Patient's question:
Lately, when I have my period, my stomach has been very painful. Before, I didn't have menstrual cramps at all. My periods are also irregular, and I got married. I want to have children, but I keep having trouble getting pregnant. During early sexual activity, it wasn't very comfortable either. Is this endometriosis infertility?Doctor's answer:
Endometriosis is a typical symptom of lower abdominal pain, menstrual disorders, dysmenorrhea, sexual discomfort, infertility, and others.1. Bladder symptoms: Common in cases where endometriosis has spread to the bladder, characterized by cyclical urinary frequency and dysuria. When the bladder mucosa is affected, periodic hematuria may occur.
2. Menorrhagia: In intrinsic endometriosis, menstrual volume often increases, and the menstrual period extends. This may be due to increased endometrial tissue, but it is often accompanied by ovarian dysfunction.
3. Sexual pain: Endometriosis in the uterosacral fossa or vaginal rectal septum causes surrounding tissue swelling, affecting sexual activity. Sensitivity discomfort before menstruation may worsen.
4. Infertility: Primary infertility due to endometriosis accounts for 41.5–43.3%, while secondary infertility accounts for 46.6–47.3%.
5. Rectal fullness: Typical symptoms of endometriosis in the uterosacral fossa and around the rectum include: during the premenstrual period or after menstruation, patients experience severe pain when passing feces through the rectum, but no such sensation at other times. Additionally, if the ectopic endometrium deeply invades the rectal mucosa, rectal bleeding may occur during menstruation. When endometriosis encircles the rectum in a narrow ring, symptoms such as tenesmus and obstruction may arise, resembling cancer.
6. Dysmenorrhea: A common and prominent symptom, often secondary, meaning that patients previously had no menstrual pain but began experiencing it after a certain period. It can occur before, during, or after menstruation. Some cases involve severe, unbearable pain, requiring bed rest or medication for relief. The pain typically intensifies with the menstrual cycle. Due to continuously rising estrogen levels, the ectopic endometrium proliferates and swells. If further influenced by progesterone, it may bleed, stimulating local tissues and causing pain.