Menstruational pain

 

What are painful periods?

Menstruation or period, is normal vaginal bleeding that happens as part of a woman's monthly cycle. Many women have painful periods, also called dysmenorrhea. The pain is most often menstrual cramps, which are a throbbing, cramping pain in your lower abdomen. You may also have other symptoms, such as lower back pain, nausea, diarrhea, and headaches. Period pain is not the same as premenstrual syndrome (PMS). PMS causes many different symptoms, including weight gain, bloating, irritability, and fatigue. PMS often starts one to two weeks before your period starts.

 

What causes painful periods?

There are two types of dysmenorrhea: primary and secondary. Each type has different causes.

Primary dysmenorrhea is the most common kind of period pain. It is period pain that is not caused by another condition. The cause is usually having too many prostaglandins, which are chemicals that your uterus makes. These chemicals make the muscles of your uterus tighten and relax, and this causes the cramps.

The pain can start a day or two before your period. It normally lasts for a few days, though in some women it can last longer.

You usually first start having period pain when you are younger, just after you begin getting periods. Often, as you get older, you have less pain. The pain may also get better after you have given birth.

Secondary dysmenorrhea often starts later in life. It is caused by conditions that affect your uterus or other reproductive organs, such as endometriosis and uterine fibroids. This kind of pain often gets worse over time. It may begin before your period starts and continue after your period ends.

 

Causes

During your menstrual period, your uterus contracts to help expel its lining. Hormone like substances (prostaglandins) involved in pain and inflammation trigger the uterine muscle contractions. Higher levels of prostaglandins are associated with more-severe menstrual cramps.

 

 

Menstrual cramps can be caused by:

·         Endometriosis. Tissue that acts similar to the lining of the uterus grows outside of the uterus, most commonly on fallopian tubes, ovaries or the tissue lining your pelvis.

·         Uterine fibroids. These noncancerous growths in the wall of the uterus can cause pain.

·         Adenomyosis. The tissue that lines your uterus begins to grow into the muscular walls of the uterus.

·         Pelvic inflammatory disease. This infection of the female reproductive organs is usually caused by sexually transmitted bacteria.

·         Cervical stenosis. In some women, the opening of the cervix is small enough to impede menstrual flow, causing a painful increase of pressure within the uterus.

 

Symptoms

Symptoms of menstrual cramps include:

·         Throbbing or cramping pain in your lower abdomen that can be intense

·         Pain that starts 1 to 3 days before your period, peaks 24 hours after the onset of your period and subsides in 2 to 3 days

·         Dull, continuous ache

·         Pain that radiates to your lower back and thighs

Some women also have:

·         Nausea

·         Loose stools

·         Headache

·         Dizziness

·         Loss of appetite

 

 

What can I do about period pain?

To help ease your period pain, you can try:

·         Using a heating pad or hot water bottle on your lower abdomen

·         Getting some exercise

·         Taking a hot bath

·         Doing relaxation techniques, including yoga and meditation

You might also try taking over-the-counter pain relievers such as nonsteroidal anti-inflammatory drugs (NSAIDs). NSAIDs include ibuprofen and naproxen. Besides relieving pain, NSAIDs reduce the amount of prostaglandins that your uterus makes and lessen their effects. This helps to lessen the cramps. You can take NSAIDs when you first have symptoms, or when your period starts. You can keep taking them for a few days. You should not take NSAIDS if you have ulcers or other stomach problems, bleeding problems, or liver disease. You should also not take them if you are allergic to aspirin. Always check with your health care provider if you are not sure whether or not you should take NSAIDs.

It may also help to get enough rest and avoid using alcohol and tobacco.

When should I get medical help for my period pain?

For many women, some pain during your period is normal. However, you should contact your health care provider if:

·        NSAIDs and self-care measures don't help, and the pain interferes with your life

·        Your cramps suddenly get worse

·        You are over 25 and you get severe cramps for the first time

·        You have a fever with your period pain

·        You have the pain even when you are not getting your period

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.

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.

 

7 Reasons You Have Period Pain

 

What causes menstrual cramps? Most women ask this question at some time in their life. It seems that when it comes to that time of the month, mild cramps, bloating, and irritability   — although nuisances — are all to be expected. However, crippling period pain, heavy bleeding, serious fatigue, and other symptoms that affect your quality of life are not.

