What’s the difference between period pain and endometriosis pain?
10almonds is reader-supported. We may, at no cost to you, receive a portion of sales if you purchase a product through a link in this article.
Menstruation, or a period, is the bleeding that occurs about monthly in healthy people born with a uterus, from puberty to menopause. This happens when the endometrium, the tissue that lines the inside of the uterus, is shed.
Endometriosis is a condition that occurs when endometrium-like tissue is found outside the uterus, usually within the pelvic cavity. It is often considered a major cause of pelvic pain.
Pelvic pain significantly impacts quality of life. But how can you tell the difference between period pain and endometriosis?
Periods and period pain
Periods involve shedding the 4-6 millimetre-thick endometrial lining from the inside of the uterus.
As the lining detaches from the wall of the uterus, the blood vessels which previously supplied the lining bleed. The uterine muscles contract, expelling the blood and crumbled endometrium.
The crumbled endometrium and blood mostly pass through the cervix and vagina. But almost everyone back-bleeds via their fallopian tubes into their pelvic cavity. This is known as “retrograde menstruation”.
The process of menstrual shedding is caused by inflammatory substances, which also cause nausea, vomiting, diarrhoea, headaches, aches, pains, dizziness, feeling faint, as well as stimulating pain receptors.
These inflammatory substances are responsible for the pain and symptoms in the week before a period and the first few days.
For women with heavy periods, their worst days of pain are usually the heaviest days of their period, coinciding with more cramps to expel clots and more retrograde bleeding.
Many women also have pain when they are releasing an egg from their ovary at the time of ovulation. Ovulation or mid-cycle pain can be worse in those who bleed more, as those women are more likely to bleed into the ovulation follicle.
Around 90% of adolescents experience period pain. Among these adolescents, 20% will experience such severe period pain they need time off from school and miss activities. These symptoms are too often normalised, without validation or acknowledgement.
What about endometriosis?
Many symptoms have been attributed to endometriosis, including painful periods, pain with sex, bladder and bowel-related pain, low back pain and thigh pain.
Other pain-related conditions such migraines and chronic fatigue have also been linked to endometriosis. But these other pain-related symptoms occur equally often in people with pelvic pain who don’t have endometriosis.
Repeated, significant period and ovulation pain can eventually lead some people to develop persistent or chronic pelvic pain, which lasts longer than six months. This appears to occur through a process known as central sensitisation, where the brain becomes more sensitive to pain and other sensory stimuli.
Central sensitisation can occur in people with persistent pain, independent of the presence or absence of endometriosis.
Eventually, many people with period and/or persistent pelvic pain will have an operation called a laparoscopy, which allows surgeons to examine organs in the pelvis and abdomen, and diagnose and treat endometriosis.
Yet only 50% of those with identical pain symptoms who undergo a laparoscopy will end up having endometriosis.
Endometriosis is also found in pain-free women. So we cannot predict who does and doesn’t have endometriosis from symptoms alone.
How is this pain managed?
Endometriosis surgery usually involves removing lesions and adhesions. But at least 30% of people return to pre-surgery pain levels within six months or have more pain than before.
After surgery, emergency department presentations for pain are unchanged and 50% have repeat surgery within a few years.
Suppressing periods using hormonal therapies (such as continuous oral contraceptive pills or progesterone-only approaches) can suppress endometriosis and reduce or eliminate pain, independent of the presence or absence of endometriosis.
Not every type or dose of hormonal medications suits everyone, so medications need to be individualised.
The current gold-standard approach to manage persistent pelvic pain involves a multidisciplinary team approach, with the aim of achieving sustained remission and improving quality of life. This may include:
- physiotherapy for pelvic floor and other musculoskeletal problems
- management of bladder and bowel symptoms
- support for self-managing pain
- lifestyle changes including diet and exercise
- psychological or group therapy, as our moods, stress levels and childhood events can affect how we feel and experience pain.
Whether you have period pain, chronic pelvic pain or pain you think is associated with endometriosis, if you feel pain, it’s real. If it’s disrupting your life, you deserve to be taken seriously and treated as the whole person you are.
Sonia R. Grover, Senior Research Fellow, Murdoch Children’s Research Institute; Clinical Professor of Gynaecology, The University of Melbourne
This article is republished from The Conversation under a Creative Commons license. Read the original article.
Don’t Forget…
Did you arrive here from our newsletter? Don’t forget to return to the email to continue learning!
