Pain and PCOS: Possible Dual Diagnosis with Endometriosis and Adenomyosis

Pain and PCOS: Possible Dual Diagnosis with Endometriosis and Adenomyosis

Understanding Pain Associated with PCOS and the Possibility of Dual Diagnosis with Endometriosis and Adenomyosis

Polycystic Ovary Syndrome (PCOS) is a complex hormonal disorder often misunderstood and misdiagnosed. Many women with PCOS experience chronic pelvic pain, which can be exacerbated by coexisting diagnoses of endometriosis or adenomyosis. This article explores these three conditions, their symptoms, their interactions, and available treatment options.

What is PCOS?

PCOS is characterized by elevated levels of androgens (male sex hormones) - hyperandrogenism - and a deficiency in hormones responsible for ovulation. This lack of ovulation leads to the chronic formation of small follicles (fluid-filled sacs) on the ovaries. PCOS symptoms usually appear with the first menstrual cycle but can develop later in life.

Common Symptoms of PCOS

  • Irregular periods: Infrequent or spaced-out menstruation.
  • Enlarged ovaries: Due to inflammation and cysts.
  • Excessive hair growth: Hirsutism or increased hair on the face and body.
  • Weight gain: Especially around the abdomen.
  • Skin issues: Acne, oily skin, skin tags, or thick, darkened patches.

Diagnosing PCOS

Diagnosis involves blood tests and ultrasounds. Other common indicators may include:

  • Infertility
  • Liver inflammation
  • Metabolic syndrome
  • Type 2 diabetes
  • Sleep apnea
  • Depression and anxiety
  • Endometrial cancer

Pain and PCOS

Pain is a common but often underestimated symptom of PCOS. It can impact daily life and relationships (pain during intercourse, difficulty managing pain).

A 2022 study using the HRQoL (Health-Related Quality of Life) questionnaire showed that women with PCOS have increased pain sensitivity, with an average score of 36 out of 100 for health-related quality of life. PCOS is often associated with low-grade chronic inflammation, increasing pain sensitivity. Early detection of this inflammation and lifestyle adjustments are crucial for effective management.

Painful Periods and PCOS

Painful periods, or dysmenorrhea, are frequent in women with PCOS. Menstrual pain is caused by the accumulation of immature follicles in the ovaries due to lack of ovulation. Chronic inflammation associated with PCOS can also contribute to this pain.

Dysmenorrhea manifests as abdominal pain, cramps, or backaches. These pains can significantly affect quality of life, academic performance, work productivity, and social relationships. Menstrual pain is caused by excessive prostaglandin secretion in response to falling progesterone levels at the start of menstruation, increasing uterine contractions and pain.

  • Pain Location: Hypogastric, radiating to the perineum, rectum, lower limbs, lumbar region, and abdomen.
  • Timing: Precedes menstruation and subsides with menstrual flow. May accompany menstruation and gradually ease. Late: Appears on the 2nd or 3rd day, often associated with endometriosis.
  • Types of Pain:
    • Spasmodic: Resembles uterine colic, intense at the onset of menstruation.
    • Congestive: Affects the entire pelvis, preceded by premenstrual syndrome.
    • Membraneous: Rare, with expulsion of a mold of the uterine cavity and heavy bleeding.
  • Other Symptoms:
    • Digestive: Diarrhea, nausea, vomiting.
    • Neurovegetative: Dizziness, faintness, nervousness, headaches.

Natural Solutions for Period Pain Associated with PCOS

  • Omega-3s, with their anti-inflammatory properties, are ideal for soothing uterine muscle contractions responsible for pain.
  • Magnesium bisglycinate, which relaxes muscles, forms an ideal combo to support your menstrual cycle.

Joint and Back Pain Related to PCOS

Joint and back pain are not usually directly caused by PCOS but may occur due to side effects and complications associated with the syndrome.

  • Weight Gain and Obesity: PCOS is often linked with weight gain and obesity, partly due to insulin resistance. Excess weight can put additional pressure on joints and the spine, leading to joint and back pain.
  • Inflammation: PCOS is often accompanied by a low-grade chronic inflammatory state. Inflammation can contribute to pain and stiffness in joints and back.
  • Sedentary Lifestyle: Women with PCOS may adopt a sedentary lifestyle due to fatigue, depression, or anxiety associated with the syndrome. Lack of physical activity can lead to muscle weakness and poor overall physical condition, increasing the risk of joint and back pain.

Natural Solutions for Joint Pain Associated with PCOS

  • Omega-3s, with their anti-inflammatory properties.
  • Collagen, a key protein for joint, bone, skin, and muscle health.
  • Magnesium bisglycinate, which relaxes muscles.
  • To assist with insulin resistance, our IG boost supplement is ideal.

Migraines and PCOS

Migraines are common among women with PCOS. While hormonal fluctuations play a crucial role, several other factors contribute to the onset and intensity of migraines.

Multifactorial Causes of Migraines in PCOS

  • Hormonal fluctuations: Variations in hormone levels, particularly estrogen and progesterone, are well known to trigger migraines.
  • Stress: A major migraine trigger.
  • Poor Sleep: Insufficient or poor-quality sleep can worsen migraines.
  • Dehydration: A common migraine trigger.
  • Nutritional Deficiencies: Deficiencies in vitamins and minerals, such as magnesium, B vitamins, and vitamin D, can also contribute to migraines.