With menstrual cramps, mild to intense abdominal cramping begins within 24 hours of the start of your period and continues for days. Symptoms of period pain include:

·         Dull, constant ache

·         Menstrual cramps that radiate to your lower back and thighs

·         Throbbing or cramping pain in your uterus during the period

Some women also experience:

·         Dizziness

·         Headache

·         Loose bowels

·         Nausea

But what causes cramps during your period? Menstrual cramps are generally categorized as “primary dysmenorrhea,” which is caused by the elevated production of prostaglandins, hormones produced by the uterus that cause it to contract. When you have strong uterine contractions, the blood supply to the uterus is momentarily shut down, depriving the uterus muscle of oxygen and setting up the cycle of menstrual cramps and pain.  Some studies show that women with severe menstrual cramps have stronger uterine contractions than others do when giving birth.

Endometriosis can cause fertility problems. Pelvic inflammatory disease can scar your fallopian tubes, which increases the risk of an ectopic pregnancy, in which the fertilized egg implants outside your uterus. Other risk factors include use of an intrauterine device (IUD), uterine fibroid tumor, and sexually transmitted disease.

If you have period pain, here are some home-care treatments to consider:

·         Dietary supplements some findings report that natural dietary supplements containing omega 3 fatty acids and magnesium may reduce period pain.

·         Relaxation While emotional stress may increase your period pain, meditation and relaxation exercises can reduce their severity.

·         Exercise Physical activity, particularly yoga, may ease the pain of menstrual cramps.

·         Heat Try using a heating pad or microwaveable warm cozy on your abdomen during your period. Some find great period pain relief with a soak in a hot bath or shower.

·         Stop smoking and avoid alcohol. Both substances have been found to make menstrual cramps much worse.

 

1.     Endometriosis: A Common Cause of Severe Period Pain

Endometriosis is a gynecological condition in which endometrium-like tissue is found outside the uterus on other structures throughout the pelvis, including the ovaries, fallopian tubes, bladder, pelvic floor, and in more severe cases, the bowel, diaphragm, liver, lungs, and even the brain.

Untreated endometriosis can lead to adhesions, chronic inflammation, chocolate cysts (cysts filled with blood), and internal bleeding — all of which can prompt excruciating pelvic pain  

2.     Adenomyosis: Painful Cramps and Sex

Adenomyosis is like endometriosis, except instead of the endometrium implanting itself outside of the uterus, it is found embedded deep within the uterine muscle.

3.     Fibroids: A Monthly Period Nightmare for Some

As many as three out of four women will develop uterine fibroids, but most will not experience any symptoms. Fibroids range in size from microscopic to large enough to distort the shape of the uterus.

 

 

4.     Copper IUD: Period Pain after Insertion vs. Cramps Later On

A copper IUD is a nonpermanent, non hormonal from birth control that can prevent pregnancy for up to 10 years. The device, which is placed in the uterus by a licensed healthcare provider, works by continuously releasing copper, which immobilizes sperm and prevents egg implantation.

“A copper IUD, as opposed to a progestin IUD, can make menses heavier and more painful, particularly in the first few cycles after insertion,” says Streicher. “But be aware — if you have had your copper IUD for years and suddenly develop severe period pain, look for another reason. Your IUD is unlikely to be the culprit.”

5.     Can Pelvic Inflammatory Disease (PID) Cause Menstrual Cramps?

 

Pelvic inflammatory disease is an infection of the female reproductive tract that is most commonly caused by untreated sexually transmitted infections. Left untreated, PID can cause inflammation, scarring, painful menstrual cramps, and infertility.

6.     Uterine Defects: Structural Oddities That Can Lead to Menstrual Cramps and Infertility Too

While a female fetus is still in its mother's uterus, its own uterus develops from two structures known as Müllerian ducts. In some cases, the uterus does not form correctly, which can cause infertility, period pain, and painful intercourse. For women with structural anomalies — such as a bicornuate uterus (two uteri that lead to one cervix), septate uterus (normal uterus with a fibrous band of tissue bisecting it), unicornuate uterus (a uterus that develops from only one Müllerian duct), uterus didelphys (two uteri, two cervices, and a septum, or membrane, dividing the vaginal canal) — menstrual cramps stem from blockages and membranes dividing the uterus and Vagina.

7.     Period Pain Affects Half of All Women

Menstrual cramps that can’t be explained by structural defect or a reproductive condition, also known as primary dysmenorrhea, occurs at some point in almost half of all menstruating women. According to the American Congress of Obstetricians and Gynecologists, these cramps are caused by increased or imbalanced levels of prostaglandins — hormone-like fatty acids that stimulate the uterus to contract during the period. Changes in prostaglandin levels can cause more intense and frequent uterine contractions, compressing nearby blood vessels and cutting off oxygen to the uterus, thus causing painful cramps and discomfort.