Recommended
Learn to Age Gracefully
Join the 98k+ American women taking control of their health & aging with our 100% free (and fun!) daily emails:
-
Skincare – by Caroline Hirons
10almonds is reader-supported. We may, at no cost to you, receive a portion of sales if you purchase a product through a link in this article.
Our skin is our largest organ, and it affects (and is affected by) most of what it contains. In other words, us.
So how do we look after this organ? Caroline Hirons lays it bare for us, in this very clear (and well-illustrated with many photos) book that gives a ground-upwards explanation of:
- Our skin’s layers and features and what they do
- The many ways our skin can be different from others
- What lifestyle factors to worry about (or not)
- What exactly the many kinds of skincare products do
- How to understand which ones are actually for our skin
- How to craft the ideal skincare routine for any individual
- What should go into a personalized skincare kit
Because, as it turns out, shockingly we can’t trust advertising. Not only is it advertising, but also, they don’t know us. What will be perfect for one person’s skin may ruin another’s, and labels can be very misleading.
A strength of this book is how Hirons demystifies all that, so we can ignore the claims and just know what a product will actually do, from its ingredients.
She also covers the changes that occur in various life processes, including puberty, pregnancy, menopause, and just plain aging. In other words, what to do when what’s been working suddenly doesn’t anymore.
Bottom line: this is a great book for anyone (though: especially those of us with female hormones) who wants to understand the skin you’re in and how to keep it well-nourished and glowingly healthy.
Click here to check out “Skincare” and take good care of yourself!
Share This Post
-
Triple Life Threat – by Donald R. Lyman
10almonds is reader-supported. We may, at no cost to you, receive a portion of sales if you purchase a product through a link in this article.
This book takes a similar approach to “How Not To Die” (which we featured previously), but focussed specifically on three things, per the title: chronic pulmonary obstructive disease (CPOD), diabetes (type 2), and Alzheimer’s disease.
Lyman strikes a great balance of being both information-dense and accessible; there’s a lot of reference material in here, and the reader is not assumed to have a lot of medical knowledge—but we’re not patronized either, and this is an informative manual, not a sensationalized scaremongering piece.
All in all… if you have known risk factors for one or more of three diseases this book covers, the information within could well be a lifesaver.
Share This Post
-
Water’s Counterintuitive Properties
10almonds is reader-supported. We may, at no cost to you, receive a portion of sales if you purchase a product through a link in this article.
It’s Q&A Day at 10almonds!
Have a question or a request? We love to hear from you!
In cases where we’ve already covered something, we might link to what we wrote before, but will always be happy to revisit any of our topics again in the future too—there’s always more to say!
As ever: if the question/request can be answered briefly, we’ll do it here in our Q&A Thursday edition. If not, we’ll make a main feature of it shortly afterwards!
So, no question/request too big or small
❝Why are we told to drink more water for everything, even if sometimes it seems like the last thing we need? Bloated? Drink water. Diarrhea? Drink water. Nose running like a tap? Drink water❞
While water will not fix every ill, it can fix a lot, or at least stop it from being worse!
Our bodies are famously over 60% water (exact figure will depend on how well-hydrated you are, obviously, as well as your body composition in terms of muscle and fat). Our cells (which are mostly full of mostly water) need replacing all the time, and almost everything that needs transporting almost anywhere is taken there by blood (which is also mostly water). And if we need something moving out of the body? Water is usually going to be a large part of how it gets ejected.
In the cases of the examples you gave…
- Bloating: bloating is often a matter of water retention, which often happens as a result of having too much salt, and/or sometimes too much fat. So the body’s homeostatic system (the system that tries to maintain all kinds of equilibrium, keeping salt balance, temperature, pH, and many other things in their respective “Goldilocks zones”) tries to add more water to where it’s needed to balance out the salt etc.
- Consequently, drinking more water means the body will note “ok, balance restored, no need to keep retaining water there, excess salts being safely removed using all this lovely water”.
- Diarrhea: this is usually a case of a bacterial infection, though there can be other causes. Whether for that reason or another, the body has decided that it needs to give your gut an absolute wash-out, and it can only do that from the inside—so it uses as much of the body’s water as it needs to do that.
- Consequently, drinking more water means that you are replenishing the water that the body has already 100% committed to using. If you don’t drink water, you’ll still have diarrhea, you’ll just start to get dangerously dehydrated.
