Menstrual-Related Rectal Pain: Causes and Concerns

Menstrual pain can be felt in the rectal area?

Hello, doctor.
I experience pain in my anus during menstruation, but it goes away afterward.
I found online that some doctors say this could be endometriosis, while others mention adenomyosis.
However, I already have external moles.
Which diagnosis is more accurate? Also, could you explain what adenomyosis is? I would like to delay my period during the summer because my family is harvesting fruit.
Thank you.

huanzhe, 40~49 year old female. Ask Date: 2014/05/27

Dr. Lin Wenbin reply Obstetrics and Gynecology

Pain in the rectum during menstruation can have various causes.
A common cause is endometriosis, and adenomyosis is also a possibility, as it shares the same underlying etiology as endometriosis.
However, adenomyosis occurs within the muscular layer of the uterus, which is why it is also referred to as uterine adenomyosis or adenomyosis.
Additionally, hemorrhoids combined with localized endometriosis are also a possibility, so it is important to undergo an examination to determine the cause.
Delayed menstruation should also be evaluated in a clinic, and a prescription will be effective only after a proper assessment.

Reply Date: 2014/05/27

More Info

Menstrual-related rectal pain can be a distressing symptom for many women, and understanding its potential causes is crucial for effective management. The pain you experience during menstruation that resolves afterward can be attributed to several gynecological conditions, including endometriosis and adenomyosis, both of which are related to the presence of endometrial tissue outside the uterus.

Endometriosis is a condition where tissue similar to the lining of the uterus (the endometrium) grows outside the uterus, often on the ovaries, fallopian tubes, and other areas within the pelvis. This ectopic endometrial tissue responds to hormonal changes during the menstrual cycle, leading to inflammation, scarring, and pain. Rectal pain during menstruation can occur if endometrial tissue is located near the rectum or if it has infiltrated the surrounding structures.

Adenomyosis, on the other hand, is a condition where the endometrial tissue exists within the muscular wall of the uterus. This can lead to an enlarged uterus and painful menstruation (dysmenorrhea). While adenomyosis primarily causes pelvic pain and heavy menstrual bleeding, it can also lead to discomfort in the rectal area due to the proximity of the uterus to the rectum.

The presence of external hemorrhoids or other anal conditions can also contribute to rectal pain during menstruation, as hormonal changes can affect blood flow and tissue swelling in the pelvic region. However, if you have a known external hemorrhoid, it is essential to consider whether it could be exacerbating your symptoms during your menstrual cycle.

Regarding your concern about delaying your period, it is essential to consult with a healthcare provider before taking any hormonal medications or contraceptives to postpone menstruation. While some hormonal contraceptives can be used to delay periods, they may not be suitable for everyone, especially if there are underlying health concerns or contraindications.

In summary, both endometriosis and adenomyosis could explain your menstrual-related rectal pain, but a definitive diagnosis requires a thorough evaluation by a healthcare professional. This may include a pelvic exam, imaging studies like ultrasound or MRI, and possibly a laparoscopy if endometriosis is suspected. It is crucial to address these symptoms with your doctor, who can provide a tailored approach to your situation, including pain management strategies and options for menstrual regulation.

If you are considering delaying your period for practical reasons, such as harvesting fruit, discuss this with your healthcare provider to ensure it is done safely and effectively. They can guide you on the best options based on your health history and current symptoms.

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