What Are The Signs The Pain Could Be Something More Serious
If you are struggling with painful periods, it’s important not to suffer in silence. Painful menstrual cramps dont always indicate an underlying problem, but Pisal says there are a few signs that the pain could be something more serious.
The first is intensity. “If you need to take constant painkillers or cannot do your day-to-day activities, you need to seek medical attention,” he says. “Associated symptoms, such as fainting, loose motions, painful motions, and vomiting, also indicate that you need to see a doctor.”
Needing to take time off work or school can also be a sign. “If your periods are affecting the quality of life in a major way, it is important to take steps to alleviate the symptoms,” Pisal adds.
You should also take note of the heaviness of your periods. “If the pain is associated with heavier periods with clots and flooding, that can indicate a physical problem such as uterine fibroids,” he says.
Likewise, pain during sex shouldnt be ignored, as it could be an indication of a condition such as endometriosis.
Why Havent I Gotten My Period
10 symptoms of perimenopause
Perimenopause refers to the time period that begins when the ovaries begin to decline in function and continues until menopause . During this time, a woman may exhibit these symptoms that are largely due to abnormal hormonal fluctuations:
- Irregular vaginal bleeding
Sometimes women in the very early stages of pregnancy experience slight cramping, similar to mild menstrual cramps, right around the time that the fertilized egg implants in the uterus. This is termed ÃÂ¢implantation painÃÂ¢ and happens right around the time of the expected period.
- Usually there are no other symptoms at this time other than the absence of a period. Sometimes there is light spotting at the time of implantation.
Hormone Therapy And Uterine Fibroids
The use of hormone therapy after menopause is associated with a greater risk for a fibroids diagnosis, as reported in a 2017 peer-review article of most studies to date. The risk of surgically confirmed fibroids increased up to sixfold in people using estrogen or combined estrogen-progestin therapy compared with nonusers.
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How Is The Cause Of Severe Period Pain Diagnosed
To diagnose severe period pain, your health care provider will ask you about your medical history and do a pelvic exam. You may also have an ultrasound or other imaging test. If your health care provider thinks you have secondary dysmenorrhea, you might have laparoscopy. It is a surgery that that lets your health care provider look inside your body.
Frequently Asked Questionsexpand All
Yes, if you have painful periods you and your obstetrician-gynecologist should talk about your symptoms and your menstrual cycle. If needed, your ob-gyn may recommend a pelvic exam. A first step in treatment may be medications. If medications do not relieve your pain, treatment should focus on finding the cause of your pain.
An ultrasound exam may be done when pain is not relieved with medications. In some cases, an ob-gyn may recommend a laparoscopy. This is a procedure that lets an ob-gyn view the organs in the pelvis. With laparoscopy, a small incision is made near the belly button. A thin, lighted cameraa laparoscopeis inserted into the abdomen. Laparoscopy often is done with general anesthesia in a surgery center or hospital.
Medications are usually the first step when treating painful periods. Certain pain relievers target prostaglandins. These medications, called nonsteroidal anti-inflammatory drugs , reduce the prostaglandins made by the body and lessen their effects. This in turn makes menstrual cramps less severe. Most NSAIDs, such as ibuprofen and naproxen, can be bought over the counter.
Acupuncture, acupressure, and nerve stimulation therapies may be useful for treating painful periods. Physical therapy that eases trigger points also may help with pain.
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You Have Other Symptoms
Maybe youre really not sure whether your cramps are normal or not, but you also experience other related symptoms. Other worrisome symptoms may include:
- Cramps accompanied by nausea or diarrhea
- Pelvic pain at times beside your period
- Spotting between cycles
To evaluate what may be wrong, your healthcare provider may suggest:
- Blood work
- Exploratory laparoscopy
- Pelvic exam with sexually transmitted infection testing
- Pelvic ultrasound
Its important to know that endometriosis can only be diagnosed with exploratory laparoscopy. It cant be ruled with ultrasound or a pelvic exam. However, laparoscopy is an invasive, surgical procedure, so your doctor may not recommend having it unless your symptoms are especially bad.
