Menstruation or periods is one painful time for many women every month when they have severe abdominal cramps, lower back pain, mood swings along discharge of blood and menstrual material. “The pain that women with ‘heavy periods’ go through is unexplainable, irrespective of the causative medical condition. Some women ask me if there is a connection between endometriosis and heavy periods and I would say, yes and no because ‘heavy periods’ is one of the symptoms of endometriosis and not every woman with heavy periods may have endometriosis” says Dr. Manu Lakshmi, one of the leading female gynecologists in Chennai.
What is endometriosis?
Endometrium refers to the inner lining of the uterus. This inner lining starts growing at the beginning of the menstrual cycle, thickens over time, and when the egg (released by the ovaries) is not fertilized, the layer is shed during periods at the end of the cycle. In order to detach the endometrial layer, the abdominal muscles push the uterus which appears as cramps.
In some women, the endometrial layer that is supposed to grow only inside the uterus also grows outside of it. (On ovaries, fallopian tubes, outside the uterus, etc). As a result, during menstruation, there can be excessive bleeding, pain, more cramps along with other symptoms.
Symptoms of endometriosis
- Dysmenorrhea or painful periods. Pain in the pelvis region, severe cramps that begin much ahead of actual menstruation and last even after the bleeding stops are commonly seen in women suffering from endometriosis.
- Pain during or after intercourse
- Diarrhea, constipation, nausea, bloating, etc
- Heavy bleeding during menstruation and spotting or bleeding in the middle of the cycle
- Pain with bowel movements and while passing urine may also be present.
What causes heavy periods in women?
Menorrhagia, heavy periods is referred to a condition when a woman experiences unusually heavy and extended/prolonged bleeding. This may be associated with more painful abdominal cramps that can disturb your regular daily activities including work.
Causes of heavy periods in women include:
- Hormone imbalance. The hormones estrogen and progesterone are responsible for maintaining the menstrual cycle in a woman’s body. The imbalance of any or both of these hormones can result in a disturbance in the menstrual cycle and can cause heavy or lighter periods. Though in many cases, what causes hormone imbalance is not clear, gynecologists have identified certain conditions like PCOS (Polycystic Ovary Syndrome), obesity, insulin problems, thyroid condition, etc.
- Improper functioning of ovaries. In some women, ovaries don’t release the egg at the right times or don’t release it at all. They also don’t produce enough progesterone and at the time when it should be produced. This in turn causes hormone imbalance resulting in heavy periods.
- Fibroids are non-cancerous (benign) growth of tissues inside or outside the uterus that can cause heavy periods, severe cramping along other symptoms. There are different types of fibroids depending on the location of their growth viz. intramural, submucous, subserous, broad ligament fibroids, etc.
- Uterine polyps. These are small growths on the lining of the uterus that can extend into the uterus. Their presence can also cause heavy bleeding during menstruation.
- When the tissue from the endometrial layer gets through the walls of the uterus and lodges itself in the uterine muscles, the condition is called Adenomyosis.
- Insertion of IUDs, especially the non-hormonal IUDs such as Copper T (in India) can cause little heavy periods during the initial months during which the body adjusts itself for the presence of foreign material.
- Uterine cancer or Cervical cancer can also cause heavy to very heavy bleeding.
- There are some other conditions such as problems with the liver, kidneys that can result in heavy menstruation in women.
In short, endometriosis is one of the several conditions that can cause heavy periods but not the only one. When you present yourself to your gynecologist near you, diagnosis of heavy periods starts with a set of questions that include other symptoms, your current medical conditions, medicines that are being taken followed by physical examination, an ultrasound, or imaging tests such as CT scan or an MRI.
If you have any of the above said symptoms such as unusually heavy periods, severe abdominal pain that starts ahead of the periods, or periods that last longer, and if that continues for a couple of months, you need to see a good gynecologist near you without delay. As long as the condition is non-cancerous, you will be perfectly fine but the problem is due to the growth of cancerous cells, it is always better to get the treatment started before it’s too late.