Understanding Period Pain: When to Worry and Seek Help

Maybe if period pain burned calories, it'd be worth it. — Unknown

Photo by Sora Shimazaki on Pexels

Are you curled up in bed, clutching a hot water bottle to your abdomen, feeling like your insides are staging a full-blown revolt? While period pain is a common experience for many people, how do you know when it's a normal part of menstruation—and when it might be something more serious?

First things first: it's essential to understand that some degree of discomfort during menstruation is normal. Cramping, bloating, and mood swings are all a norm when it comes to "that time of the month." However, if your pain is so severe that it interferes with your daily activities or requires you to miss school, work, or social events, it could be a sign of an underlying condition, like endometriosis or adenomyosis.

It’s important to pay attention to your body and the signals it’s sending. If you experience sudden, intense pain that doesn’t improve with over-the-counter pain medication, it could point to something more serious.

Endometriosis occurs when tissue similar to the lining of the uterus grows outside the womb, often on the ovaries, fallopian tubes, or other pelvic organs. This misplaced tissue behaves like uterine lining—it thickens, breaks down, and bleeds during your menstrual cycle—but since it has no way to exit the body, it causes inflammation, pain, and sometimes the formation of scar tissue. Endometriosis can lead to debilitating pain during periods, chronic pelvic pain, pain during intercourse, and even infertility.

On the other hand, adenomyosis is a condition in which the lining of the uterus grows into the muscular wall of the uterus. This can lead to heavy or prolonged periods, severe cramping, and an enlarged uterus that can sometimes cause bloating or a feeling of heaviness in the abdomen. Adenomyosis and endometriosis can co-exist, as they do in my case, which can make managing symptoms even more challenging.

While both conditions can cause intense pain and heavy bleeding, they are distinct and require different approaches to treatment. Unfortunately, neither endometriosis nor adenomyosis has a quick fix or cure. However, there are ways to manage symptoms, and understanding these conditions is the first step in advocating for yourself.

One of the biggest hurdles with endometriosis is how long it takes to get a proper diagnosis—on average, it can take 7 to 10 years. The symptoms of endometriosis are often dismissed as "bad periods," leading many people to feel unheard or misunderstood by healthcare professionals. Adenomyosis, while slightly easier to detect via imaging or symptoms, can also go undiagnosed for years.

This delay in diagnosis is why it’s so critical to listen to your body and seek medical advice if you feel like something is wrong. Severe period pain is not normal, and you shouldn’t have to suffer in silence.

When managing conditions like endometriosis and adenomyosis, some people consider more drastic treatment options, such as a hysterectomy (the surgical removal of the uterus). While a hysterectomy can effectively cure adenomyosis (since the problematic tissue is within the uterus), it is not a cure for endometriosis. Because endometriosis involves tissue growing outside the uterus, a hysterectomy won’t necessarily remove all the endometrial-like tissue.

That being said, for those with adenomyosis—or a combination of endometriosis and adenomyosis—this procedure can provide significant relief. However, it’s a major surgery with lifelong implications, especially for those who are younger or hope to have biological children in the future.

If you're considering a hysterectomy, it's vital to think it through carefully, consult with a trusted healthcare provider, and, if applicable, discuss it with your partner. Understanding the potential benefits and risks can help you make an informed decision that’s right for your unique circumstances.

Living with conditions like endometriosis and adenomyosis can be an isolating experience, but it doesn’t have to be. Through the tough moments—painful periods, endless doctor’s visits, cancelled plans, and the emotional toll of it all—having a support system can make a world of difference.

Whether it’s a trusted friend, a supportive family member, or an online or in-person endometriosis support group, reaching out for help is a vital step. Speaking from experience, finding others who understand what you’re going through can be incredibly empowering. You are not alone in this journey, and you don’t have to navigate it in silence.

Knowing when to seek help is crucial. If your periods cause:

• Pain so severe that you can’t function in daily life,

• Heavy bleeding that soaks through pads or tampons in an hour,

• Bleeding between periods,

• Pain during or after intercourse, or

• Chronic pelvic pain even outside of your period,

It’s time to talk to a healthcare provider. These could be signs of endometriosis, adenomyosis, or another underlying condition that requires attention.

Periods are a natural part of life, but they should never take over your life. If you’re struggling with pain or other symptoms, know that help is available. Reach out for support, advocate for your health, and, most importantly, know that you are not alone. Whether it’s connecting with a doctor, confiding in a loved one, or joining a support group, there is strength in community and hope on the horizon.

As someone who has walked this journey and continues to navigate its ups and downs, I can say this: even on the toughest days, you are stronger than you realise.

Signed,

#EndoWarriorH