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" I&amp;#039;ve had really bad menstrual cramps since I was a teen. Over the last few months, my cramps have been starting almost 10 days before my period. Sex hurts. My gynecologist put me on birth control, which initially helped but now my pain is getting worse. Help! What should I do? It sounds like you may have endometriosis. That&amp;#039;s when cells from the lining of the uterus grow outside of the uterus. Typical symptoms include painful periods, painful sex, cramps any time during the month, back pain, constipation, pelvic and abdominal pain. Ten percent of women have endometriosis at some point in their lives, but not all of them have these symptoms. Endometriosis can&amp;#039;t be diagnosed with an ultrasound, but you should ask your gynecologist to have one to rule out any ovarian cysts. Then she&amp;#039;ll probably recommend a laparoscopy (an out-patient surgery in which they insert a tiny camera through your belly button) to diagnose endometriosis. If you do have endometriosis, make sure your doctor &amp;quot;excises&amp;quot; the endometriosis (cuts out the misplaced uterine cells). It will not come back in areas where it was excised but new areas of endometriosis can develop in the future, so continuing the birth control to prevent it is a still a good idea. Patients with endometriosis generally do better on a 24-day pill or continuous birth control pill, as opposed to a typical 21 day pill. I was diagnosed with endometriosis and am doing better after a laparoscopic excision. Lately I&amp;#039;ve been having pain after sex, sometimes lasting for hours. I&amp;#039;ve been really bloated too. I keep thinking I have urinary tract infections because I have to pee all the time, but I&amp;#039;ve had tests and the doctor says my culture is negative so I don&amp;#039;t have a UTI. What is going on?  You should see your doctor to ask about interstitial cystitis. That&amp;#039;s basically endometriosis&amp;#039;s evil twin. The symptoms of the two can overlap and up to 80 to 90 percent of women with endometriosis actually have both. The treatment isn&amp;#039;t surgical for this, you would just need a diet lower in acid (citrus fruits) and potassium (carbonated beverages). (Ic-network.com has a lot of great information about adjusting your diet for this.) Also ask your gynecologist if you might also have muscle disfunction in your pelvis. Patients with endometriosis and/or interstitial cystitis often have pain from too-tight pelvic floor muscles and she can recommend exercises to stretch those out. Dr. Iris Orbuch is the director of the Advanced Gynecologic Laparoscopy Center and the co-director of gynecologic robotic surgery at Beth Israel Hospital in New York City. Do you have a women&amp;#039;s health question for Dr. Iris? Submit it here! Photo credit: Courtesy of Iris Orbuch "^^<http://www.w3.org/2001/XMLSchema#string>
<http://www.cosmopolitan.com/sex-love/advice/a6736/dr-iris-bad-menstrual-cramps/>