- Runny nose: this is usually a case of either fighting a genuine infection, or else fighting something mistaken for a pathogen (e.g. pollen, or some other allergen). The mucus is an important part of the body’s defense: it traps the microbes (be they bacteria, virus, whatever) and water-slides them out of the body.
- Consequently, drinking more water means the body can keep the water-slide going. Otherwise, you’ll just get gradually more dehydrated (because as with diarrhea, your body will prioritize this function over maintaining water reserves—water reserves are there to be used if necessary, is the body’s philosophy) and if the well runs dry, you’ll just be dehydrated and have a higher pathogen-count still in your body.
Some previous 10almonds articles that might interest you:
- Hydration Mythbusting
- When To Take Electrolytes (And When We Shouldn’t!)
- Keeping Your Kidneys Healthy (Especially After 60)
Would you like this section to be bigger? If so, send us more questions!
Share This Post
- Bloating: bloating is often a matter of water retention, which often happens as a result of having too much salt, and/or sometimes too much fat. So the body’s homeostatic system (the system that tries to maintain all kinds of equilibrium, keeping salt balance, temperature, pH, and many other things in their respective “Goldilocks zones”) tries to add more water to where it’s needed to balance out the salt etc.
Related Posts
-
Hot And Sour Shiitake Soup
10almonds is reader-supported. We may, at no cost to you, receive a portion of sales if you purchase a product through a link in this article.
This is a popular, easy, and delicious soup that nonetheless is not found in many western kitchens, despite being enjoyed in restaurants/take-out. Best of all, making it at home means that you know all the ingredients, can account for quality, and also can customize it per your preferences (i.e. how much heat/sourness you like).
You will need
- 3 cups shiitake mushrooms, sliced
- 3 cups bok choy, chopped
- 2 cups cherry tomatoes, quartered
- 1 cup carrot, grated
- 3 spring onions, chopped
- 2 shallots, sliced lengthways
- 2 serrano chilis (or similar), sliced thinly
- 2 tbsp apple cider vinegar
- 1 tbsp lemon juice
- 1 tbsp fresh ginger, sliced into 1″ strips
- 1 tsp black pepper, coarse ground
- ½ bulb garlic, crushed
- 6 cups low-sodium vegetable stock. Ideally you will have made it yourself from vegetable cuttings that you saved in the freezer until you had enough to make stock from, but if that’s not an option, then low-sodium vegetable stock cubes can be purchased and used.
- Garnish: ¼ cup (or 4 tbsp) cilantro, chopped, or if you have the soap gene, then this time we recommend chopped basil as the subsitution
Method
(we suggest you read everything at least once before doing anything)
1) Put the ginger in a big pot with the stock; cover and simmer for about 20 minutes (otherwise the ginger flavor will remain mostly concentrated in the ginger strips).
2) Bring it to a boil and add the bok choy, mushrooms, shallots, chili peppers, and the carrot; simmer for another 5 minutes
3) Add the remaining ingredients except for the garnish, and simmer for another 5 minutes
4) Serve, adding the garnish
Enjoy!
Want to learn more?
For those interested in some of the science of what we have going on today:
- The (Longevity) Magic of Mushrooms
- Our Top 5 Spices: How Much Is Enough For Benefits?
- An Apple (Cider Vinegar) A Day…
- Enjoy Bitter/Hot/Sour/Pungent Foods For Your Heart & Brain
- Brain Food? The Eyes Have It!
- Some Surprising Truths About Hunger And Satiety
Take care!
Don’t Forget…
Did you arrive here from our newsletter? Don’t forget to return to the email to continue learning!
Learn to Age Gracefully
Join the 98k+ American women taking control of their health & aging with our 100% free (and fun!) daily emails:
-
Why are people on TikTok talking about going for a ‘fart walk’? A gastroenterologist weighs in
10almonds is reader-supported. We may, at no cost to you, receive a portion of sales if you purchase a product through a link in this article.
“Fart walks” have become a cultural phenomenon, after a woman named Mairlyn Smith posted online a now-viral video about how she and her husband go on walks about 60 minutes after dinner and release their gas.
Smith, known on TikTok as @mairlynthequeenoffibre and @mairlynsmith on Instagram, has since appeared on myriad TV and press interviews extolling the benefits of a fart walk. Countless TikTok and Instagram users and have now shared their own experiences of feeling better after taking up the #fartwalk habit.
So what’s the evidence behind the fart walk? And what’s the best way to do it?
CandyBox Images/Shutterstock Exercise can help get the gas out
We know exercise can help relieve bloating by getting gas moving and out of our bodies.
