Cheryl Phua: I find it frustrating when women with painful periods tell me this

It breaks my heart seeing patients when they come to me with this problem and they have been suffering for years.

I had a lovely 25-year-old patient last year who had extremely painful periods.

About four years earlier she’d had keyhole surgery which had led to her being diagnosed with endometriosis.

But when the pain came back she had been told by her GP it couldn’t possibly be the return of the disease.

However she was still having awful pain despite being on the pill.

Struggling and wanting answers she came to me for a second opinion.

I’m so glad that she did.

When I investigated further with scans it showed that the endometriosis had indeed returned and it was severe.

Because of how serious it was I sent her straight to a specialist endometriosis surgeon as there were abnormal growths around the bowel, ovaries and womb.

She’s now doing better.

But I find it really frustrating.

Period pain is not normal and we should not take normalising period pain as OK.

Never be afraid to ask for a second opinion.

Endometriosis is a progressive, chronic condition where abnormal tissue grows outside of the womb.

Women with painful periods should get a second opinion, Dr Cheryl Phua says.

Women are on average waiting six-and-a-half years for it to be diagnosed in the first place which is far too long to be suffering.

It starts at puberty and can continue into old age, affecting at least one in nine women.

The symptoms are variable and I see a lot of patients diagnosed with irritable bowel syndrome when it’s really endometriosis.

They also may have bloating, anxiety and feel really tired.

Although keyhole surgery – or a laparoscopy – remains the gold standard to diagnose and treat endometriosis, we know it does grow back because it’s chronic and progressive.

Like my patient from last year, research has shown that it can return in three to five years.

It’s important to note though that surgery does come with risks so it’s best to look at all the options available and weigh them up.

The good news is that treatment is becoming more affordable in Australia and things are changing.

There are plans now to open 11 more endometriosis and pelvic pain clinics across Australia – bringing the total number to 33.

Cheryl Phua is a respected fertility specialist.

Last year Visanne – a daily tablet which can suppress the growth of the abnormal tissue and shrink the lesions – was listed on the PBS to help endometriosis sufferers.

Only this week it was announced that new endometriosis treatment Ryeqo will also be available on the PBS from May 1.

And Slinda – another progesterone-only pill will also be available on the PBS from that date.

In another plus, from July longer specialist consultations of 45 minutes or more will be covered under Medicare for the painful disease.

Previously an initial gynaecologist appointment received an $81.30 rebate, but this will now be increased to $168.60, so sessions can be longer.

Rebates for follow-up appointments will also be higher.

These are all positive changes, so let’s continue to talk about endometriosis to raise awareness and make sure women are no longer suffering in silence.

Knowledge is power – if someone is struggling with fertility and they have endometriosis we can individualise their care and treatment.

Dr Cheryl Phua is a distinguished specialist offering personalised fertility and gynaecological care with IVF Australia in Sydney. She is also among the 5 per cent of gynaecologists and obstetricians with a subspecialty in reproductive endocrinology, which focuses on hormone health, fertility assessments and therapeutic options.

You can follow her on Instagram at @drcherylphua or ivf_australia.