Sometimes it happens that you see your doctor and are told everything is fine. If your cramps arent interfering with your daily life, this may be reassuring and an acceptable answer. However, if your cramps are making it difficult to work and live, dont accept Youre fine as an answer. Seek out another doctor.
Severe abdominal or pelvic pain may indicate something more serious than your period, like an ectopic pregnancy, toxic shock syndrome, acute PID, or appendicitis.
What Helps With Cramps
Here are a some things that can help ease cramps:
Over-the-counter pain medicine like ibuprofen , naproxen , or acetaminophen . Always follow the instructions on the bottle. Talk with your doctor before taking pain medication if you have an allergy to aspirin or severe asthma.
Hormonal birth control .
Acupuncture and acupressure.
Transcutaneous electric nerve stimulation therapy that uses mild electric currents to stimulate your nerves to relieve pain.
Certain vitamins and herbs like vitamin B1, fish oil, fenugreek, ginger, valerian, zataria, and zinc sulfate.
Cramps are a pretty normal part of getting your period, but sometimes people have period cramps that are so painful its hard to do everyday things . If your period pain is really bad, and over-the-counter medicine doesnt help, talk with your doctor. They can help with other ways to manage the pain, or they may want to check to see if theres something more serious going on.
Cramps that are really bad may be a sign of:
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Medicine For Period Cramps
To alleviate menstrual cramps you can go for pharmacological treatment or home remedies. Both have their pros and cons. Medicines work fast and bring relief immediately. However, drugs might negatively impact the bacterial flora of your digestive system. Home remedies, on the other hand, despite their gentler effect on your organism, usually arent enough to combat menstrual cramps.
As far as the former go, nonsteroidal anti-inflammatory drugs are recommended for severe menstrual cramps. They impede the synthesis of prostaglandins. Such medicines include:
Keep in mind that NSAIDs might irritate your gastric mucosa. They shouldnt be used regularly. At length, they may cause stomach ulcers. Analgesics containing acetylsalicylic acid reduce the pain, but might intensify menstrual bleeding. There are also antispasmodics which might help with menstrual cramps.
In some cases, your doctor might prescribe monophasic hormonal birth control to reduce the symptoms of menstrual cramps. Gynaecological examination should precede such treatment. Additionally, a breast check and medical tests should be carried out.
Use A Heating Pad Or Take A Warm Bath
- For some women, heat is a better source of relief than over-the-counter medication. Take a heating pad and place it over your lower abdomen, or treat yourself to a nice, warm soak in the bathtub. You can make it fun by adding bubbles or a bath bomb. It may not help with the pain, but maybe the bubbles and bright colors can help distract you from your pain!
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What Are Treatments For Severe Period Pain
If your period pain is primary dysmenorrhea and you need medical treatment, your health care provider might suggest using hormonal birth control, such as the pill, patch, ring, or IUD. Another treatment option might be prescription pain relievers.
If you have secondary dysmenorrhea, your treatment depends upon the condition that is causing the problem. In some cases, you may need surgery.
Reason For Painful Cramps: Uterine Defects
Your uterus is formed while you are a female fetus in your mothers uterus and it is developed from a structure called the paramesonephric ducts. Sometimes, the uterus wont be formed as it should, which can lead to several things like infertility, painful intercourse, and period pain.
Menstrual cramps are often present and caused by the blockages and membranes diving the uterus and vagina. The most common types of uterine defects include bicornuate uterus , septate uterus and unicornuate uterus .
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What To Do For Simple Cramps
For simple cramps, the first-line option is ibuprofen, 400 milligrams four times a day. If that is not working, or if twice a day works better for your teens schedule than four times a day, try naproxen sodium, 500 milligrams twice a day.
Both schedules only work when no doses are missed, starting from when you know your period is coming through the number of days of cramps you usually get.
Another option is Ponstel®, or methanimic acid, 500 milligrams as a loading dose and then 250 milligrams every six hours.
Symptoms Of Menstrual Pain
Besides cramps in the lower abdomen, you may also have some of these symptoms with menstrual cramps:
- Current medications
- What things seem to improve or worsen the pain
The doctor will perform a pelvic exam to check for any problems. If there are concerns about a possible infection, cervical cultures and a blood test will confirm the diagnosis. You might get these tests, too:
- The doctor may order a pregnancy test if your periods are irregular or you are not using birth control regularly.