Researchers from Barcelona, Spain in 2006 asked eight patients complaining of bloating, seven of whom had irritable bowel syndrome, to avoid “gassy” foods such as beans for two days and to fast for eight hours before their study.
Each patient was asked to sit in an armchair, in order to avoid any effects of body position on the movement of gas. Gas was pumped directly into their small bowel via a thin plastic tube that went down their mouth, and the gas expelled from the body was collected into a bag via a tube placed in the rectum. This way, the researchers could determine how much gas was retained in the gut.
The patients were then asked to pedal on a modified exercise bike while remaining seated in their armchairs.
The researchers found that much less gas was retained in the patients’ gut when they exercised. They determined exercise probably helped the movement and release of intestinal gas.
Walking may have another bonus; it may trigger a nerve reflex that helps propel foods and gas contents through the gut.
Walking can also increase internal abdominal pressure as you use your abdominal muscles to stay upright and balance as you walk. This pressure on the colon helps to push intestinal gas out.
Proper fart walk technique
One study from Iran studied the effects of walking in 94 individuals with bloating.
They asked participants to carry out ten to 15 minutes of slow walking (about 1,000 steps) after eating lunch and dinner. They filled out gut symptom questionnaires before starting the program and again at the end of the four week program.
The researchers found walking after meals resulted in improvements to gut symptoms such as belching, farting, bloating and abdominal discomfort.
Now for the crucial part: in the Iranian study, there was a particular way in which participants were advised to walk. They were asked to clasp hands together behind their back and to flex their neck forward.
The clasped hands posture leads to more internal abdominal pressure and therefore more gentle squeezing out of gas from the colon. The flexed neck posture decreases the swallowing of air during walking.
This therefore is the proper fart walk technique, based on science.
Could walking with your hands behind your back yield better or more farts? candy candy/Shutterstock What about constipation?
A fart walk can help with constipation.
One study involved middle aged inactive patients with chronic constipation, who did a 12 week program of brisk walking at least 30 minutes a day – combined with 11 minutes of strength and flexibility exercises.
This program, the researchers found, improved constipation symptoms through reduced straining, less hard stools and more complete evacuation.
It also appears that the more you walk the better the benefits for gut symptoms.
In patients with irritable bowel syndrome, one study increasing the daily step count to 9,500 steps from 4,000 steps led to a 50% reduction in the severity of their symptoms.
And just 30 minutes of a fart walk has been shown to improve blood sugar levels after eating.
Walking after eating can help keep your blood sugar levels under control. IndianFaces/Shutterstock What if I can’t get outside the house?
If getting outside the house after dinner is impossible, could you try walking slowly on a treadmill or around the house for 1,000 steps?
If not, perhaps you could borrow an idea from the Barcelona research: sit back in an armchair and pedal using a modified exercise bike. Any type of exercise is better than none.
Whatever you do, don’t be a couch potato! Research has found more leisure screen time is linked to a greater risk of developing gut diseases.
We also know physical inactivity during leisure time and eating irregular meals are linked to a higher risk of abdominal pain, bloating and altered bowel motions.
Try the fart walk today
It may not be for everyone but this simple physical activity does have good evidence behind it. A fart walk can improve common symptoms such as bloating, abdominal discomfort and constipation.
It can even help lower blood sugar levels after eating.
Will you be trying a fart walk today?
Vincent Ho, Associate Professor and clinical academic gastroenterologist, Western Sydney University
This article is republished from The Conversation under a Creative Commons license. Read the original article.
Don’t Forget…
Did you arrive here from our newsletter? Don’t forget to return to the email to continue learning!
Learn to Age Gracefully
Join the 98k+ American women taking control of their health & aging with our 100% free (and fun!) daily emails:
-
What’s Your Vascular Dementia Risk?
10almonds is reader-supported. We may, at no cost to you, receive a portion of sales if you purchase a product through a link in this article.
We often say that “what’s good for your heart is good for your brain”, and this is because the former feeds the latter, with oxygen and nutrients, and also clears away detritus like beta-amyloid (associated with Alzheimer’s) and alpha-synuclein (associated with Parkinson’s).
For more on those, see: How To Clean Your Brain (Glymphatic Health Primer)
For this reason, there are many risk factors that apply equally cardiovascular disease (CVD), and neurodegenerative diseases like Alzheimer’s and other vascular dementias, as well as stroke risk.
