Period pain isn't always normal, your genes may raise endometriosis risk

In India, most women wait 7-10 years for a diagnosis because often doctors lack simple tools to identify it early | Image: Freepik

Period pain is often dismissed as a normal part of menstruation, but severe or persistent pain could be a sign of endometriosis, a chronic condition that can affect fertility and significantly impact a woman's quality of life, according to doctors.

Experts said growing evidence suggests that genetic and epigenetic factors may influence a woman's susceptibility to the condition, highlighting the need for greater awareness and earlier diagnosis.

"Symptoms of period pain are often dismissed as 'normal' because many of us lack awareness of a condition called endometriosis. It is a painful condition where tissue like the womb lining grows outside the uterus. It affects 1 in 10 women and girls, often causing severe period pain, pelvic pain, and infertility," said Dr Priti Arora Dhamija, senior consultant, Obstetrics and Gynecology and Fertility expert at Sitaram Bhartia Institute of Science and Research.

In India, most women wait 7-10 years for a diagnosis because often doctors lack simple tools to identify it early, she pointed out.

This delay leads to worsening pain, missed school or work and decreased quality of life.

Over the past decade, epigenetics has emerged as a central mechanism in the pathogenesis of endometriosis, Dr Dhamija said.

"Epigenetic modifications, including DNA methylation, histone modifications and chromatin remodelling, can alter gene expression without changing the underlying DNA sequence. India's pluralistic health system and lack of referral systems creates a gap that forces women to navigate multiple providers, including traditional healers and alternative practitioners, increasing complexity and financial burden," she said.

Dr Jyotsna Suri, Head of the Department of Gynaecology and Obstetrics at Safdarjung Hospital, Delhi, said that endometriosis is not simply a genetic disorder but a complex disease resulting from the interaction of genetic, hormonal, immune and environmental factors.

"Women with a close family member affected by endometriosis may have a higher risk, but genes are only one piece of the puzzle. Increasing evidence suggests that genetic susceptibility interacts with hormonal and inflammatory pathways as well as environmental factors to influence whether the disease develops and how severely it manifests," she said.

Epigenetic changes may also play an important role by altering how genes are expressed without changing the underlying DNA sequence, she said.

"Importantly, severe period pain should never be dismissed as something a woman simply has to live with. Pain that disrupts daily life, pain during intercourse, persistent pelvic pain or difficulty conceiving warrants medical evaluation.