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Severe Period Pain Can Mask Conditions Such As Adenomyosis, Endometriosis, Or Fibroids

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Specialists Help Educate Women On Abnormal Period Symptoms


When young women first get their period, it can be hard to know what to expect. Books, websites, or conversations with friends and family can give some insight into what is about to happen, but second-hand experiences are different from feeling it for yourself. A bit of discomfort and period pain is expected and considered normal, but what amount of pain is considered abnormal or unhealthy? Speaking up when something doesn’t feel right is the first step to a diagnosis and treatment. Severe period pain is not normal. And, although up to 90 percent of women experience cramping to some degree prior to or during their period, it should not be so severe as to keep a woman from living life, attending school, work, or normal activity. If normal pain relievers do not help and extreme pain comes with every cycle — a diagnosis is necessary.

In hindsight, many women who suffer from GYN conditions such as endometriosis, fibroids, or adenomyosis commonly say that they had been suffering with severe pelvic pain, difficulty going to the bathroom, lower back pain, and other symptoms since their early teens when their periods first started. Not realizing what symptoms may be abnormal, women can suffer for years before talking to a doctor. And even when they do, unfortunately, it is common for doctors and even OBGYNs to tell their patients the pain is normal, just in their head, or that they are seeking attention. For many of these women, once finally examined by a specialist, such as the experts at The Center for Innovative GYN Care (CIGC®), the extent of damage done to the pelvis, including the bowel and bladder, can be severe.

If too much time has passed without a proper diagnosis, the resulting inflammation may lead to scarring in the pelvic cavity, which can in turn lead to infertility, chronic pain, or difficulty going to the bathroom. Specialists see a higher volume of patients with these complex conditions and are better able to diagnose and treat them. While mild pelvic pain is common with menstruation, severe pelvic pain can also be caused by one or more of the following complex GYN conditions:

  • Pelvic adhesions: Usually caused by multiple pelvic/abdominal surgeries, infection, or endometriosis. Laparoscopic resection of adhesions is the preferred method due to less pain, faster recovery, and less risk of new adhesions compared to open surgery.
  • Adenomyosis: Symptoms include debilitating pain and severe menstrual bleeding for some women. While not cancerous or pre-cancerous, the only surgery that can cure adenomyosis is a hysterectomy.
  • Endometriosis: Can cause severe pain with every monthly cycle. Endometriosis occurs when the endometrium (uterus lining) grows beyond the uterus. There is no cure for endometriosis, but laparoscopic resection of endometriosis can potentially control the pain for some time. For women who have completed childbearing or in cases of severe endometriosis, a hysterectomy is an effective option.
  • Pelvic/Ovarian Masses: Often small, harmless, and produce no symptoms. However, extreme pain can occur, and immediate attention is needed if they get larger, if they twist (torsion), or if they burst. An ovarian cystectomy refers to the removal of an ovarian cyst or tumor while preserving the ovary.
  • Fibroids: Non-cancerous growths that originate from the muscle of the womb. They affect 80 percent of ALL women, and some patients suffer from heavy bleeding and pain. The removal of fibroids (myomectomy) or removal of the uterus (hysterectomy) are the recommended surgical treatment options.

Advancements in diagnostics, treatment, and pain management have evolved rapidly in the last decade, providing medical professionals with the tools to address the underlying causes of pelvic pain. The experts at CIGC are leading the way in changing the perception about women who present with complex GYN conditions and advocating for earlier minimally invasive surgical intervention.


CIGC patient, Kia, had suffered through her period for years with intense pelvic pain and uncontrollable bleeding that was getting worse over time.

“It was like someone stabbed me every month. The cramps leading up to my menstrual cycle were horrible. I had to wear 2 tampons and Depends. The first 2-3 days were awful. I had to carry extra Depends, extra underwear, extra everything,” said Kia.

After being diagnosed with adenomyosis and going through a surprise pregnancy and subsequent loss of the baby, Kia knew she wanted a definitive approach to treating her condition.

“Nobody wanted to do a hysterectomy. I had been to three OBGYNs, but I felt like I was being deterred from what I really wanted to do. They said they could perform a myomectomy, but there is always the risk of fibroids coming back. I felt like my life was just revolving around my menstrual cycle, and that wasn’t how I wanted to live.”

Kia wanted to find a hysterectomy specialist and started searching online. She discovered CIGC and Dr. Paul MacKoul, MD. She did extensive research before deciding on a laparoscopic hysterectomy with the DualPortGYN® technique.

After her surgery, Kia was pain and worry-free, “I feel like a totally different woman. I don’t have to hold back. I can plan my life.”

The CIGC specialists have made a commitment to diagnosing conditions that can cause heavy menstrual cycles, debilitating pelvic pain, or severe anemia — and performing the most minimally invasive procedures with advanced, modern techniques. Even the most complex GYN surgeries at CIGC are performed with exceptional outcomes. DualPortGYN and LAAM-BUAO® (laparoscopic assisted abdominal myomectomy) were developed to improve patient outcomes. DualPortGYN and LAAM take advantage of advanced surgical techniques that enhance the safety of each procedure.

CIGC is dedicated to providing information and materials for women to help navigate the complicated healthcare system. No woman should suffer with extreme pain during their periods, at any age. Book a consultation or call 888-787-4379 to talk to a minimally invasive GYN specialist.


The CIGC state-of-the-art specialists are available at two locations in the DC metro area. Virginia patients can visit the Reston, VA location, and Saturday appointments are available. The Maryland office is located in Rockville, MD.

CIGC is dedicated to providing information and materials for women to help navigate the complicated healthcare system. The CIGC founders, minimally invasive GYN surgical specialists Dr. Paul MacKoul, MD and Dr. Natalya Danilyants, MD, developed their advanced GYN surgical techniques using only two small incisions with patients’ well-being in mind.

Their personalized approach to care helps patients understand their condition and the recommended treatment so that they can have confidence from the very start. Our surgeons have performed over 20,000 GYN procedures and are constantly finding better ways to improve outcomes for patients.

Book a consultation today with Paul MacKoul MD or Natalya Danilyants MD.

Dr. Paul MacKoul Reviews: Vitals | RateMDs | Google | Yelp | Facebook

Dr. Natalya Danilyants Reviews: Vitals | RateMDs | Google | Yelp | Facebook