The link between the two has also been studied; recently a team of scienists led by Dr. Anisa Dhana asked the question:
❝What is the association between cardiovascular health (CVH) and biomarkers of neurodegeneration, including neurofilament light chain and total tau?❞
To answer this, they looked at data from more than 10,000 Americans aged 65+; of these, they were able to get serum samples from 5,470 of them, and tested those samples for the biomarkers of neurodegeneration mentioned above.
They then tabulated the results with cardiovascular health scores based on the American Heart Association (AHA)’s “Life’s Simple 7” tool, and found, amongst other things:
- 34.6% of participants carried the APOE e4 allele, a genetic risk factor for Alzheimer’s.
- Higher CVH scores were associated with lower NfL levels, but not with t-tau concentrations.
- APOE e4 carriers with high CVH had significantly lower NfL levels.
- Race did not influence the CVH-NfL relationship.
- Higher CVH was linked to a slower annual increase in NfL levels but did not affect t-tau changes.
- Over 10 years, participants with the lowest CVH scores saw a 7.1% annual increase in NfL levels, while those with the highest CVH scores had a 5.2% annual increase.
- Better CVH is linked to lower serum NfL levels, regardless of age, sex, or race.
- CVH is particularly crucial for APOE e4 carriers
In other words: higher cardiovascular health meant lower markers of neurodegeneration, and this not only still held true for APOE e4 carriers, but also, the benefits actually even more pronounced in those participants.
You may be wondering: “but it said it helped with NfL levels, not t-tau concentrations?” And, indeed, it is so. But this means that the overall neurodegeneration risk is still inversely proportional to cardiovascular health; it just means it’s not a magical panacea and we must still do other things too.
See also: How To Reduce Your Alzheimer’s Risk
And as for the study, you can read the paper itself in full here:
Cardiovascular Health and Biomarkers of Neurodegenerative Disease in Older Adults
Life’s Simple 7
We mentioned that they used the AHA’s “Life’s Simple 7” tool to assess cardiovascular health; it is indeed simple, but important. Here it is:
Metric Poor Intermediate Ideal Current smoking Yes Former ≤12 mo Never or quit >12 mo BMI, kg/m2 ≥30 25–29.9 <25 Physical activity None 1–149 min/wk of moderate activity or 1–74 min/wk of vigorous activity or 1–149 min/wk of moderate and vigorous activity ≥150 min/wk of moderate activity or ≥75 min/wk of vigorous activity or ≥150 min/wk of moderate and vigorous activity Diet pattern score* 0–1 2–3 4–5 Total cholesterol, mg/dL ≥240 200–239 or treated to goal <200 Blood pressure, mm Hg SBP ≥140 or DBP ≥90 SBP 120–139 or DBP 80–89 or treated to goal <120/<80 Fasting plasma glucose, mg/dL ≥126 100–125 or treated to goal <100 *Each of the following 5 diet elements is given a score of 1: (1) ≥4.5 cups/day of fruits and vegetables; (2) ≥2 servings/week of fish; (3) ≥3 servings/day of whole grains; (4) no more than 36 oz/wk of sugar‐sweetened beverages; and (5) no more than 1500 mg/d of sodium.
As the AHA notes,
❝Unfortunately, 99% of the U.S. adult population has at least one of seven cardiovascular health risks: tobacco use,
poor diet, physical inactivity, unhealthy weight, high blood pressure, high cholesterol or high blood glucose.❞It then goes on to talk about the financial burden of this on employers, but this was taken from a workplace health resource, and we recognize the rest of it won’t be of pressing concern for most of our readers. In case you are interested though, here it is:
American Heart Association | Life’s Simple 7® Journey to Health™
For a more practical (if you’re just a private individual and employee healthcare is not your main concern) overview, see:
Want to know more?
Here are some very good starting points for improving each of those 7 metrics, as necessary:
- Which Addiction-Quitting Methods Work Best?
- How To Lose Weight (Healthily!)
- The Doctor Who Wants Us To Exercise Less, & Move More
- Which Diet? Top Diets Ranked By Experts
- Lower Cholesterol Naturally, Without Statins
- 10 Ways To Lower Blood Pressure Naturally
- 10 Ways To Balance Your Blood Sugars
Take care!
Don’t Forget…
Did you arrive here from our newsletter? Don’t forget to return to the email to continue learning!
Learn to Age Gracefully
Join the 98k+ American women taking control of their health & aging with our 100% free (and fun!) daily emails:
