PMS or a Warning Sign? Identifying When Pelvic Pain Signals Something More

Being female can be a painful experience. Many of us have been programmed to “power through” PMS and menstrual pain, with the help of an over-the-counter pain medication if necessary. However, pelvic pain could be a sign of something more. Severe pain during your menstrual cycle or pain before and after menstruation - accompanied by excessive bleeding - could be a red flag for something more serious than menstrual cramps, like endometriosis or fibroids.

Endometriosis and fibroids are very distinct gynecological conditions but often may present sim with similar symptoms.  The overlapping symptoms for both conditions are pelvic pain, menstrual irregularities, pain associated with intercourse, pain with bowel movements and urination as well as bloating, constipation, and fatigue with periods.

Some key differences between Endometriosis and Fibroid Symptoms:

            Endometriosis is generally associated with chronic pelvic pain that may be severe, especially during the menstrual cycle. The pain may also occur during sex, bowel movements, and urination.

Fibroid pain occurs by the location of the fibroid and creates pelvic pressure that may cause back and/or leg pain if the fibroid is large.

Endometriosis is a common women’s health concern affecting around 5-10 percent of women of reproductive age (15-49 years), but it can frequently be misdiagnosed.

In endometriosis, tissue closely resembling the lining of the uterus grows outside the uterus, affecting the ovaries and fallopian tubes, and sometimes adjacent organs (bowel, bladder). The tissue behaves like the uterine lining – responding to hormonal changes in your cycle. This causes pain, inflammation of the tissue or organ where it attaches, and sometimes scar tissue.

We don’t know for sure what causes endometriosis, but we can identify some risk factors, among them never having given birth, frequent periods, heavy and prolonged periods, low BMI, structural issues with the vagina, cervix, or uterus, family history of endometriosis, starting periods earlier than normal or starting menopause later.

What is available if a diagnosis of endometriosis is confirmed? The first step is to manage the symptoms with hormones – birth control pills. If hormones don’t significantly improve the condition and you find the pain and other symptoms seriously impacting your quality of life, surgery may be considered to remove the tissue.

When you have questions or concerns, it’s never a bad idea to call your OBGYN. Prepare your questions and gather as much information about your condition as possible, including detailed dates of the pain and where it occurs in your cycle. Any additional details you can add from your family history of urogenital issues could also add valuable insight for your practitioner.

Wherever you are in your reproductive life, we can find a solution that suits your needs and relieves your symptoms. The Women’s Healthcare of Princeton team is experienced in identifying the cause of your abdominal pain. Finding the correct source of the pain is the first step toward ending it.