Why Period Pain Isn't ‘Normal'? - Decoding the Endometriosis and Infertility Connection

Mint

29-05-2025

Meet Priya, a 34-year-old software professional who endured excruciating period pain for years, brushing it off as something normal just another part of being a woman. Like many, she was told to 'tough it out.' It wasn't until the pain began disrupting her daily life that she sought medical help and was diagnosed with endometriosis, a condition that often goes undetected and can quietly impact fertility if not managed in time.
Endometriosis is a medical condition where tissue similar to the lining inside the uterus starts growing outside it usually on the ovaries, fallopian tubes, or other parts of the pelvis. This tissue behaves like the uterine lining: it thickens, breaks down, and bleeds each month. But unlike a normal period, this blood has nowhere to go.
Over time, this can cause pain, swelling, scar tissue, and in some cases, fertility issues. The most common sign is severe period pain, but it can also lead to discomfort during sex, heavy bleeding, and fatigue. As per World Health Organization (WHO) states that endometriosis may affect 10% of women of reproductive age globally, many of whom may be undiagnosed for years. While not every woman with endometriosis has fertility issues, studies indicate that endometriosis is associated with infertility in 30–50% of cases (American Society for Reproductive Medicine). In some cases, even when a woman with endometriosis is fertile, the pain and hormonal imbalances can interfere with her ability to conceive naturally.
Data Point Statistic Source Global prevalence among women of reproductive age ~10% (approx. 190 million globally) World Health Organization (WHO), 2023 Average delay in diagnosis 7 to 10 years Human Reproduction Update, Volume 27, Issue 5, 2021 Percentage of women with endometriosis who face infertility 30% to 50% American Society for Reproductive Medicine (ASRM) Percentage of infertile women found to have endometriosis 25% to 50% Journal of Endometriosis and Pelvic Pain Disorders, ScienceDirect Women reporting moderate to severe menstrual pain Around 60% of endometriosis patients Journal of Endometriosis, Vol. 2, Issue 2 Average time to treatment after first symptoms Often more than 6 years BMJ Open, 2019
Endometriosis is one of the most underdiagnosed reproductive health disorders, often taking years to be identified. On average, there is a delay of 7 to 10 years between the onset of symptoms and a proper diagnosis (Source: Human Reproduction Update). This delay happens for several key reasons: Symptom Overlap : The pelvic pain, heavy bleeding, and digestive discomfort caused by endometriosis often mimic other conditions like irritable bowel syndrome (IBS) or regular menstrual cramps, making it difficult to pinpoint.
: The pelvic pain, heavy bleeding, and digestive discomfort caused by endometriosis often mimic other conditions like irritable bowel syndrome (IBS) or regular menstrual cramps, making it difficult to pinpoint. Normalisation of Pain : Many women are led to believe that intense period pain is just part of life. As a result, they delay seeking help until symptoms worsen. Nearly 60% of women with endometriosis experience moderate to severe menstrual pain ( Journal of Endometriosis ).
: Many women are led to believe that intense period pain is just part of life. As a result, they delay seeking help until symptoms worsen. Nearly ( ). Invasive Diagnosis: A confirmed diagnosis usually requires laparoscopic surgery, a procedure that many delay unless symptoms become severe, contributing further to late detection.
Dr. Rashmika Gandhi, Senior Reproductive Health Specialist at Birla Fertility & IVF, explains:
'Because the symptoms of endometriosis are so varied - and often dismissed as 'normal period pain' - many women suffer silently for years. Early and accurate diagnosis is critical, not just for managing pain, but also for addressing potential fertility issues.' Symptoms of Endometriosis
While there is currently no definitive cure for endometriosis, several treatment options can manage its symptoms and potentially reverse its progression: Hormonal Therapies: These therapies aim to shrink endometrial lesions and reduce inflammation. Medications such as birth control pills, GnRH agonists, and progestins can help reduce or eliminate pain by regulating the menstrual cycle.
These therapies aim to shrink endometrial lesions and reduce inflammation. Medications such as birth control pills, GnRH agonists, and progestins can help reduce or eliminate pain by regulating the menstrual cycle. Surgical Intervention: Laparoscopic surgery can remove endometrial implants and adhesions, often leading to significant pain relief and improved fertility outcomes.
Laparoscopic surgery can remove endometrial implants and adhesions, often leading to significant pain relief and improved fertility outcomes. Pain Management: Non-steroidal anti-inflammatory drugs (NSAIDs) are commonly prescribed to manage the pain associated with endometriosis.
Non-steroidal anti-inflammatory drugs (NSAIDs) are commonly prescribed to manage the pain associated with endometriosis. Lifestyle Modifications: Incorporating a balanced diet rich in antioxidants, regular exercise, and stress-reduction techniques like yoga or meditation can help alleviate symptoms.
Incorporating a balanced diet rich in antioxidants, regular exercise, and stress-reduction techniques like yoga or meditation can help alleviate symptoms. Emerging Treatments: Research into novel therapies, such as immunomodulators and targeted anti-inflammatory drugs, offers hope for more effective long-term management.
Dr. Rashmika Gandhiadds, 'While science is yet to find a cure for endometriosis, a combination of surgical and non-surgical treatments tailored to each woman's needs can significantly reduce symptoms and improve quality of life.'
Endometriosis is more than just painful periods; it's a chronic condition that can affect quality of life and fertility if left unmanaged. Recognising symptoms early, understanding potential risks, and seeking timely medical care can make a significant difference.
Open conversations and better awareness help individuals make informed choices about their health. No one should have to live with ongoing pain or unanswered questions about their body.
If you've been experiencing severe menstrual cramps, pelvic pain, or difficulties conceiving, consult a gynaecologist. With the right care and support, managing endometriosis is possible — and so is living well.
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