Is it ‘normal’ period pain or endometriosis? Here’s how to know

For so many of us, life-disrupting period pain is an all-too-familiar experience – and it’s a shared one here at TRB HQ, too.

I began experiencing severe and unpredictable pelvic pain in my early 20s, both during my bleeds and at other points in my cycle, and I quickly started to wonder – is this just ‘normal’ period pain, or could it be something more, like endometriosis? 

Taking to Google, as I’m so often guilty of doing, gave me precious little clarity. Reaching out for advice within the healthcare system and attending multiple OBGYN appointments also left me with a pervasive, sinking feeling that getting answers wouldn’t be straightforward. “Unless you’re worried about starting a family, there’s not much we can recommend right now”, one provider told me.

Endometriosis vs normal period pain, explained

Jumping forward to 2024, I’m lucky enough to be looking into some of the very latest support in women’s health and wellbeing, including a trailblazing test called MyReceptiva™ which can reliably detect inflammation associated with endometriosis and provide answers for unexplained pain and infertility, using a protein marker called BCL6.

Partnering with the amazing MyReceptiva™ team – watch out for more insight over the next few months – we’re excited to lift the lid on painful periods, pelvic pain, (in)fertility and the endometriosis link.

Today though, we’re putting endometriosis pain vs normal period pain in the spotlight, as well as the red-flag symptoms to look out for, and a quick-fire intro to when and how to explore testing with MyReceptiva™.

Period pain – what’s ‘normal’?

Everyone is different, of course. But most of us probably know that nagging, characteristic cramping that can kick in on the first few days of our periods, or sometimes just before. The good news is that in most cases, this type of period pain is considered ‘normal’. 

Typically, this kind of ‘normal’ period pain comes from your uterus contracting to shed its lining, which causes the lower abdominal and back discomfort that many of us experience.

Normal period pain is generally:

• manageable with over-the-counter pain relievers or heating pads
• felt in the lower abdomen and back
• short-lived, at the beginning of your period
• accompanied by other typical period symptoms like mild bloating or temporary mood changes

In short, occasional pain and manageable cramps are considered a common and ‘normal’ part of menstruation.

When is period pain considered abnormal?

So, what are the red flags for period pain? Keep a mini diary over several cycles, and mark down each time you notice any of these.

• Severity – While cramps are often uncomfortable, abnormal pain can be severe and even debilitating, causing you to miss work or school.
• Duration – Normal period pain typically only lasts during the beginning of your period, but abnormal pain can often appear before, during, and after your bleed as well.
• Location – While period cramps are usually limited to the lower abdomen and back, abnormal pain may be felt through the pelvis and into the rectum, or even in the upper legs.
• Timing – You might also notice you’re experiencing painful intercourse, persistent pelvic pain, and discomfort during bowel movements or urination – none of which are limited to your normal menstrual period.

In my case, I realized the above played a huge part in my daily life and it got me wondering if I was actually dealing with something else, like endometriosis.

What is endometriosis?

Endometriosis is a chronic, inflammatory condition where tissue similar to the lining inside your uterus (endometrium) begins to grow outside of the uterine cavity. 

This misplaced tissue responds to hormonal cycles in a similar way to the uterine lining, meaning it thickens, breaks down, and bleeds. 

But, unlike a period, there’s no way for this tissue to exit the body, causing inflammation, pain, and sometimes the formation of scar tissue.

Endometriosis affects an estimated 2–10% of women in the US, typically between the ages of 25 and 40. But getting a confirmed diagnosis isn’t easy. 

Average wait times still sit around the 10-year mark, and 46% of women have to see more than 5 doctors before getting an accurate diagnosis.

Main symptoms of endometriosis

So, we know the textbook signs – think extreme pelvic and abdominal pain and heavy periods. 

But the reality is that endometriosis impacts women differently, causing a range of symptoms including:

• pain during bowel movements or urination, especially during menstruation
• painful sex, which may be experienced throughout the month
• pain in areas outside the pelvic and abdominal region, such as the lower back or thighs
• fatigue that persists even after restful sleep
• frequent urination which might get you up many times during the night
• persistent bloating, sometimes referred to as “endo belly”
• nausea and digestive issues like diarrhea during periods
• fertility issues

These symptoms can so often feel non-specific and are easily overlooked by physicians, especially as many women’s healthcare providers are not endometriosis specialists.

How do I know if my pain is endometriosis?

Laparoscopy, a surgical procedure that allows doctors to look directly inside your abdomen and pelvic area, is still considered the gold standard for diagnosing endometriosis. It can be life-changing, but it’s also no small thing to undertake.

It is an invasive procedure which may not be accessible or appealing to everyone, especially if we’re not feeling quite ready to make big decisions around our bodies in relation to family building or fertility treatment.  

If any of what we’ve covered so far today resonates, you might be a good candidate for testing with MyReceptiva™. Their message is clear – knowing you likely have endometriosis will help you decide your next steps, and book a consult with an endometriosis specialist.

And if you’re not interested in or ready for surgery, like me, the MyReceptiva™ test can help identify whether you’d benefit from trying medication to ease associated pain and symptoms.

Plus, it can also empower you with the knowledge to navigate future fertility decisions early on, whenever you’re ready further down the line.

What is the MyReceptiva™ test?

The MyReceptiva™ test identifies inflammation in your uterine lining using a protein marker called BCL6. If detected, BCL6 is highly associated with the presence of endometriosis. 

The test consists of a quick, non-surgical endometrial biopsy that can be collected during a routine OBGYN office visit – no specialist referral needed.

What exactly can it tell you?

With a detection rate of over 90%, the MyReceptiva™ test can reliably predict whether you’d benefit from surgery to diagnose and treat endometriosis.  

After testing, MyReceptiva™ will also tell you where to find a vetted endometriosis specialist near you.

How can you get tested?

Get started by ordering your collection kit – TRB readers get an exclusive $75 off with code TRB, to be applied at the end of the purchase process. 

Want to ask a question before ordering? Hop on a free 20-minute phone consult with one of their team. 

The MyReceptiva™ website also has all the information on how to talk to your doctor, plus all the information you need to bring to them, packaged up in one super clear cheat sheet. 

I know, having to self-advocate can feel exhausting at times, but getting in the know and being able to ask for the test with a kit in your hands will help ensure your provider is listening and ready to help.