of the Sírio-Libanês Hospital. See below, what are the symptoms of endometriosis:

Menstrual cramps are one of the main symptoms of an endometriosis attack. Although pain in the lower abdomen is common during menstruation, severe, long-lasting, and sometimes debilitating pain is not normal and can be an indicator of endometriosis.

Learn more: 5 problems that can be mistaken for endometriosis

“It’s a cramp that starts before menstruation, a day or two before, and lasts throughout the menstrual flow,” explains Alexandre. As the disease progresses, menstrual cramps can intensify more and more and also cause back pain, especially in the lumbar region.

Besides menstrual cramps, one of the most common symptoms of endometriosis is pain during penetrative sex, also known as deep dyspareunia. “It’s a pain as if the penis hit the bottom of the vagina, in a place that causes pain and often forces the woman to change position or to interrupt the sexual act because of the pain”, details the gynecologist .

In addition to pain, some women may experience bleeding during intercourse due to chronic inflammation caused by endometriosis. The pain is most common around the menstrual period, but it can occur at other times in the cycle.

Endometriosis can also cause infertility. “If a couple tries to get pregnant, maintains sexual frequency at least three times a week, for a year, and fails to get pregnant, this condition is called infertility and the cause may be endometriosis”, explains Alexandre.

This can happen because endometriosis can cause anatomical changes that prevent the fallopian tubes from working properly. Additionally, the presence of inflammatory endometrial cells in other regions outside the uterine cavity can affect egg quality and sperm function, making fertilization difficult. According to the Brazilian Endometriosis Society, more than 30% of cases of the disease lead to infertility.

Know more: Can people with endometriosis get pregnant?

Bowel changes, such as increased frequency of bowel movements, diarrhea and pain on bowel movements, are among the Symptoms of Intestinal Endometriosis. “These are cyclical changes, which occur during menstruation”, specifies the gynecologist. “During the menstrual period, the patient has a looser bowel and sometimes diarrhea,” he adds.

Additionally, the presence of bleeding and changes in stool texture and size may also occur. “If endometriosis compresses the bowel and reduces the lumen, the stools can become thinner,” adds Alexandre.

Endometriosis can also reach the bladder and, with that, cause physiological changes, such as the frequent urge to urinate and the presence of blood in the urine. “These unique symptoms of the menstrual period are also indicative of endometriosis,” explains the gynecologist.

Also, symptoms of endometriosis of the bladder may include discomfort during urination, presence of pus in the urine, urgent urination, pain in the kidneys and pelvic region which worsens during menstruation. , tiredness and tiredness; there may or may not be a fever.

A The belly of people with endometriosis may also become more swollen., with a feeling of “fullness”, especially during menstruation. “Along with the other symptoms above, the patient may have what we call dyspsia, which is abdominal swelling, discomfort, swelling and pain. If it occurs cyclically, that is- i.e. always during the menstrual period, this can be associated with endometriosis,” explains Alexandra.

It is also a common symptom in people with intestinal endometriosis and may be related to the other gastrointestinal symptoms mentioned above, such as frequent bowel movements and diarrhea.

The presence of bleeding in the stool and urine during the menstrual period can also be symptom of deep endometriosis. In this type of disease, the endometrial tissue that has grown outside the uterine cavity infiltrates deeper into the affected organ – at least five centimeters deep.

“Deep endometriosis can affect the intestine, the bladder, the ovary itself and the posterior part of the uterus, in addition to the uterine ligaments”, explains Alexandre. “Usually this is noticed by a change in bowel function and bladder function,” he adds.

In deep endometriosis, the pain typical of the disease, which begins during the menstrual period, can become chronic pain over time. “It is a continuous pain in the pelvic region which, during menstruation, gets much worse. It becomes more worrying when it is associated with bleeding in the stool or urine and when this pain is so strong that it prevents the woman from going about her daily business,” he says.

The treatment of endometriosis varies according to the degree of the disease. In less severe cases, this can be done with anti-inflammatory drugs to relieve pain, or with combined oral contraceptives (estrogen and progesterone), which block menstruation and help reduce flare-ups of the disease.

In more important cases, with more intense symptoms, the treatment must be surgical. According to gynecologist Alexandre Pupo, the best options are laparoscopy and robotic surgery. “These are minimally invasive surgeries, in which it is possible to identify where the foci of the disease are”, specifies the professional.

Learn more: When is endometriosis surgery necessary?

As he explains, endometriosis appears as “little islands” of endometrial tissue in places near the uterus. “If you remove 100% of all the disease found in the peritoneal cavity, that is, inside the abdomen, you have cured that event of endometriosis,” he says.

However, it is important to point out that endometriosis still does not have a fully known cause in medicine and therefore it is not yet known what makes the patient more likely to have the disease. “Even after this event of endometriosis is treated, a woman is still at increased risk of having endometriosis again. But this event, once removed in its entirety, is cured,” he concludes.

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