Painful periods: Could it be PCOS, endometriosis or maybe both?

“MONIQUE, my main issue is that my periods are irregular and very painful. I can go months without seeing it…but when it does come, it’s very painful. I had to take the whole week off work last time because I couldn’t get out of bed.”

These were the words of a client on a coaching call just last week.

I paused, and quickly asked if she had ever been screened for endometriosis.

Being a nutritionist, I interact almost daily with women diagnosed with polycystic ovarian syndrome (PCOS) who are seeking to learn how to reclaim their bodies and manage this complex condition.

Against the common misconceptions, painful periods are not “normal”… even if you have PCOS, and they’re maybe an indication of a gynaecological condition called endometriosis.

Before we dive into the difference between the two, let me help you to get a basic understanding of what both of these conditions are.

What is endometriosis?

Endometriosis is a condition where the endometrium (the section of the womb that sheds during menstruation) is found outside of the uterus and may be present in the Fallopian tubes, ovaries, the bladder, intestine or the colon. The presence of the endometrial tissues in these areas triggers an inflammatory response, resulting in severe pain.

Unlike PCOS where women’s bodies produce higher than normal levels of testosterone resulting in missed periods, excess facial hair, acne, fertility issues, and weight gain, among other symptoms; severe menstrual pain isn’t a critical marker of PCOS.

How common is this condition?

Like PCOS, endometriosis is very common, but hardly ever spoken about.

It is believed that 10-15 per cent of women suffer from endometriosis, while PCOS affects one in 10 women. So it is no surprise that these two conditions can occur together in the same body.

So what is the main difference?

As said previously, the main difference between PCOS and endometriosis is the level of pain.

Yes, your cycle may cause some discomfort, but it should not be severe.

Unsure if your period can be considered “severe”? Ask yourself these questions:

1. Do you take on average over four extra strength painkillers during your cycle?

2. Do you feel as if the pain increases over the length of the day?

3. Do you experience pain during sessions of intimacy with your partner?

4. Does it hurt when you pass stool or urine?

If you answered yes to any of the above, you want to have a discussion with your doctor.

What should I do if I have both PCOS and endometriosis?

If you have been diagnosed with both PCOS and endometriosis, know that you don’t need to continue suffering in silence or shame.

My mission is to ensure that my clients don’t carry on the cycles of painkillers, hot water bottles and missing days from work or school. In my practice I help women with PCOS lose weight to reclaim their bodies without restrictive diets, relying on medications, or spending hours in the gym.

If you are a woman with PCOS, know that your body wants to work with you — you may just not know what it needs.

Monique Allen, BSc, is a certified holistic nutritionist and PCOS educator. She runs a web-based practice where she helps women with PCOS lose weight without diet, the gym, or pills. For additional resources or personal support, follow her on social media @themoniqueallen or e-mail hello@ themoniqueallen.com.