As a part of endometriosis awareness month, today’s post is devoted to one of the main symptoms of endometriosis: painful menstruation. Doctors theorize that endometriosis can cause painful menstruation because the endometrial cells outside of the uterus respond to the same hormones that control the menstrual cycle. Thus, estrogen causes the cells to thicken, but they cannot exit the body through the vagina. As a result, they can cause pain and inflammation. Some doctors believe that over time, this can lead to scar tissue that causes organs to stick together. In some women, this “sticking together” causes infertility, chronic pain, bowel symptoms, and other painful symptoms.
In October of 2008, researchers published a study in the Gynecological and Obstetric Investigation, in which they investigated factors associated with the risk of developing painful menstruation in women with ovarian endometriomas. Ovarian endometriomas occur when endometrial cells form small cysts on the outside of the ovary. As they respond to hormone stimulation each month, they produce more cysts and can enlarge. Endometriomas (also known as chocolate cysts) can rupture and spill into the uterus, sometimes causing adhesions (scar tissue) and pelvic pain.
In the above study, researchers evaluated and interviewed 710 women with surgically confirmed ovarian endometriomas. 376 of these women also had a major complaint of painful menstruation. The researchers found that the following items as risk for dysmennorhea (painful menstruation):
- Age: A younger age at time of surgery increased a woman’s risk of developing menstrual pain
- Previous Medication Use
- Presence of Adhesions
- Presence of Adenomyosis, which had the strongest correlation
At Clear Passage Therapies, we specialize in treating adhesions. Our therapists have often noted a strong correlation between adhesions and endometriosis pain and dysfunction. We have found that by gently breaking apart the adhesions with manual techniques (see What is the Wurn Technique?) pain subsides and function returns. To learn more about our treatment, please visit our endometriosis pain page.