For years, many women have spent money seeking relief from severe menstrual pain,buying painkillers, visiting health facilities, undergoing examinations and trying different treatments, only to be told that the discomfort is simply part of having periods.
But Dr Teddy Mulenga has warned that unusually severe or persistent period pain, particularly pain felt in unexpected parts of the body, should not be dismissed as normal menstrual discomfort.
The pain could be a sign of endometriosis, a condition that can affect a woman’s reproductive health and, in some cases, contribute to infertility.
Speaking in an exclusive interview with the Zambian Business Times (ZBT), Dr Mulenga said while menstrual pain is common, women should pay attention when the pain becomes unusually severe, persistent or occurs outside the lower abdomen.
He explained that endometriosis occurs when tissue similar to the lining of the uterus, known as endometrial tissue, grows outside the uterus.
According to Dr Mulenga, the tissue can develop in different parts of the abdomen, including around the intestines and other organs.
The condition may go unnoticed until a woman begins menstruating.
“During menstruation, that tissue also starts to behave like the inside of the uterus and starts to bleed,” Dr Mulenga said.
He explained that although the bleeding from the misplaced tissue may be small, it can irritate surrounding tissues and trigger pain.
This, he said, can explain why some women with endometriosis experience pain in parts of the body beyond the lower abdomen.
“During menstruation, you start feeling pain in the wrong places,” he said.
Dr Mulenga noted that ordinary menstrual pain is generally experienced in the lower abdomen and advised women to take particular note when period-related pain occurs elsewhere.
He cited areas such as the hip, side of the body or chest as examples of locations where unusual menstrual-related pain may warrant further medical assessment.
“Normal period pains don’t go that far,” he said.
However, Dr Mulenga stressed that not every woman who experiences painful periods has endometriosis, noting that menstrual pain can vary from mild to severe.
One of the major concerns associated with endometriosis, according to Dr Mulenga, is its potential impact on fertility.
He explained that repeated bleeding and irritation caused by endometrial tissue outside the uterus can lead to the formation of adhesions.
Adhesions are bands of scar-like tissue that can cause organs within the abdomen to stick together.
Dr Mulenga said these adhesions can affect the fallopian tubes and, in some cases, result in tubal blockage, making it difficult for an egg and sperm to meet.
“Every endometriosis patient sooner or later develops blocked tubes,” Dr Mulenga said.
He explained that doctors can use a procedure known as laparoscopy to examine the inside of the abdomen and, where possible, separate adhesions affecting the fallopian tubes.
However, he cautioned that such surgery does not cure endometriosis.
Instead, he said, the procedure is primarily aimed at dealing with complications such as infertility.
“The surgery we do in endometriosis is laparoscopic… trying to cut out the adhesions inside there, to unblock the tubes. But it’s not meant to treat endometriosis. It is meant to treat the complications of endometriosis,” he said.
Dr Mulenga said surgery to repair damaged fallopian tubes can have limited success when the tubes have already sustained significant damage.
He said this was one of the reasons he had stopped performing such operations.
Other procedures, including flushing the fallopian tubes, may sometimes be considered depending on the nature and location of the blockage.
However, he stressed that not every blocked tube can be successfully opened through such procedures.
The limitations, he said, highlight the importance of seeking medical attention before complications become more difficult to manage.
Dr Mulenga described endometriosis as a difficult condition to manage because there is currently no medication that can completely cure it.
He explained that medicines may instead be used to suppress the condition and help relieve the pain and discomfort experienced by patients.
For this reason, he urged women experiencing unusual or persistent menstrual pain to seek the opinion of a gynaecologist instead of assuming that the pain is simply a normal part of menstruation.
“It’s always to have an opinion of a gynaecologist because you may not know exactly what is causing that,” Dr Mulenga said.
He said doctors can sometimes suspect endometriosis based on a patient’s symptoms and medical history.
Where necessary, procedures such as laparoscopy can be used to examine the abdomen and identify endometrial tissue and adhesions.
The warning comes amid growing attention to women’s reproductive health and conditions that can remain undiagnosed when symptoms are dismissed as normal menstrual discomfort.
For women, the financial cost of repeatedly seeking relief from unexplained pain can also become significant, particularly when the underlying cause remains unidentified.
Dr Mulenga emphasized that unusual pain should not be ignored, especially when it repeatedly occurs during menstruation or affects parts of the body beyond the lower abdomen.
While painful periods do not automatically mean a woman has endometriosis, persistent or unusual symptoms deserve proper medical assessment.
Early consultation with a qualified health professional, particularly a gynaecologist, can help determine the possible cause of the pain and identify complications that may otherwise become more difficult to manage.
Article by Karen Ngulube
