How does a woman know how painful a period should be and how “sad” is too “sad” just before a period? Is this “normal”? Is this how other women feel? Or is this something more than pre-menstrual cramping?… Could this be endometriosis?
Endometriosis is a chronic health condition which affects 5 – 10% of menstruating women in Australia; it can impact on many aspects of a women’s life through the ongoing symptoms of pain and fatigue. Endometriosis can be a very painful condition as the endometrial tissue, which normally lines the uterus, develops in other areas of the body – most commonly in the lower abdomen and genito-urinary system. The endometrial cells continue to respond to the monthly fluctuations in hormones and as a result will bleed into the surrounding tissue. The hormonal bleeding can create an inflammatory reaction, fibrosis or adhesions and in more severe cases this can lead to infertility.
For someone experiencing endometriosis the tissue is commonly found in the pelvis, on the ovaries, ligaments, fallopian tubes, cervix, vagina, vulva, and in the Pouch of Douglas (area between the uterus and the rectum). Physical symptoms experienced by women with endometriosis may include:
- Pelvic pain
- Pain during intercourse
- Ovulation pain
- Lower back, thigh, or leg pain
- Painful urination
- Other bodily pains
- Heavy periods
- Premenstrual syndrome
- Difficulty falling pregnant
- Bowel disturbance
The culmination of these physical symptoms can have a profound emotional impact on a women. This can have an ongoing impact on her personal and professional life.
The emotional roller-coaster
Common emotional symptoms experienced by a women with endometriosis may include:
- Sleep disturbance
- Fertility concerns
- Lack of control
- Effects on intimacy
- Finding appropriate sexual positions
In light of the above physical and emotional symptoms of endometriosis, it is not surprising that women with this chronic health condition report that their quality of life is impacted and they experience times of emotional distress. Emotionally women have reported feelings of anger toward their body due to a lack of control over their menstrual cycle, fear of infertility, and ongoing intimacy issues related to pain during intercourse and unpredictable bleeding. This may also result in experiencing depression and anxiety; all of which can be compounded through pain, insomnia, and other bodily disturbances.
Endometriosis can take a long time to diagnose and there are several reasons for this. Women often think that their physical and emotional feelings are normal and will delay in talking to a doctor about this. Doctors will often attribute these symptoms to other conditions, such as irritable bowel syndrome, kidney stones, or cystitis.
Such ongoing pain, discomfort, and significantly heavy periods may effect a women’s emotional well-being; particularly when answers are not found by medical professionals
Complementary therapies for endometriosis
Many women find the use of complementary therapies helpful in managing their endometriosis. Prior to commencing any additional therapies it is important to remember to discuss this with your general practitioner. There are a range of therapies available, including:
- Herbal medicine
- Mindfulness therapy
- Counselling – couples therapy, fertility support, stress and anger management, sleep hygiene
A Women’s Physical and Psychological Wellbeing
Endometriosis may lead to ongoing pain symptoms which can be treated with both medical and complementary treatments. Research into the psychological distress and coping strategies of women with endometriosis has found that increasing knowledge of the condition and treatment options helped women gain control back over their health leading to improved health outcomes.
Speaking with a Psychologist is an important step to learning how to manage your health and emotional wellbeing. A psychologist can help you with the following emotional and physical symptomology of endometriosis:
- Pain management strategies
- General adjustment for a chronic health condition
- Assist in finding a full life despite difficulties conceiving
- Relationship– communication between a couple, managing mood fluctuations, and intimacy issues
- Help a women adjust to not falling pregnant when desire
Gilmour, J.A, Huntington, A, and Wilson, H.V. (2008). International Journal of Nursing Practice, The impact of endometriosis on work and social participation. 14, pp 443-448
Huntington, A., and Gilmour, J.A. (2005). Journal of Clinical Nursing. A life shaped by pain: women and endometriosis. 14 (9), pp. 1124 – 1132.