Endometriosis is typically thought to happen when cells that are native to the uterus begin to grow on other organs. However, there’s a debate in the medical world about whether or not the tissue is similar to endometrial cells, but different because it can produce its own estrogen.
However they wind up in the wrong place, these cells are still sensitive to estrogen fluctuation and bleed just like they normally would inside the uterus. This can lead to extreme pain and abnormal bleeding, and if these growths crop up on your fallopian tubes and ovaries, they can affect their function, making your periods even more irregular, Dr. Minkin says.
Endometriosis treatments vary. Doctors will typically recommend pain medications like nonsteroidal anti-inflammatory drugs (NSAIDs) along with hormonal birth control to make periods lighter and less painful, according to the Mayo Clinic. Beyond that, they can perform laparoscopic surgery, which is minimally invasive and done with thin surgical instruments and tiny cameras, to remove as many of the lesions as possible. In severe cases that don’t respond to more conservative treatments, hysterectomy (removal of the uterus and potentially other reproductive organs like the cervix and ovaries, depending on the type of procedure) is an option, though it’s typically a last resort since it makes it impossible to physically carry a pregnancy. (It may still be possible to have children after a hysterectomy thanks to options like adoption, surrogacy, or using your own eggs with a gestational carrier if you keep your ovaries.)
Fibroids
These are benign (non-cancerous) growths in and on the muscle of the uterus, and they can cause heavy, long, painful periods in some women, though many others who have fibroids experience few notable symptoms.
In addition to pain medications like NSAIDs, doctors may choose to treat symptomatic fibroids with a myomectomy (surgery to remove the growths), uterine artery embolisation to block blood flow to these tumours, and a hysterectomy in severe cases, according to the Mayo Clinic.
Polycystic ovary syndrome (PCOS)
PCOS is a condition marked by infrequent, irregular, or absent periods, high levels of male hormones known as androgens (this can cause issues like acne and facial hair), and abnormal fluid-filled cysts on the ovaries, according to the Mayo Clinic. This is why people with PCOS may experience inconsistent (or completely missing periods), which might then be torrentially heavy when they do show up, according to the Mayo Clinic.
Combined hormonal birth control pills are a first-line treatment for PCOS, Dr. Minkin says, since they can regulate periods and reduce androgen-related symptoms like acne and facial hair growth. If irregular or absent ovulation is interfering with your ability to get pregnant, doctors can walk you through various medications designed to promote ovulation, like Clomid, according to the Mayo Clinic.
As with anything else in the human body, your menstrual cycle will be individual to you, and you shouldn’t feel embarrassed to see a doctor if you think something’s wrong.
If your menstrual cycle is disrupting your life in any major way, chances are doctors can help. It might feel embarrassing to talk about all of this, but periods — and your body — aren’t dirty, shameful, or a burden you should have to bear on your own. Bringing up any concerns you have with a doctor is the only real way to make your menstrual cycle fade into the background so you can live your life.
This article originally appeared on SELF.