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Is your period pain normal?

Experts tell you what signs to watch out for...

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It’s that time of the month that has women in distress, experiencing cramps, abdominal pain, mood swings, etc. While these are considered a part and parcel of periods, there are some women who go through an ordeal with the severity of these effects and more. But then how much pain is normal? According to a recent study, signs like vomiting, leg pain and painful sex could point to a serious problem like endometriosis. Experts guide on the same.

The study
According to an Australian study, about 90 per cent of women experience menstrual cramps every month. However, signs like vomiting, leg pain and painful sex could be signs of something much more serious, and shouldn’t be ignored. Also, while most normal menstrual pain can be relieved by over-the counter anti-inflammatory pills, severe symptoms like back or leg pain, nausea or bleeding at unexpected times of the month could all signal to a more serious condition — endrometriosis.  Endometriosis is a condition where bits of the uterus lining grow in other places outside of the uterus such as the ovaries, bladder or intestines, explains Dr Lara Briden.

“Women who experience some degree of menstrual pain, caused by prostaglandins, will be suffering from your run of the mill, standard period pain,” says Briden. “You can easily lower prostaglandins with an anti-inflammatory or it can be addressed and removed with diet. However, Briden says it’s when pain is abnormal and can lead to sever pain and vomiting that women should go straight to a doctor. Normal period pain should be on the first or second day of bleeding, not later in the bleeding cycle or before. So timing is all part of the warning signs,” adds Briden.

Expert speak
Do experts agree with the above study? Gynaecologist Dr Suman Agarwal says, “Yes, it is definitely possible. The most common symptoms of endometriosis include severely painful periods (including pain starting a few days before onset of periods and often continuing through the period), which may be accompanied by nausea or vomiting. Some women, especially those who have endometriosis just behind and below the uterus and around the rectum, tend to have painful sex especially on deep penetration.”

What’s normal and what’s not
It is often difficult to differentiate between normal period pain and pain of endometriosis, says Dr Agarwal adding that a woman should note any deviation from her ‘normal pattern’. For example, if a woman who has been having normal periods and intercourse, finds that she has recently developed painful periods or painful sex, she certainly needs to visit her gynaecologist. Another simple rule is — any period pain which consistently prevents a woman from performing her daily routine tasks (such as taking leave from school or work) should be checked by a doctor. Every woman’s threshold for pain is different. Hence, if it is troubling, she should go and meet her gynaecologist. That way, at least screening tests are carried out to rule out the pathologies, advises Dr Nandita Palshetkar, head of IVF, Lilavati Hospital.

Diagnosing endometriosis
The diagnosis of endometriosis is done either by imaging techniques like sonography or by laparoscopy. Dr Palshetkar says, “The incidence of endometriosis is approximately 10 to 15 per cent in women undergoing diagnostic laparoscopy, and 14 to 53 per cent in women with pelvic pain.”

Endometriosis is becoming increasingly common in today’s times. Previously considered more a disease of the West, it is now found with disturbing frequency in our country too, especially in urban, affluent and educated women, opines Dr Agarwal saying, “Since symptoms are not reported by women early and many women do not undergo laparoscopy, we do not know the full extent of the problem in our population. In developed nations, it is suspected that roughly 11 per cent of the female population suffers from endometriosis. It is suspected that 25 to 40 per cent of infertile women, and 25 to 38 per cent of teenage girls with pelvic pain and painful periods suffer from endometriosis.”

Other problems
Dr Palshetkar says, “Besides endometriosis, these symptoms may be indicative of adenomyosis, or fibroid uterus. It may also be suggestive of pelvic inflammatory disease. Hence, meeting the gynaecologist and getting the screening tests done is essential.”

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