Can My Dysmenorrhea Be Related to Endometriosis?

Dysmenorrhea is characterized as painful menstruation and is reported by 50-90% of women.
Primary dysmenorrhea is defined as the absence of an underlying cause of pain and the appearance of normal reproductive organs and pelvic. This appears to be more common in younger women and typically resolves with age.

Other risk factors include a BMI <20, smoking, menarche before age 12, longer cycles and length of bleeding, irregular or heavy flow, and a history of sexual assault.

Secondary dysmenorrhea occurs when your doctor discovers an underlying cause of menstrual pain. This could include endometriosis, adenomyosis, fibroids, or a pelvic infection. Endometriosis is the most commonly diagnosed cause of secondary dysmenorrhea.

Endometriosis
Endometriosis is a prevalent illness that affects around 8% of the female population.
It is caused by the uterine lining (endometrium) appearing in other areas of the body. Endometriosis is most usually found in the pelvic area and can connect to the ovaries, ligaments behind the womb, the tissue layer lining the pelvis, the bladder and ureters, or the intestine.
Endometriosis can range from mild to severe (Stages 1–4). The cause of endometriosis is yet unknown. Adenomyosis is endometriosis that affects the muscle layer of the womb itself.

Dysmenorrhea and Endometriosis - Symptoms
Endometriosis can induce pelvic pain or infertility; however, many women with endometriosis experience neither. Having more endometriosis does not guarantee increased pain; women with only a small amount can have more pain than women with severe disease.

Pelvic discomfort in endometriosis is primarily connected with menstruation and happens on a monthly basis. However, additional, prominent symptoms could be:

- Pain felt deep within the vagina during or following sexual intercourse.
- Pain felt while traveling through motion.

These symptoms are also exacerbated during menstruation. Discomfort might also occur throughout the month, which can be classified as chronic pelvic discomfort.

Although it is usual to feel some discomfort during menstruation, it is not typical to have pain that cannot be addressed by basic pain relievers or to be forced to take time off work or skip social engagements. These may indicate that you have endometriosis and should seek medical attention.

Rarer types of endometriosis
In rare circumstances, you may have bleeding in the back passage or when passing urine during menstruation, indicating that endometriosis has affected the rectum or bladder. Cyclical discomfort during menstruation in an old surgical scar (such as a cesarean section scar) may indicate endometriosis. Coughing up blood during your period may indicate lung endometriosis.

Dysmenorrhea and Endometriosis - Diagnosis
The typical age of developing o pain symptoms in endometriosis is 20 years, although the average age of diagnosis is 28. This is because many women ignore discomfort symptoms since they believe they are normal and do not want to appear to be complaining, and doctors reject their concerns too quickly.

Your gynecologist may assume you have endometriosis after discussing your symptoms. Normally, they will schedule an ultrasound scan to diagnose endometriotic cysts in the ovaries. A professional endometriosis scanner can detect severe endometriosis in other regions as well.

However, no test or scan can diagnose minimal or mild endometriosis. The only approach to diagnosis is to do a diagnostic laparoscopy (keyhole surgery) under general anesthesia and examine it immediately. A gynecologist who specializes in endometriosis would then attempt to remove all visible endometriosis at the same time.

Some women may choose to proceed immediately to a diagnostic laparoscopy to determine whether or not they have endometriosis. Knowing the source of the problem assists them psychologically in dealing with it.

Surgical treatment involves the assistance of a gynecologist who specializes in endometriosis and minimally invasive surgery (keyhole surgery). For mild to moderate disease (Stage 1-3), the surgeon should be able to diagnose the problem during laparoscopy and surgically remove it, ideally by excision, while providing the highest possibility of pain alleviation. Many general gynecologists are not properly trained in these approaches.