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  • Painful Period Care : (Know about your painful menstrual periods)

What is endometriosis?
Endometriosis is a condition that occurs when tissue similar to the lining of the uterus is found outside its normal location.
Common locations of endometrial implants include the ovaries, Pelvic walls, and Uterosacral ligaments that support the uterus and tissue covering the bladderand rectum. The location of the endometrial implants and the way in which the lesions affect the pelvic organs contribute to the symptoms adolescent and adult women may have. Severity of pain varies with extent of Endometriosis (Mild, Moderate, and Severe)
Symptoms of endometriosis
Occasional or constant pelvic pain and/or severe period cramps are definitely the most common symptoms.
There can be pain before, during or after your period. The pain may occur at regular times in your cycle or the pain may occur at any time during the month.
It is often referred to as "chronic" pelvic pain.
Some teens may have pain with exercise, sex, and/or after a pelvic exam.
Painful or frequent urination, diarrhea or constipation may accompany the pelvic pain.
Dyschasia indicates pain during defecation indicates recto-vaginal Endometriosis.
How is endometriosis diagnosed?
If you have unexplained pelvic pain, menstrual cramps that are so bad that you miss school, or pain when you have sex, you could have endometriosis.
There could be other reasons for your symptoms too. Only your health care provider can tell for sure. In fact, the ONLY way to be 100% certain of this diagnosis is to have a procedure called a “laparoscopy”.
A laparoscopy allows your doctor to look inside your belly at your pelvic organs with a special lens to identify the endometriosis (implants). Other tests that MAY be ordered by your health care provider BEFORE a laparoscopy might include blood tests, cultures to check for infection, ultrasound or an MRI (to make sure it's not something else).
If you think you could have endometriosis, you will want to find a qualified Gynaecologist to evaluate you. Most of the time Endometriosis is treated with medicines in teens. Rarely operation in the form of laparoscopy is requires in teens.

What causes endometriosis?
Although we know that some young women may be slightly more likely to develop endometriosis because female relatives have it, the truth is we do not know the cause of this disease.
So Females with Family history of Endometriosis are advised to get married as early as possible and try pregnancy as early as possible as pregnancy is known to relive her from pain of Endometriosis and the diseases itself.
The three most accepted theories are:

  • Sampson's Theory: This theory explains that the flow of menstrual blood gets "backed up" causing some of the blood to flow in a reverse direction. This process causes blood containing endometrial tissue to attach to surfaces outside of the uterus.
  • Meyer's Theory: This theory proposes that specific cells called "metaplastic cells" change into endometrial cells and are actually present at birth.
  • Vascular Theory: This theory suggests that the endometrial tissue "travels" through the body via blood vessels. It then reaches various tissues, implants, and then grows, causing pain.

What can I do if I think I might have endometriosis?
While we can't cure endometriosis fully, you can be treated for your symptoms.
If you are having pelvic pain or unexplained period cramps which cause you to be absent from school several days a month, you may want to keep a record of your symptoms.
You can also identify your pain by writing a pain diary. Ways to help you describe your pain:

  • Type (sharp, dull, burning, aching, cramps)
  • Location (where is the pain?)
  • Duration (how long does it last?)
  • Intensity (scale of 1-10, how "bad" is the pain?)

Next, talk to your gynecologist about your symptoms and bring your pain diary with you for your doctor to review.
It's a good idea to bring copies of test results, operative notes (a summary by your doctor if you have had surgery) and/or radiology reports (you can ask for copies of these too from the x-ray department of the health care facility where you had your ultrasound or x-ray).
Most importantly, make sure you are evaluated by a gynecologist who specializes in taking care of teens with endometriosis.
A research study done at Children's Hospital in Boston found that endometriosis was the most common diagnosis after surgery in teens that had chronic pelvic pain.
Never forget to preserve video of your laparoscopic surgery for Endometriosis from your Doctor for future prognosis and Infertility treatment.
What kinds of treatment are available?
Talk to your gynecologist about treatment options. When an evaluation by your gynecologist suggests endometriosis, it is likely that you will be scheduled to following options:

  • Observation
    After a complete evaluation and before beginning therapy, you and your health care provider may decide to keep track of your symptoms and try mild pain medicine.
  • Medical suppression
    Hormonal treatment such as birth control pills either taken in cycles or continuously are felt to relieve symptoms in 8 out of 10 patients. Another medication is a GnRh agonist, such as Luperide, works by shutting off hormones made by the ovaries and temporarily stopping your period. The use of GnRh agonist therapy lowers your body's estrogen level (one of the hormones that cause your body to have periods). This medicine has been approved by the Food and Drug Administration to be used for 6 months at a time. If used for over 6 months, studies have found it can cause changes in bone density.
  • Surgery
    Surgery is not indicated unless pain is very severe and not relived with medicines as Endometriosis is likely to be recurrent if she does not become pregnant within nine months. So patients with Endometriosis are not generally operated till she gets married and plans for pregnancy.
  • Lifestyle changes
    Aerobic exercises & change in life style helps in recurrent diseases. Dealing with chronic pelvic pain can be challenging. Exercise often helps to relieve or lessen pelvic pain and menstrual cramps. Eating well and getting enough rest also helps the body to manage pain. Practicing relaxation techniques such as yoga and meditation help to ease pain too.
  • Pain Treatment Services
    many centers work closely with other health care providers in programs that provide treatment and support for acute and chronic pain. Following an evaluation, services such as biofeedback, physical therapy, TENS (transcutaneous electrical stimulation) and exercise programs may be offered.
  • Complementary medicine
    Acupuncture, herbal remedies, homeopathy and healing touch are among popular "alternative approaches" to medical treatment. Many of these therapies can be helpful; however, not every alternative approach has been proven to be safe and effective. Research studies are limited. Before experimenting with any alternative therapy, check with your doctor.

What else do you need to know about endometriosis?

  • Young women CAN suffer from symptoms of endometriosis. Medical studies have found this disease in teenagers and young children.
  • Endometriosis is NOT an STD (sexually transmitted disease).
  • Chronic pelvic pain is not normal. Most young women have none or mild to moderate menstrual cramps one or two days a month. If you are absent from school excessively due to pelvic pain or menstrual cramps, consult your health care provider.
  • Endometriosis occurs among women of ALL races. But more common in blacks.
  • Getting pregnant does NOT cure this disease but may improve symptoms for some women. Some women with endometriosis who have had children continue to have pain.

The goal of the treatment should be aimed at relieving pain, controlling the progression of the endometriosis and preserving fertility for future childbearing. Treatment can make a big difference in improving the quality of your life.
Medical science is constantly moving ahead. Ask your health care provider about more information about teens with endometriosis.


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