Deciphering Period Pains

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Kuala Lumpur, Feb 16: Late, painful and irregular periods are some of the signs that indicate something more serious is developing in the body, but it is not always easy to narrow it down to one root cause. While these are major symptoms of gynaecological conditions such as Endometriosis and Polycystic Ovarian Syndrome (PCOS), most people may not be able to differentiate the two as some of the signs overlap and can cause further worry among patients who want to seek out treatment.
In conjunction with Endometriosis Awareness Month held next month, Sunway Medical Centre Velocity (SMCV)’s consultants share their insight on what sets these two conditions apart, along with treatment options and next steps for patients to have a better quality of life.

Dr Farah Leong Rahman. Supplied.


Consultant Obstetrician and Gynaecologist Dr Farah Leong Rahman said that both conditions vary very much from each other, with PCOS related to abnormal hormone levels in the body, including high levels of insulin.
“Some of the common symptoms of PCOS are infrequent or irregular periods, weight gain, oily face, hair at unwanted places or acne caused by increased production of male hormones.”

Dr Ashley Chung Soo Bee. Supplied.


Endometriosis, however, is a condition where the tissue lining the womb starts to grow elsewhere such as on the ovaries, uterus, fallopian tubes, bowels or rarely even lungs.
“Symptoms can vary in women, but they can present with painful periods, pain during or after sex or a constant pain at the lower tummy or back.”

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Endometriosis is rather common, affecting one in 10 women worldwide.
Consultant Obstetrician and Gynaecologist Dr Ashley Chung Soo Bee explains that Endometriosis usually affects women during their reproductive age.
With PCOS, research has shown that genetics play a factor in developing the condition, with 25-30 per cent of women with PCOS having a mother or sister with PCOS as well.
“Family members of a woman with PCOS are at a higher risk of developing the same metabolic abnormalities in the family,” she explains.

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On some occasions, patients can develop both conditions at the same time.
This makes it all the more important for patients to seek out proper medical counsel and help so they can find and receive the right balance in treatment when it comes to both Endometriosis and PCOS.
Women with PCOS or Endometriosis are able to conceive naturally but some may require assistance. “Women with PCOS who have irregular or infrequent periods, there is a lack of ovulation (release of egg from ovary) thus making it difficult in determining their fertile period.”

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“Women with Endometriosis can have distorted anatomy of the pelvis, scarring tissues around the ovaries and fallopian tubes making the environment less conducive for pregnancy,” Dr Farah said.
With Endometriosis cysts being found in or on fallopian tubes, bowels, on, behind or around the womb in the area between the vagina and rectum, the subsequent bleeding that occurs may cause pain, inflammation, scarring and possibility of organ damage.
“Please consult a gynaecologist if you have a painful period, regular pain before, during or after your period, pain or discomfort during sex, pain related to your bowel and bladder movement or difficulty in getting pregnant as you might be having Endometriosis,” Dr Ashley said.
She further explained that PCOS may vary from woman to woman, with some experiencing milder symptoms and others experiencing more severe ones.
“Once you have a PCOS diagnosis, you will be at higher risk of getting long term health problems such as diabetes, high blood pressure, depression and psychological issues and cancer of the womb.
“If you have not had a period for over four months, it is advisable to see a gynaecologist for further assessment.”
Dr Farah shares that there is no permanent cure for both conditions, but there are treatments to help ease the symptoms faced.
“The primary treatment for women with PCOS is lifestyle changes such as maintaining an optimal weight, eating a healthy and well-balanced diet and regular exercise.”
“As for women with Endometriosis, the management and treatment depends on the severity of symptoms and whether it affects the quality of life.
“Another important thing to consider is whether one plans to get pregnant. Surgery is indicated when medical treatment fails or can’t be managed with medications.”
In the case of both conditions, both doctors advise that the ideal course of action is to speak to a trusted consultant that can advise what tests and check-ups can be done to ensure a proper diagnosis is delivered.
From pelvic ultrasound scans to hormonal blood tests to check on the patient’s hormonal status and ovarian reserve, patients can then figure out the appropriate treatments to live well with the conditions.

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