Managing Digestive Pain Associated with PCOS

PCOS is often associated with low-grade chronic inflammation. This inflammation can affect various body systems, including the gastrointestinal tract, leading to symptoms such as bloating, abdominal pain, diarrhea, and constipation.

Impact:

  • Gut Microbiome Imbalance: Chronic inflammation can disrupt the balance of good bacteria in the gut, promoting the growth of pathogenic bacteria.
  • Leaky Gut: Inflammation can increase gut wall permeability, leading to "leaky gut," where toxins and undigested food particles enter the bloodstream, exacerbating systemic inflammation.

Supplements to Help with Nutritional Deficiencies and Reduce Inflammation

  • Omega-3s: Fish oil supplements for their anti-inflammatory properties.
  • Probiotics: To improve gut microbiome health.
  • Vitamins and Minerals: Supplements of vitamin D, B, and magnesium for proven deficiencies.

Managing PCOS Pain

Pelvic Floor Therapy and PCOS

Pelvic floor physical therapy helps treat various disorders and dysfunctions related to pelvic floor muscles. This therapy can relieve abdominal and pelvic pain, as well as pain during menstruation or intercourse. Through physical therapy, you can learn lifestyle changes to minimize pain.

Massage and reflexology can help manage pain by improving blood circulation and reducing stress.

  • Hydrotherapy: Saunas, steam rooms, and hydro-massage jets promote toxin elimination and soothe pain.
  • Physiotherapy and Osteopathy: Relieve pelvic and digestive pain.
  • Electrostimulation Devices: These medical devices send light electrical impulses to muscles and nerves, reducing pain and improving muscle function.

PCOS, Endometriosis, and Adenomyosis: Is It Possible to Have Both?

What is Endometriosis?

Endometriosis affects approximately 10-15% of women of reproductive age. It is characterized by the presence of cells similar to those in the endometrium outside the uterus, often in the pelvic area, intestines, or ovaries. This condition is linked to excess estrogen production and may be caused by retrograde menstruation.

Symptoms of Endometriosis

  • Chronic pelvic pain
  • Heavy and painful periods
  • Pain during intercourse or bowel movements
  • Chronic fatigue
  • Infertility

Diagnosing Endometriosis

Diagnosis is made by a doctor who will analyze symptoms and conduct appropriate tests.

  • Clinical Examination: Basic gynecological exam to specify the diagnosis and guide further tests.
  • Pelvic or Transvaginal Ultrasound: To visualize internal organs, performed by a radiologist trained in endometriosis.
  • MRI: Used to detect deep endometriosis lesions.
  • Salivary Test: Endotest analyzes micro-RNA in saliva to detect endometriosis profiles. This non-invasive test may provide early and reliable diagnosis.

What is Adenomyosis?

Adenomyosis is characterized by the infiltration of endometrial cells into the uterine muscle, causing uterine muscle hypertrophy and thickening of the uterine wall. It is often referred to as internal endometriosis. The causes of adenomyosis are still poorly understood.

Symptoms of Adenomyosis

  • Heavy menstrual bleeding
  • Significant pain during menstruation
  • Bleeding between periods
  • Pain during intercourse
  • Difficulty conceiving

Diagnosing Adenomyosis

Diagnosis is primarily based on histological analysis of a uterine muscle biopsy, although ultrasound often suffices to identify the disease.

While adenomyosis is often associated with endometriosis, it is possible for a woman to suffer from both PCOS and adenomyosis/endometriosis. There are no precise statistics on the prevalence of this coexistence. About 7% of people with endometriosis may also have PCOS. The simultaneous presence of these conditions can complicate diagnosis and treatment due to overlapping symptoms.

Naturally Managing Symptoms of Endometriosis/Adenomyosis and PCOS

  • Reduce Chronic Inflammation:
    • Anti-inflammatory Diet: Rich in omega-3s (fatty fish, nuts, canola oil, flaxseed) and low in pro-inflammatory foods (alcohol, coffee, dairy, red meat, sugar).
    • Mental Health and Stress Management: Heart coherence, yoga, or meditation.
    • Gut Health: Probiotics to restore gut balance and reduce inflammation.
    • Physical Activity: Regular exercise to increase anti-inflammatory cytokines and reduce estrogen levels.

Natural Solutions for Managing Inflammation

  • Curcumin: Powerful anti-inflammatory and antioxidant.
  • Omega-3s: Essential fatty acids found in fatty fish.
  • Boswellia Serrata: Anti-inflammatory.
  • Ginger: Anti-inflammatory and antioxidant.
  • Vitamin D: Reduces inflammation.
  • Probiotics: Reduces intestinal inflammation and supports digestive health.
  • Magnesium: Reduces inflammation, helps muscle and nerve relaxation.

PCOS, endometriosis, and adenomyosis are complex and often interrelated conditions, each causing significant pelvic pain. It is crucial to consult a doctor for accurate diagnosis and a suitable treatment plan. By better understanding these conditions and adopting effective management strategies, women can improve their quality of life and reduce their symptoms. Embracing a holistic approach, including lifestyle changes, appropriate medical treatments, and pain management techniques, can help manage these conditions more effectively.

Back to Blog

You may also like

View all