Painful Periods: Dysmenorrhea or Something Else?


True HealthMany women assume that menstrual cramps normally occur with their periods. But if you’re old, underweight, have never given birth, and drink alcohol, you may be suffering from something more sinister. What you think is a simple case of dysmenorrhea may, in fact, be endometriosis, a debilitating condition that may damage your reproductive organs and increase your risk for cancer.

The evils of endometriosis were disclosed by obstetrician-gynecologist Dr. Maynila Domingo during the Urban Health Forum held yesterday at ManilaMed (Medical Center Manila) in Ermita, Manila. Citing statistics from the World Health Organization, Domingo said nearly 60 percent of women with dysmenorrhea have endometriosis which most women take for granted.


That’s understandable since dysmenorrhea is a common condition that goes away once the menstrual cycle is over. However, that is not the case for some women, especially those with short menstrual cycles, high levels of estrogen in the body, uterine abnormalities, or a family history of the disease.

Outside Growth

In endometriosis, endometrial tissue that is a normally found inside the uterus grows outside. This displaced tissue thickens, breaks down, and bleeds during the menstrual cycle. This is normal to make a good environment for the fertilized egg.

Unfortunately, since this happens outside the uterus, it creates a lot of problems. The trapped tissue can cause severe pain and affect a woman’s fertility.  Aside from painful periods, the patient may experience painful sex, painful urination or bowel movements, and excessive bleeding.

The degree of pain doesn’t reflect the extent of the problem. Some women who experience severe pain may only have mild endometriosis, while those with little or no pain at all may suffer from the advanced stage of the disease.

Are You at Risk?

Who are at risk for endometriosis? Domingo said this might be caused by several factors acting together. In general, she said the usual candidates are women with early menarche (menstruation that starts before the age of 11).

“Other risk factors include shorter monthly cycles (less than 27 days) and a heavy menstrual flow lasting more than seven days,” she added.

Untreated endometriosis can lead to other, more serious conditions. It can damage the ovaries, fallopian tubes, and surrounding tissues. This may lead to low fertility or infertility.

Dr. Maynila Domingo of ManilaMed stresses a point during the Urban Health Forum on endometriosis.

“The exact mechanism behind infertility from endometriosis is not fully known, but it may be related to distorted pelvic anatomy, endocrine and ovulatory abnormalities, altered peritoneal function, and altered hormonal and cell-mediated functions in the endometrium,” Domingo revealed.

Women who have endometriosis may still have children if the disease is not severe. It’s also advisable for them to have kids earlier since the disease may worsen over time.

Deadly Complication

“The other more serious complication of endometriosis is cancer. There are some studies showing a link between endometriosis and certain cancers, especially ovarian cancer. However, the association is not definitive; it does not mean that if you have endometriosis, you will eventually get cancer. Nevertheless, early treatment is recommended to prevent or reduce the risk of both infertility and cancer,” Domingo stressed.

Management and treatment of endometriosis are different for patients, depending on the symptoms, the severity of the disease, and other concerns.

“Endometriosis may be treated with medicines or surgery, or both. The goals of treatment include pain control, preservation of fertility, cancer prevention, and reducing the risks of recurrence,” she concluded.

National Press Club and Philippine Dental Association awardee George Nava True II is the author of three health books based on his popular medical column that has been running for over 30 years. For inquiries, email or text 09331366645.


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