Normal PMS or Endometrial Pain? How to Tell the Difference

Menstrual periods can be inconvenient and uncomfortable. About 3 out of 4 menstruating women experience some degree of physical or emotional discomfort associated with their periods.

However, if you have severe pain, this might not be a symptom of premenstrual syndrome, or PMS. It might be due to endometriosis. In this blog, Darin L. Weyhrich, MD, explains the differences between normal PMS symptoms and endometrial pain.

PMS and its symptoms

The exact cause of PMS is unclear, but doctors think it may be linked to the drop in estrogen and progesterone levels associated with a woman’s period. Normal symptoms of PMS can vary from woman to woman, but the most common symptoms of PMS include the following:

• Appetite changes and food cravings
• Tension or irritability
• Acne
• Sadness or depressed mood
• Breast tenderness
• Abdominal pain or bloating

Some women experience cramping in the days leading up to their periods, but this is not a frequent experience. The more intense the cramping, the more likely it is to be a sign of a problem.

If you have normal PMS symptoms, such as cramping, the cramping will generally be mild, and an over-the-counter pain medication, such as Tylenol, should provide relief. In addition, you may not experience symptoms every month.

Endometriosis and its symptoms

When your menstrual cycle occurs, your endometrium — the tissue that lines your uterus — thickens with blood vessels to prepare for a potential pregnancy. If you don’t get pregnant, the endometrial tissue sheds, which leads to menstrual bleeding.

With endometriosis, the tissue that normally lines the uterus grows outside of the uterus, such as on the Fallopian tubes and ovaries. However, when it tries to shed with the monthly cycle, there’s nowhere for it to go, which can cause severe pain. If you have endometriosis, the symptoms can be very severe. The may include any of the following:

• Severe pain during menstruation, sex, urination, and bowel movements
• Heavy bleeding
• Fatigue
• Nausea
• Constipation
• Diarrhea
• Infertility

Endometriosis often causes severe pain, and over-the-counter pain relievers don’t usually bring much relief. Furthermore, endometriosis is predictable. If you experience any of these symptoms every month during your cycle, you may have endometriosis.

What you can do about endometrial pain

There are a number of options to treat endometrial pain. One option is to take a birth control pill, which can prevent menstruation from occurring and therefore prevent the symptoms of endometriosis from occurring.

Another option is to perform an endometrial ablation. This procedure provides a nonsurgical way to remove the lining of the uterus. This will likely reduce your menstrual bleeding or even stop it entirely. However, it’s not a good choice for women who have certain conditions, such as pelvic inflammatory disease or a scar from a C-section.

In some cases, a hysterectomy might be the best option. This surgery removes your uterus, so it’s only recommended when you’re absolutely certain that you don’t want to have any more children.

Endometrial pain is never normal, and you shouldn’t have to live with it. If you have endometriosis and want treatment, or if you suspect you have the condition and want a diagnosis, book an appointment over the phone with the office of Darin L. Weyhrich, MD, today.