Why Your Period Pain Might Not Be ‘Normal’: The Silent Signs of Endometriosis

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"Let's start with something I tell almost every young patient who walks into my clinic: period pain is common, but that doesn't mean it's always normal," said Dr Velaga Sirisha, Consultant- Laparoscopic Surgeon, Urogynaecologist and Reconstructive Pelvic Surgeon, Obstetrics & Gynaecology, Arete Hospitals, Hyderabad.

Some discomfort during periods is expected. But if your pain is intense enough to make you cancel plans, miss college or work, or curl up with a hot water bag every month, your body might be trying to tell you something more.

Photo Credit: Magnific

Is It Endometriosis?

One of the most commonly missed causes? Endometriosis.

"In simple terms, endometriosis happens when tissue similar to the lining of the uterus starts growing outside it-on the ovaries, fallopian tubes, or even the pelvic lining. This tissue still behaves as it would during a menstrual cycle, which means inflammation, irritation, and pain," explained Dr Sirisha.

The tricky part? It doesn't always look dramatic. In fact, many women live with it for years, thinking their symptoms are just "bad periods."

Silent signs you shouldn't ignore

Here are some patterns I often see that deserve attention:

Photo Credit: Magnific

1. Pain that feels out of proportion: If your cramps are severe, worsening over time, or not relieved by usual painkillers, that's a red flag.
2. Pain outside your period: Pelvic pain that shows up before your period starts-or lingers after it ends-is not typical.
3. Pain during or after sex: This is a big one that many hesitate to talk about, but it's a common clue.
4. Dyschezia: Painful, difficult, or strained bowel movements.
5. Difficulty getting pregnant: In some cases, endometriosis only comes to light during fertility evaluations.
6. Recurrent UTIs: Can lead to recurrent Urinary Tract Infections (UTI) with urinary urgency & pelvic pain

Why Does It Get Missed?

"A lot of it comes down to normalisation. Many women grow up hearing that painful periods are just part of life. Add to that the tendency to self-manage with painkillers or home remedies, and the diagnosis gets delayed," said Dr Sirisha.

"Also, symptoms can overlap with things like IBS or general hormonal issues, which adds to the confusion. The average time period between symptoms and diagnosis is 5-7years. It's a very benign and locally progressing condition," she added.

What you can do

If any of this sounds familiar, the next step isn't to panic; it's to pay attention. Track your symptoms. Notice patterns. And most importantly, don't hesitate to speak to a gynaecologist.

Bottomline

Dr Sirisha concluded, "Early diagnosis doesn't only help manage pain better-it can also protect long-term reproductive health. You don't have to 'push through' period pain every month. Your body is allowed to ask for help; and it's worth listening."

Disclaimer: The information provided in this article is for general informational and educational purposes only and is not intended as a substitute for professional medical advice, diagnosis, or treatment. Always seek the advice of your physician or a qualified healthcare provider with any questions you may have regarding a medical condition.