Sarah Uwase remembers her first period to be messy and shocking as it is for any other 12-year-old girl. At the age of 16, though, her monthly bleeding started becoming extremely painful. Having heard that the menstruation period is generally painful for other girls as well, she tried failingly, to shove it aside and accept her fate.

However, it almost got fatal. One morning, she wakes up, follows her routine at her boarding school, and sits for the last end of year exam. All of a sudden, she groans in pain when the pain shoots down from her pelvis to the back of her legs. Her feet go numb, and she tries to breathe slowly, stopping herself from screaming, while the pain eats her out from the lower abdomen.

The school matron takes her to the hospital where she explains that it is not the first time it has happened. She goes on to explain how she bleeds massively through pads, underwear, and sheets when she sleeps. She also recounts how she once collapsed in the shower or passed out in class. 

Uwase is later diagnosed with endometriosis, a chronic condition that affects 10 percent of women and girls, according to the World Health Organization. That is despite the usual misconception that it affects older women.

According to the latest data, one in five girls often experience abnormal pain prior to endometriosis and ignore it until it's too late, due to the common belief that periods are painful. 

It is true that period pain is common and a normal part of the menstrual cycle, even if it is not the case for all women or painful throughout the whole four to five days that it lasts. Most women even get it only at some point in their lives and not every month as it may be for some. 

According to Healthline, period pain happens when a hormone called prostaglandin causes muscle contraction in the uterus to remove the lining that had previously been formed to prepare for conception. This results in pain and inflammation, however not as excessive pain that may disable someone from performing usual activities.

How to tell the difference between endometriosis and period pain?

Painful menstruation is called dysmenorrhea, occurring in two types, primary and secondary. According to Odile Rurangwa, a gynecologist, primary dysmenorrhea is when you experience pain before and during menstruation. 

While secondary dysmenorrhea is when normal periods become painful later in life. This is a condition that affects the uterus or other pelvic organs, caused by endometriosis or uterine fibroids.

Endometriosis is a disease where a tissue similar to the one that normally lines the inside of the uterus, the endometrium, grows outside the uterus. It most commonly involves ovaries, fallopian tubes and the tissue lining the pelvis. It often causes pain and/or infertility. 

Dr Rurangwa explains that the formed endometrial-like tissue acts as an endometrial tissue would. It thickens, breaks down and bleeds at each menstrual cycle. When endometriosis involves the ovaries, it may form cysts.

She says that endometriosis is sometimes mistaken for other conditions such as pelvic inflammatory disease or ovarian cysts. It can also be confused with irritable bowel syndrome, which causes diarrhea, constipation and abdominal cramping, which can complicate the diagnosis. It is also associated with an increased risk of comorbidities such as cancers and cardiovascular diseases. 

Endometriosis is primarily characterised by extreme pain in the abdomen and lower back, but includes other symptoms such as painful sex, painful urination and bowel movements, gastrointestinal disruptions, like painful diarrhea and constipation, which patients often confuse for signs of another health issue, says Dr Rurangwa.

Up to date, endometriosis has no cure. "Patients are often prescribed birth control, the pill, a patch or a vaginal ring, or sometimes a hormonal IUD. They reduce estrogen and slow the growth of endometrial tissue, helping to reduce pain,” Dr Rurangwa said.

Dr Rurangwa advises girls who experience excessive pain during periods to seek medical help and generally calls for a regular gynecological checkup. It may aid in detecting such conditions before they become severe, she noted.

Patients are often prescribed birth control, the pill, a patch or a vaginal ring, or sometimes a hormonal IUD.Photos/Net