Painful, heavy periods are not normal, warn fertility doctors

Fertility experts are concerned that women waiting for treatment for painful, heavy periods may not be aware of the potential impact on their fertility. Dr Thanos Papathanasiou, Medical Director and CEO at Bourn Hall Clinic, says that one of the common reasons for female infertility is endometriosis but the condition itself can harm the reproductive organs and some surgery to treat it can have an impact on fertility.

Speaking during Endometriosis Action Month in March he comments: “Many women that we see in the clinic are often not aware that painful, heavy or prolonged periods are not ‘normal’. They may have had endometriosis for many years before seeking advice, often because the contraceptive hormones have masked the condition.”

New research by Endometriosis UK shows that 75 per cent of women would put off seeing a GP if they were experiencing painful periods which were interfering with day-to-day activities – with the figure rising to 92 per cent of those aged  16-34. One of the reasons given by 24 per cent for putting off seeing a doctor was that they considered painful periods to be a ‘normal part of life.’

Endometriosis occurs when tissue like that lining the womb starts to grow in other places, such as around the ovaries and fallopian tubes, creating scar tissue and blocking the tubes. It can swell with hormones, so the pain can become worse before and during a period. There are different stages of the disease, and the symptoms can vary so it is problematic to diagnose. It can be identified with a scan and diagnosed with certainty using laparoscopy.

Wednesday 8th March is International Women’s Day and one of its missions is to assist women to be in a position of power to make informed decisions about their health. Dr Papathanasiou adds:

“The decision whether to proceed with fertility treatment or surgery for endometriosis is a difficult one and should always be individualised. Whilst surgery may remove some endometriosis, and sometimes encourage natural conception, it is not always the preferred option. Operating on a woman’s ovaries can often reduce the egg stores irreversibly, even in the hands of an expert surgeon. It is therefore important that every woman has the support from a team of specialists, including the fertility specialist, so that she fully understands her options and can make an informed decision that is right for her.

“For women who struggle to get pregnant IVF treatment is often a good option as it works well even for women with severe endometriosis, damaged tubes or a scarred pelvis.

“For women who have severe endometriosis but do not want to have a baby at the moment there is the option of preserving their fertility by harvesting and storing their eggs. Accumulating evidence suggests that this option works better before undertaking major surgery for endometriosis. Storing eggs because of severe endometriosis may be offered under the NHS in some regions.

“If a woman has painful periods and is struggling to get pregnant then they would be advised to seek fertility advice. Depending on their age and the severity of the condition the NICE guidelines recommend they should be prioritised for fertility testing.”

Megan would pass out from painful periods

Megan Jolly, from Swaffham, Norfolk said that she had never heard about endometriosis until the couple started trying for a baby.

As a teenager Megan’s periods were so painful she would pass out – but she didn’t realise at the time that this wasn’t normal. “I would say that it’s not okay to have really painful periods,” she says. “I remember one time I really burnt my stomach on a hot water bottle because the pain was just that bad.”

Megan was put on the pill to ease the pain, but when she stopped contraception to try for a baby her symptoms returned.

“My periods became very heavy, and very painful, so I went to the GP and she basically said, ‘either you have a baby, or you go back on contraception’,” explains Megan. “I said, ‘actually we have been trying’. She asked how long for and then agreed to do a referral to Bourn Hall Clinic for fertility testing.”

Fertility specialists at Bourn Hall suspected endometriosis and this was confirmed by a surgeon at the local hospital.

“The consultant at the hospital explained that I did have lesions all around my bowel that they carefully burnt away to try and ease the pain,” says Megan. “I also had a dye test that showed my tubes were partly blocked and sluggish, so they recommended IVF.”

Megan and Kyle had successful IVF treatment at Bourn Hall Norwich and are now parents to 15-month-old daughter Faith. Megan says the name came out of hope:

“After I had the embryo transfer, I was talking to my tummy saying, ‘come on, Faith, stick around’. When we found we were pregnant my husband’s words were ‘Faith has stuck’. Corny, I know – so that’s why her name is Faith; she has always been Faith.

“We found out I was pregnant on Easter Sunday and Faith was born just before Christmas. I love being a mum, it still feels surreal. I just think ‘Oh My God, I can’t believe she is mine.’”

Read more about endometriosis on our blog.