Severe menstrual pain is still often treated as something expected in women’s lives. This naturalization contributes to the fact that endometriosis, a chronic inflammatory disease that can affect different organs of the pelvis, takes years to be diagnosed.
Many patients go through offices, emergency rooms and emergencies before receiving adequate guidance. The idea that it is just common colic delays the investigation and prolongs the suffering. Disabling pain is and should be evaluated.
Far beyond common colic
Habitual menstrual cramps are usually predictable, respond to simple painkillers and do not impede daily activities. In endometriosis, the picture tends to be different. The pain can become progressive over the months or years, cause absences from work or school, appear during sexual intercourse and appear during bowel movements or urination, especially during the menstrual period. Abdominal distension, cyclical intestinal or urinary changes and, in some cases, abnormal bleeding may also occur.
When these symptoms recur or intensify, it is recommended to seek specialized investigation. It impacts quality of life, promotes anxiety and can affect fertility.
Silent impacts on quality of life
The disease goes beyond pelvic pain. It can compromise emotional relationships, professional performance, sleep, mood and sex life. In deep forms, it affects the intestine, bladder and nervous structures, which generates complex symptoms that are often confused with other clinical problems.
In some patients, infertility is the first manifestation noticed. Even when there is no immediate desire to become pregnant, preserving reproductive health is part of adequate care. The limitation imposed by recurrent pain also leads to social isolation and a reduction in physical and professional activities.
Diagnosis based on listening and precision
Diagnosis begins with qualified listening and detailed clinical assessment. A targeted physical examination and well-conducted history guide the ordering of appropriate imaging studies. Ultrasonography with specific mapping and magnetic resonance imaging protocols allow identifying the extent of the disease and planning treatment.
In recent years, Brazil has advanced in standardizing protocols and integrating clinical, imaging and surgical teams, which has increased diagnostic accuracy and reduced conduct based solely on suspicion.
Individualized treatment and multidisciplinary approach
Treatment varies depending on the severity of symptoms, the extent of the disease and the patient’s reproductive plans. In many cases, a clinical approach with pain control, pelvic physiotherapy and lifestyle adjustments is sufficient to stabilize the condition.
When there is profound disease, obstructions or clinical treatment failure, minimally invasive surgery may be indicated, as long as it is carried out by an experienced team and is part of a line of care that includes preparation and follow-up. The current trend favors shared decisions, clear goals and multidisciplinary action.
Early recognition changes the course of the disease
Endometriosis requires early recognition, continuous monitoring and evaluation of results. Technological advances expand, but the most important change is cultural. Taking pain seriously, combating misinformation and ensuring access to trained teams are central measures to reduce the time until diagnosis and improve patients’ quality of life.
*Text written by gynecologist and obstetrician Maurício Simões Abrão (CRM 52842 | RQE 61894), national head of Brazil Health
