Talking to Your Doctor About Endometriosis

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talking to your doctor, endometriosis
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Is your period incredibly painful, especially in the days leading up to your cycle? Is intercourse painful for you? Do other women in your family—like your mother, aunts, or sisters—also have similar symptoms? You may be experiencing endometriosis.

What Is Endometriosis?

Endometriosis is a chronic condition that results when the tissue that lines the uterus also grows outside of the uterus. This tissue builds up and forms adhesions that can attach to the bladder, bowel, vagina, and other places within the reproductive tract.

These adhesions build up with every menstrual cycle and, unlike the lining that is shed during a woman's period, the tissue that builds up outside the uterus remains. This can cause severe pain for women, along with other symptoms such as heavy or irregular bleeding, cramping, stomach problems including constipation, and painful intercourse. The condition can impact a woman's quality of life, interfere with her relationships, and also affect fertility.

Despite the fact that approximately 1 in 10 are affected by endometriosis, Beth Battaglino, RN, CEO of Healthy Women, explains that the condition can be commonly overlooked by doctors. Doctors may not be well aware of the symptoms of endometriosis or they may not be taking the time to assess a woman's pelvic health and the symptoms that can be associated with variations of pelvic health disorders.

Endometriosis, in particular, can go overlooked for a very long time.

"Many women go 6 to 10 years before an accurate diagnosis of endometriosis," Battaglino notes. This can be due to the fact that women aren't talking about their symptoms to their doctors and that, often, doctors aren't accurately assessing patients for the condition as part of their overall discussion on pelvic health.

In order to change that, it's important to raise awareness about endometriosis—both among women and among their doctors.

Endometriosis Is Not "Normal"

Battaglino explains that one of the factors that can prevent women from getting an accurate diagnosis is that they can mistakenly believe that their symptoms are "normal." Many women might live with their symptoms for years, not even realizing that what they are experiencing is out of the ordinary. Or, it's common for endometriosis to run in families, so women might hear female family members talking about their experiences with their period or pelvic pain and absorb the message that those symptoms are normal.

However, any pain or symptom that is affecting your quality of life, or is occurring so frequently that it leads to a woman being forced to miss work, school, or the like, is not normal and needs to be addressed. And in some cases, endometriosis is a silent condition, which makes it even more important for doctors to be vigilant about doing a thorough assessment and evaluation of women's pelvic health and how it affects their overall quality of life.

Starting the Conversation

A conversation about endometriosis is a conversation that needs to take place as a discussion of overall pelvic health, says Battaglino.

For women, their menstrual cycle is another vital sign that affects almost every other area of health. It needs to be discussed more openly and freely in every physical check-up and exam.

Women should also be encouraged to talk freely about any pain they are experiencing in their pelvic region, especially as it occurs with sexual relations. Your doctor should be asking you questions about your cycle, including how it affects your life, any symptoms, like pain, that you may be experiencing, and what pain you have before, during, or after your cycle.

A woman's menstrual cycle is an important indictor of her overall health and pelvic health.

If your doctor isn't addressing it, it's important for you to either bring it up yourself or find a doctor who is willing to discuss it. "Women should not be embarrassed to talk about pelvic health and have that conversation with their healthcare provider," adds Battaglino.

Battaglino points women to Healthy Women for prompts that may help them get the conversation about pelvic health started with their doctors. These include:

  • I am experiencing cramps that I feel are more severe than normal.
  • This pain is affecting my quality of life. Could this be endometriosis?
  • Explaining what their pain is on a pain scale of 1 to 10 (with 10 being the worst pain imaginable).
  • Sex with my partner is painful.

Tracking Your Symptoms

One of the most important things you can do when approaching a conversation with your doctor about an endometriosis diagnosis or while having an ongoing discussion about the condition is to keep track of the signs and symptoms you are experiencing.

Healthy Women is partnered with the campaign Get in the Know About Me In EndoMEtriosis which offers different resources to help you recognize your own symptoms and take charge of your own health. You can assess your symptoms with an endometriosis checklist that walks you through all the possible signs and symptoms of the condition.

Symptoms can vary widely among women and, in some cases, women may not have any symptoms at all. So, it's especially important to be thorough in your own self-examination.

For example, some women might have severe back pain in the days leading up to their period, some may experience pain only during their periods, and others may have pain with urination. Other women may not have pain at all—so know your own symptoms.

Also offered is a symptoms tracker to help you document any symptoms you may be experiencing in relation to your menstrual cycle. The symptoms tracker prompts you to keep track of when you have pain, at what point it occurs during your period, and how it affects your quality of life. Knowing your symptoms can help you bring up the conversation with your doctor to help you both explore treatment options together.

A Second Opinion Can Help

If your doctor or healthcare provider is not receptive to talking about your pelvic health and symptoms or exploring the possibility of an endometriosis diagnosis, you should not be afraid to seek a second opinion. Statistically, women's pain, especially in relation to pelvic issues and menstrual cycle, hasn't been taken as seriously by doctors. But, if pain is affecting your quality of life, it's serious.

Moreover, it's important for women to know their own pain, be knowledgeable about how it affects their lives, and to stand strong in advocating for a physician who will work with them to figure out what is causing it, instead of dismissing it.

"This is your life and you need to become empowered," Battaglino says. If you aren’t comfortable with your healthcare provider, she recommends that you seek out an expert from a database of physicians who specialize in endometriosis to find a doctor who is educated and open to discussing the condition.

A Word From Verywell

Endometriosis is a condition that can be treated best with early intervention, which is why it's best for doctors to assess for it early on in a woman's life. Symptoms can appear anytime during a woman's reproductive and post-reproductive years, so it also needs to be monitored. Lifestyle modifications, such as exercise or diet changes, are usually not effective in treating endometriosis, which is why early intervention is key.

If you are experiencing symptoms, such as severe pain with your periods or intercourse, heavy or irregular bleeding, or stomach problems, it's especially important to initiate a conversation with your doctor about endometriosis. Symptoms can vary among women, so some doctors may not be aware of the possibility of endometriosis, therefore it's important that you are your own health advocate.

As you prepare to bring up your pelvic health with your doctor, learn to track your symptoms, know your body, and be willing to seek a second opinion if your doctor is not willing to discuss what you are experiencing. "The sooner, the better," says Battaglino.

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