For years, actress Shamita Shetty believed that the pain she experienced was just another part of being a woman. It was only after living with persistent symptoms and struggling to get the right diagnosis that she discovered she had endometriosis and was also going through perimenopause. Her story has resonated with many women who continue to dismiss severe period pain, fatigue and hormonal changes as something they simply have to live with. Experts say recognising these symptoms early can make a significant difference to health and quality of life.
One of the biggest reasons for delayed treatment is that many symptoms are normalised. Explaining why this happens so often, Dr Vimee Bindra, obstetrician and gynaecologist at Apollo Hospitals, Jubilee Hills, says, “Delayed diagnosis is common because symptoms such as painful periods, fatigue and pelvic pain are often dismissed as a normal part of menstruation. Greater awareness among women and healthcare providers is essential for timely diagnosis and treatment.”
Hormones also play an important role in why these conditions can feel so confusing. Dr Vidya Tickoo, consultant endocrinologist and diabetologist at Yashoda Hospitals, Hitec City, explains, “Although they do so in distinct ways, hormones are crucial in both endometriosis and perimenopause. Endometriosis is an estrogen-responsive disorder; changes in estrogen can exacerbate pain and bleeding, and it increases the growth and inflammation of endometrial tissue outside the uterus. Declining ovarian function and increasingly unpredictable levels of progesterone and estrogen during the perimenopause cause symptoms like hot flashes, irregular periods, sleep disturbances, and mood swings.”
Many women wonder where normal period pain ends, and something more serious begins. Dr Vimee narrates, “Mild menstrual cramps that improve with routine pain relief are generally normal. However, severe pain that disrupts daily life, worsens over time, persists beyond menstruation, or is associated with painful intercourse, bowel movements or infertility should never be ignored and requires medical evaluation.”
The early signs of perimenopause can also be easy to overlook because they vary from one woman to another. Dr Vidya expresses, “Early perimenopausal hormone changes are mild. Shorter or longer periods, heavier or lighter bleeding, new breast discomfort, increased PMS, sleep disturbances, hot flashes, or mood swings are all possible symptoms for women. If your symptoms make it difficult for you to go about your everyday life, if your bleeding is heavy or protracted, or if you experience new pelvic discomfort, heavy bleeding, abrupt weight changes, persistent exhaustion, or mood issues, you should consult with a doctor.”
Living with untreated endometriosis can affect much more than monthly cycles. Dr Vimee explains, “Common symptoms include severe menstrual cramps, chronic pelvic pain, painful intercourse, heavy bleeding, painful bowel movements and infertility. Left untreated, endometriosis can significantly affect fertility, emotional wellbeing, work productivity and overall quality of life. Early diagnosis and personalised treatment help improve long-term outcomes.”
At the same time, hormonal symptoms can overlap with other conditions, making proper evaluation essential. Dr Vidya states, “Perimenopause can be mistaken for thyroid issues and other endocrine diseases (such as prolactinoma, adrenal abnormalities, or polycystic ovary syndrome). Endocrinologists differentiate between them using a focused history and biochemical testing.”
Doctors also point out that endometriosis and perimenopause can exist together. Dr Vimee highlights, “Both conditions may cause pelvic discomfort and menstrual changes. Perimenopause is typically associated with irregular cycles, hot flashes and mood changes, while endometriosis causes persistent pelvic pain. Both conditions can coexist.”
Women’s bodies often send signals long before a diagnosis is made. Listening to those signals, asking questions and seeking a second opinion from experts when symptoms persist can help women receive timely care instead of accepting pain as their normal.