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Painful periods are among the most common endometriosis symptoms. The causes of painful menstruation can differ, from high estrogen, other hormonal imbalances, inflammation, severe endometriosis lesions (including nodules) or some other serious issues.

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As an endometriosis patient (two surgeries, the last one in 2016 involving a bowel resection, so it was a stage IV endometriosis), but also as an editor who wrote a lot about this disease, I would like to give you my insight about this topic: painful periods in endometriosis.

1.    Painful periods can have different causes – look for the best endometriosis specialist in your area

As I have stated above, there could be different causes of painful periods. Especially in endometriosis, it is better to investigate more this symptom as it can hide other complications.

My doctor, Dr. Voicu Simedrea, often says the level of pain is not always correlated with the endometriosis stage.

Therefore, a patient who has a pain of 9 or 10 does not always have stage 3 or 4 endometriosis.

Yet, “not always” does not mean “all the time”, you’d better find the best endometriosis surgeon in your area and see what is really going on.

2.    Choose between birth control pills and natural treatment

Most doctors will recommend birth control pills in endometriosis or even in not endo related painful periods. This is the conventional treatment; this is what allopathic path gives us at this point.

I don’t want to debate about “birth control pills” efficiency. If you are “into these things” and you can tolerate them, great, listen to your doctor and see where it goes. It will surely alleviate your pain to a certain extend.

Unfortunately, me and a lot of other patients cannot tolerate birth control pills and I am very frustrated that the medical world continues to ignore us.

Yet, if you do take birth control pills or you are going to take them, allow me an advice.

Make sure that after you give them up, you still do something for your endometriosis. Diet, supplements, acupuncture, surgery etc., I don’t know, but do something, do not stay like this, because there are great chances your endometriosis to "bloom" afterwards. It happened to me and it happened to a lot of other patients (yes, I took birth control pills 2 years in high school and college and 10 years later on and off for a year when I had almost constant bleeding from them – but I will tell you more about this in another article).

If you are not into “birth control pills treatment”, look for complementary treatment, you will see below my recommendations.

In case you take birth control pills but still want to choose something natural too, always consult your family physician or a naturopath regarding their interactions. For example, high doses of vitamin C interact with birth control pills, and the same happens with St. John’s Wort tea. I will detail this subject in some other article.

3.    Choose the painkillers that “fit” your body

Let’s be honest. No matter how we would try to use only natural methods for diminishing period pains, we cannot always stay on the right track or rely only on that.

We sometimes need painkillers. They can be our salvation till we have the money to do surgery (if absolutely necessary) or till the natural treatment we take will show its effects.

Therefore, try to stick to those painkillers that “fit” your body.

For example, my pain does not diminish after Ibuprofen no matter the dose. Instead, all my period pains go away and I totally forget about my menstruation if I take a Ketonal (ketoprofen).

Look for these substances as they could interact with your some other conditions. Each has its own particularities and you have to know them. For example, I cannot take Ibuprofen firstly because my pain does not go away it and because it interacts with my asthma symptoms. Then, it is said that ketoprofen might be too strong for the stomach, but I always take it after a meal and it never gave me problems.
Hence, do your homework  about this.

4.    Change your diet

I know, it seems so a “trendy" advice, but believe me, especially in endometriosis it makes a difference.

Pain signals an inflammation. Inflammation is triggered by our diet, our stress level our physical condition etc.

I try to cut off completely gluten, dairy, sugar, alcohol, soy and meat and eggs that are not from a clean source.

I am that “weird girl” from the market that asks every woman with eggs if she gives soy to her hens. It is not easy to find “a clean sources”, but it is neither impossible.

I am going to tell you a short story about diet and my painful periods and maybe it will convince you to change something about your diet.

After my second surgery (hopefully the last one) in 2016, as it was a very hard one, 4 hours of surgery, stage 4 etc, I had horrible pains at periods.

For those of you who wonder, it is possible that after excision surgery periods to be even more painful than before. Well, this was my case. My pains only got away after a suppository with diclofenac or indomethacin, but it returned quickly.

After several months I decided to give up dairy completely (at that point I only ate goat cheese/yoghurt).

Well, in just 1 month I could return to 1 Ketonal every 12 hours which, for me, was amazing.

5.    Use essential oils, but don’t rely on them

I won’t lie to you. I  use some essential oils (not many), but only to prevent adhesions. Essential oils, no matter the brand, did not diminish my painful periods. Yet, let’s do not forget I was a stage 4 so maybe you could use them efficiently.

If you do that, please, be very careful! Essential oils could be very estrogenic.

Try to choose the safe way. There are some essential oils included in some studies or about whom we really know they are good in endometriosis. Use them! Among them I would mention here copaiba oil and frankincense oil.

On the other hand, there are studies that have shown lavender oil and tea tree oil are estrogenic. I avoid them by all costs.

6.    Try to balance your hormones

It is a well known fact that painful and heavy periods could be a sign of high estrogen. So,  consult a doctor who knows about it. I recommend Dr. Cristina Toader Ion.

P.S: Changing your diet will also help you with that too.

Here I would also add some supplements for endometriosis. You can read my list here, but afterwards please consult Dr. Toader Ion, or your family physician.

7.    Pay attention to some supplements that are recommended for painful periods

Curcuma (turmeric), cinnamon or some other natural plants or powders like these can disrupt your hormones. I know, some of them are included even in studies, but in our case, things might be different “on practice” than “in theory”.

Even if curcuma is great for some endometriosis patients, for me it makes the things worse. Just listen to your body and see where this goes.

Yet, if you have time or are passionate about researching, google the names of all herbs you would want to take to see if they are estrogenic.

8.    If nothing of these help or do not help too much, go again to the doctor to investigate your condition better

You might have painful periods because of deep infiltrating endometriosis, (peri)menopause, uterine polyp or you could have those pains due to some other related problems (such as an UTI).

Whatever the case, look for the best doctor in your area and know your  real situation.

This is what I would suggest in terms of painful periods in endometriosis. Be patient, diligent, try all the means possible and do not think to surgery right away. Unless  absolutely necessary, surgery can lower our chances of getting pregnant, surgery can higher the risk of adhesions, surgery can be risky,  can have side effects. Of course, when it is absolutely necessary, a well done excision surgery can change your life.

But only under these conditions: when it is absolutely necessary and when it is very well done.

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