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February 11, 2019

If Your Cramps Feel Like a Nuclear Explosion, It Might Be Endometriosis

It is universally acknowledged that a woman in possession of a uterus is likely to experience some degree of excruciating abdominal pain at regular intervals throughout her life. A cheap price to pay in exchange for the power of sustaining other human life forms? Maybe. Massively inconvenient in both personal and professional settings? Definitely.

Out of fear of showing weakness or being disbelieved, many women opt to just push through the pain when cramps hit. This comes as no surprise, as it is widely reported that men and women experience and report pain differently, and that women have a harder time getting our self-reported pain to be taken seriously [1].

But what happens when you enter an echelon pain so intense that you are forced to give a truly Oscar-worthy performance in front of your colleagues at a board meeting? What happens when you feel like your monthly menstrual cramping has mutated into an entirely different beast? It’s possible that your abdominal demon might just have a name: endometriosis.

What is Endometriosis?

Endometriosis is a common condition that occurs when the tissue that normally lines the inside of a womb also grows outside of it. In most cases, this impacts ovaries, fallopian tubes, and the tissue lining your pelvis. While in some cases the condition can occur without presenting any symptoms, for many women, endometriosis can develop into a chronic disease frequently linked to debilitating pain and issues in the realm of fertility. Endometriosis is currently incurable.

Here’s how it works: when endometrial tissue is displaced to areas outside the womb, it continues to function as if it is still in the womb with each menstrual cycle. But unlike endometrial tissue that thickens, bleeds, then exits your body during your period, this tissue outside the womb has no escape hatch. When this tissue gets marooned outside the womb, the tissue around it can become irritated. The condition has the potential to cause ovarian cysts, as well as develop scar tissue and adhesions [2] [3].

Treatment for endometriosis ranges depending severity. Common treatment options include anti-inflammatory pain medication like ibuprofen, or hormone therapy using progestin and/or estrogen-based contraceptive methods. For many endometriosis patients, low-estrogen or progestin-only oral contraceptives are great options for bleeding control, which helps with overall pain management [4].

How Do I Tell the Difference Between Endometriosis and Just Plain Cramps?

Pain is highly subjective. One woman’s root canal could be another woman’s paper cut. If you live with chronic pelvic pain, it can become especially difficult to define what a “normal” uterine pain baseline feels like. If your abdominal pain subsides shortly after your period starts, and if the pain tends relatively subside after a recommended over-the-counter size dose of anti-inflammatory medication, you might just have severe menstrual cramps. If this describes you, you should still see your doctor anyway. He or she may have some ideas about healthy, sustainable paths to menstrual pain management.

With that said, there are certainly several known symptoms to look out for if you suspect you might be affected by endometriosis. If you have intense pelvic pain that continues well into your period, pain while using the restroom, pain with intercourse, heavy bleeding, or have struggled with fertility [3], you might want to chat with your doctor about what you are experiencing. When you meet with your doctor, she or he may conduct a pelvic exam, ultrasound, MRI, and/or laparoscopy to examine for signs of endometriosis under a microscope.

This goes without saying, but when in doubt, make an appointment to see your medical professional if any of the symptoms listed above start to feel out of hand. Whether it’s full-blown endometriosis or regular menstrual cramps, there are steps you can take to lessen the burden for yourself so you can focus on what’s important to you and stop being bogged down by relentless pain.



  1. Sex-Based Differences in Pain Perception and Treatment https://www.ncbi.nlm.nih.gov/pmc/articles/PMC2745644/
  2. Endometriosis — NCBI https://www.ncbi.nlm.nih.gov/pubmedhealth/PMHT0024650/
  3. Endometriosis — Mayo Clinic https://www.mayoclinic.org/diseases-conditions/endometriosis/symptoms-causes/syc-20354656
  4. All Birth Control Pills Aren’t Created Equal In Managing Endometriosis, Say Experts https://www.endofound.org/all-birth-control-pills-arent-created-equal-in-managing-endometriosis-say-experts