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Painful Menstrual Cramps

Another condition that can cause menstrual cramping, particularly in people who have heavy menstrual flow, is endometriosis. Endometriosis is a diagnosis that your doctor may consider if your symptoms are severe, or if they are not responding to usual menstrual cramp relief medicines.

Endometriosis affects about 10-15 percent of all women in their reproductive years. It is a condition where the tissue that normally lines the inside of the uterus is found growing in areas outside of the uterus. This displaced tissue can be found on the ovaries, the surface of the intestines or bladder and elsewhere.

Endometriosis tissue, like the uterine lining, responds to the female hormones and releases small amounts of menstrual-like blood wherever it is found. Because this blood cannot pass through the vagina and out of the body like normal menstrual blood, it can cause irritation, pain, and scarring of some pelvic or abdominal organs.

Endometriosis can cause infertility because the irritation and scarring can block the fallopian tubes, preventing the egg and sperm from uniting.

The diagnosis of endometriosis is most commonly made by laparoscopic (camera-guided) surgery. During the operation, your surgeon may be able to destroy some of the endometriosis tissue by removing it or cauterizing the tissue (burning the tissue with an electrical wand). This can reduce symptoms.

Treatment may also include hormone medications that suppress the menstrual cycle such as birth-control pills, vaginal ring (NuvaRing), or patches -- leuprolide (Lupron) or danazol (Danocrine). If your symptoms are severe enough that your doctor considers a diagnosis of endometriosis, your doctor may consider treatment with birth control hormones even before your diagnosis is confirmed, to see if you have improved symptoms.

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