Endometriosis: women tell their story


        ENDOMETRIOSIS: WOMEN TELL THEIR STORY
Christina's Story: After working for an insurance company for five years, twenty-five-year-old Christina decided to do what she'd always felt suited her best—she became a police officer. Christina leads a high-stress life, and although she experiences pelvic pain, she has been told that she does not have endometriosis. Christina tells it this way: "I've had cramping my whole life, and days of heavy bleeding, and I can't afford to be fuzzy-headed when it's a matter of life and death. My doctor says I don't have endometriosis, just cramps. My mother had a hysterectomy when she was fifty-two (two years ago) and the gynecologist told her that her abdominal organs were almost literally cemented together by endometriosis. He was amazed that her intestines weren't completely obstructed. I want to keep this disease in control and wonder if there's some way to 'track' it. If I can predict a bad day, I can be better prepared."
There are many ways to follow the symptoms of endometriosis as they seesaw through the month, but first we need to differentiate between normal cyclical functions—that is, menstruarion—and abnormal conditions. Normal function includes an approximate twenty-eight-day cycle with some premenstrual pelvic pressure and bloating. Any menstrual cramps can easily be controlled with Midol or aspirin. Discomforting premenstrual symptoms will vary from person to person, sometimes including mid month low-range pain (mittelschmerz), indicating ovulation.
Christina can increase her awareness of the disease by using a calendar. Ideally, entries should begin with the first day of menstrual bleeding, which is an absolute marker. Each day, symptoms should be listed from good to bad. Over a two-month period, it will become clear when the side effects of high levels of prostaglandins are the most virulent. Those effects may include severe cramps, fainting, diarrhea, and pounding headache. There are also cases in which endometriotic tissue growing on the fallopian tubes causes a special dysfunction: during ovulation, the fallopian tube "misfires" and cannot draw in all the fluid surrounding the egg. Some of this fluid drops into the abdomen, causing tremendous pain. Furthermore, some women will experience psychological symptoms of premenstrual syndrome (PMS) along with die more physically debilitating problems associated with endometriosis.
Keeping a chart of her symptoms is vital for helping a woman and her doctor assess the severity of the disease and select an appropriate treatment.

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