- An ultrasound exam is necessary if the doctor discovers any abnormal masses during the pelvic exam or there is a new onset of menstrual pain.
- A doctor may recommend a laparoscopy, which is a minor surgical procedure allowing the doctor to look directly into the pelvic cavity with a fiber-optic scope. This is an outpatient procedure using very small incisions.
- A hysteroscopy is another possible procedure. By inserting a hysteroscope through the vagina, the doctor can see inside the cervix and the inside of the uterus without incisions. This can be done in a doctor’s office or a hospital.
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Your Life Is Disrupted
If your period pain is so bad that you need to call off work on a regular basis, you should speak to your doctor. The condition is not rare. But its not normal, either.
Depending on which study you look at, between 5% and 20% of women experience painful periods that interfere with their daily life.
Some countries offer a couple days off every month for menstruation. Dont misconstrue this for saying that menstruation should be so painful that you cant come to work. The issue is more complex than that. Its not even clear whether these laws are good or bad.
In 2013, Russian lawmaker Mikhail Degtyaryov proposed that Russia should offer days off for menstruation. He argued that sometimes the “pain for the fair sex is often so intense that it is necessary to call an ambulance. Not exactly a realistic portrayal of menstruation.
If your pain is bad enough to call an ambulance, please call one. Those aren’t period cramps. Something much more serious is going on. In a more likely scenario, if your pain is bad enough to regularly miss work or school, make an appointment to speak to your doctor.
How To Treat Menstruation Cramps Before Period
For typical period cramps and PMS cramps, a safe remedy is an over-the-counter painkiller. This can help dull the pain or make it go away entirely. Many women also find that a warm heating pad or hot bath helps to relax the muscles. Some research has also found cramping can be linked to certain nutritional deficiencies. Make sure you get plenty of water and magnesium in the days leading up to your period.
If you are getting cramps outside of your normal period and PMS, the best gynecological treatment will be identifying the underlying cause of the issue. There are all sorts of diagnostic tests available for abnormal menstrual cramps. You can start by taking a pregnancy test at home to see whether the cramps are caused by pregnancy. To identify problems like a UTI, your doctor may need to test the area for bacteria. Cysts can be seen with imaging tests like an ultrasound or an MRI. Issues like endometriosis may need exploratory surgery to diagnose.
Once your doctor helps you figure out what is wrong, you can move on to treating it. For infections, a round of antibiotics could resolve the cramping for good. Hormonal contraceptives can help with many of the symptoms associated with ovarian cysts and endometriosis. However, some women may need surgery to completely solve the problem.
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Period Pain Caused By Contraceptive Devices
An intrauterine device is a type of contraception made from copper and plastic that fits inside the womb. It can also sometimes cause period pain, particularly during the first few months after it’s inserted.
You may notice a change in your normal pattern of pain if your period pain is linked to a medical condition or a contraceptive IUD. For example, the pain may be more severe or it may last much longer than normal.
You may also have:
See a GP if you have any of these symptoms as well as period pain.
Reason For Painful Cramps: Ectopic Pregnancy
The fertilized egg didnt travel to the uterus to attach to the endometrium of the uterus. Instead, it is attached to the fallopian tube, most often in ampulla, ovarian, isthmus parts, fimbria site of the ovary or cervix.
Very often ectopic pregnancy is mistaken for appendicitis. The symptoms of the ectopic pregnancy are severe pain and bleeding. Shall you develop any of the symptoms, dont hesitate to address your healthcare provider.
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An Overview Of Menstrual Cramps
Monique Rainford, MD, is board-certified in obstetrics-gynecology, and currently serves as an Assistant Clinical Professor at Yale Medicine. She is the former chief of obstetrics-gynecology at Yale Health.
Menstrual cramps are the result of hormone-induced muscular contractions of the uterus. They are often heaviest during the first day or two of your period, and usually subside within a few days. Cramps are a normal part of your cycle as your uterus sheds its lining each month, but significant pain or heavy flow should not be dismissed. They may have other causes and are always treatable.