Painful Periods Could Indicate Endometriosis

Mimicking the uterus lining, it grows and flakes off as if it were in the uterus during a normal period cycle, sometimes even bleeding. It can cause swelling, irritation and pain.

Arkansas Children’s has the only two fellowship-trained pediatric and adolescent gynecologists in the state: Dr. Laura Hollenbach, medical director for the AC pediatric and adolescent gynecology clinic and associate professor of Obstetrics and Gynecology and Pediatrics at the University of Arkansas for Medical Sciences, and Dr. Kathryn Stambough, AC pediatric and adolescent gynecologist and assistant professor of Obstetrics and Gynecology at UAMS.

They see patients from newborns to 22 years old for a variety of conditions, including endometriosis.

According to 2020 statistics from the World Health Organization (WHO), about 10 percent or 190 million girls and women who have had their first period globally are affected by endometriosis. Some women can have endometriosis and mild symptoms, never needing treatment beyond over-the-counter drugs.

For those with symptoms, the disease can cause complications, including chronic pelvic pain, abnormally painful periods, infertility, pain with sex, urination and bowel movements, bloating and nausea, fatigue, anxiety and depression, according to WHO.

Girls can experience endometriosis symptoms when they get their first period through a woman reaching menopause. Some may have mild endometriosis, with fewer implants but severe symptoms, while others may have several implants but mild symptoms. Because pelvic pain or pain with periods is the most common with endometriosis, many do not go to the doctor, thinking their pain is normal.

Surgery is the only way to confirm a patient has endometriosis, so doctors look at a patient’s history and symptoms to see if endometriosis is possible.

ACH gynecologists listen to how younger patients describe their symptoms to determine if endometriosis could be the cause.

Red flags include:

• Pelvic pain or pain with periods that interferes with activities, like attending school, sports or hanging out with friends
• Over-the-counter drugs and heating pads providing no relief
• Pain while peeing
• Irregular period patterns
• Family history

Pelvic exams, which are not always needed, can reveal suspicious issues, including sensitivity in certain areas. Ultrasounds looking at the pelvis can also rule out other conditions.

Endometriosis can be treated with drugs, surgery and/or with physical therapy. Prescribed drugs target prostaglandins, which trigger muscles to contract and push out the uterus lining, causing cramping during a period. Doctors can also prescribe hormonal treatments and other drugs that help the pain. ACH physical therapists offer pelvic floor therapy, which includes exercise techniques for the pelvis or hip muscles that can help endometriosis patients.

Surgery is typically the last resort. It removes the implants growing outside the uterus, and a patient is then managed with drugs. Because it is an ongoing disease, it sometimes requires multiple surgeries down the road if drugs are not controlling it.

Make an in-person or telehealth appointment with the ACH Gynecology Clinic in Little Rock or Arkansas Children’s Northwest in Springdale to learn more.