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Women’s health: Which symptoms should signal a doctor’s visit

March is Endometriosis Awareness month. The most common symptom of endometriosis is pelvic pain, typically occurring with the menstrual period.
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Many women ignore gynecological symptoms, believing they are a normal part of their regular menstrual cycle or related to approaching menopause. Recognizing the symptoms of different conditions can help women know when to seek advice from their physician.

Endometriosis

Endometriosis is a condition that can affect women at various stages of life and can bring with it a wide range of symptoms. For some women, the condition can be incredibly painful. For others, it may go undetected until a secondary problem like infertility is investigated.



March is Endometriosis Awareness month, drawing attention to this disorder which causes tissue that normally lines a woman’s uterus — the endometrium — to grow outside of the uterus. Endometriosis usually involves tissue growing on and around the ovaries, bowel or tissue lining the pelvis. In rare cases, endometrial tissue may spread beyond the pelvic region.

Regardless of where it is in the body, when endometrial tissue begins to grow it continues to act as it would normally if it were within the uterus. This means the tissue will thicken, break down and then bleed along with a woman’s menstrual cycle. Because this displaced tissue has no way to exit the body, it can become trapped.




When endometriosis affects the ovaries, cysts may form. Surrounding tissue may become irritated, eventually developing scar tissue and adhesions.

The most common symptom of endometriosis is pelvic pain, typically occurring with the menstrual period. Menstrual cramps associated with endometriosis are typically far more severe than regular menstrual cramps and may escalate in severity over time. They can also include lower back and abdominal pain.

Other symptoms may include painful intercourse, pain with bowel movements or urination, and heavier than normal bleeding or bleeding between periods (menometrorrhagia). Fatigue, diarrhea, constipation, bloating or nausea, especially during menstrual periods, can also accompany these symptoms.

Endometriosis causes infertility, and in some cases, it is first diagnosed in women who are seeking treatment for infertility.

Because endometriosis may be mistaken for other conditions that cause similar pain in the pelvis, such as irritable bowel syndrome; pelvic inflammatory disease (PID); or ovarian cysts, women should discuss these symptoms with their doctor. As always, finding the underlying cause of symptoms is important and early diagnosis can aid in treatment.

Is it menopause?

For women between the ages of 40 and 55, menopause gets blamed for a variety of ailments, complaints and problems. This can make it difficult to differentiate when something else may be amiss.

Menopause is caused by normal changes to the reproductive and hormone systems, and by definition occurs when a woman has gone a full year without a menstrual period. On average, women will experience their last period at 50 or 51 years of age, however every woman’s body has its own timeline and that age can vary from the mid-40s to later 50s.

The time leading up to menopause, called peri-menopause, can last anywhere from two-eight years, during which some women begin to experience symptoms such as irregular periods, hot flashes, breast tenderness, fatigue, sleep disruption or more intense premenstrual syndrome.

As a way of tracking cycles and symptoms, many doctors suggest that women keep a log of their menstrual cycles and any variations. There are some symptoms that should be checked out by your doctor:

Excessively long menstrual periods (more than 10 days out of your cycle)

Heavier menstrual period than usual — sometimes accompanied with dizziness or light-headedness

Shorter cycles (if cycle is getting shorter and is less than 20 days)

These symptoms may be linked to a number of conditions, including a thyroid disorder, anemia, fibroids, uterine polyps or even pregnancy. It is worth noting, that though rare, women can get pregnant until one year past the last menstrual cycle.

To diagnose the underlying cause of symptoms, your doctor may provide diagnostic testing in the form of a pap smear, ultrasound, uterine biopsy, hysteroscopy and/or bloodwork, depending on your symptoms and history.

For more resources on women’s health at any age, visit Dignity Health’s Care Begins with Me program at carebeginswithme.org. Membership is free and provides exclusive access to health articles, events, healthy recipes, discounts and giveaways.

All physicians providing care for patients at SNMH are members of the medical staff and are independent practitioners, not employees of the hospital.


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