Menstrual cramps painful. Menstrual Cramps: Understanding Normal vs. Severe Pain, Causes, and Effective Relief Tips
What are the signs of severe menstrual cramps. How do they differ from normal period pain. What causes intense menstrual cramps. Which relief methods are most effective for severe period pain.
Decoding Menstrual Cramps: From Mild Discomfort to Severe Pain
Menstrual cramps, medically known as dysmenorrhea, are a common experience for many individuals during their menstrual cycle. These cramps can range from a mild inconvenience to debilitating pain that significantly impacts daily life. Understanding the difference between normal and severe menstrual pain is crucial for proper management and knowing when to seek medical attention.
Typical menstrual cramps present as a throbbing or cramping sensation in the lower abdomen, sometimes radiating to the lower back and inner thighs. They usually begin a day or two before menstruation, peak within 24 hours of the period’s onset, and subside within two to three days. Accompanying symptoms may include nausea, fatigue, loose stools, headaches, and dizziness.
Characteristics of Normal Menstrual Cramps
- Respond well to over-the-counter pain relievers
- Do not significantly interfere with daily activities
- Typically last for 2-3 days
- Pain is manageable with basic self-care techniques
Indicators of Severe Menstrual Cramps
- Unresponsive to over-the-counter pain medications
- Disrupt daily activities and quality of life
- Often accompanied by heavy bleeding or clotting
- May begin earlier in the menstrual cycle and last longer
- Can be associated with underlying medical conditions
The Science Behind Menstrual Pain: Understanding Prostaglandins
At the core of menstrual cramps lies a group of hormone-like substances called prostaglandins. These compounds play a crucial role in the uterine contractions that help shed the uterine lining during menstruation. Higher levels of prostaglandins are directly correlated with more intense menstrual pain.
How do prostaglandins cause menstrual cramps? When released, prostaglandins trigger the uterine muscles to contract. These contractions compress the blood vessels lining the uterus, temporarily cutting off oxygen supply to the tissue. This lack of oxygen results in the pain and discomfort associated with menstrual cramps.
Factors Influencing Prostaglandin Levels
- Hormonal imbalances
- Stress levels
- Diet and nutrition
- Genetic predisposition
- Underlying health conditions
Unveiling the Causes of Severe Menstrual Cramps
While some individuals naturally experience more intense menstrual pain without a clear underlying cause, severe cramps can often be a symptom of various medical conditions. Identifying these potential causes is essential for proper diagnosis and treatment.
Endometriosis: A Common Culprit of Severe Menstrual Pain
Endometriosis is a chronic condition characterized by the growth of endometrial-like tissue outside the uterus. This misplaced tissue responds to hormonal changes during the menstrual cycle, leading to inflammation, scarring, and often intense pain.
What are the primary symptoms of endometriosis? In addition to severe menstrual cramps, individuals with endometriosis may experience:
- Heavy or prolonged periods
- Bleeding between periods
- Gastrointestinal pain
- Pain during intercourse
- Painful bowel movements
- Difficulty conceiving
Polycystic Ovary Syndrome (PCOS): Hormonal Imbalance and Menstrual Pain
PCOS is a common hormonal disorder affecting approximately 1 in 10 women of reproductive age. It is characterized by higher levels of androgens (male hormones) and irregular menstrual cycles, which can contribute to more severe menstrual cramps.
How does PCOS affect menstruation? The hormonal imbalances associated with PCOS can lead to:
- Heavy or prolonged periods
- Irregular menstrual cycles
- Increased menstrual pain
- Anovulation (lack of ovulation)
Uterine Fibroids: Non-cancerous Growths and Their Impact on Menstrual Pain
Fibroids are non-cancerous growths that develop in or on the uterus. They can vary in size from small seedlike masses to large growths that can cause an enlarged uterus. While many individuals with fibroids may not experience symptoms, others can suffer from severe menstrual cramps and other complications.
How do fibroids contribute to menstrual pain? Fibroids can cause:
- Increased uterine contractions
- Pressure on surrounding organs
- Heavy menstrual bleeding
- Prolonged periods
- Pelvic discomfort or pain
Effective Relief Strategies for Severe Menstrual Cramps
Managing severe menstrual cramps often requires a multifaceted approach. While over-the-counter pain relievers may not be sufficient for severe pain, there are several strategies that can provide relief and improve quality of life during menstruation.
Heat Therapy: A Simple Yet Effective Pain Management Technique
Applying heat to the lower abdomen can help relax the uterine muscles and alleviate menstrual pain. Heat therapy works by increasing blood flow to the area, which can help reduce muscle tension and cramping.
What are the best ways to apply heat for menstrual cramp relief?
- Use a heating pad or hot water bottle
- Take a warm bath
- Use adhesive heat patches designed for menstrual pain
- Try warm compresses
Exercise: Moving Towards Pain Relief
Regular physical activity, particularly during menstruation, can help alleviate menstrual cramps. Exercise promotes the release of endorphins, natural pain-relieving chemicals in the body, and improves blood circulation, which can reduce muscle tension and cramping.
Which exercises are most beneficial for menstrual cramp relief?
- Low-impact aerobic exercises like walking or swimming
- Yoga and gentle stretching
- Pilates
- Light resistance training
Dietary Adjustments: Nourishing Your Way to Less Pain
Certain dietary changes can help reduce inflammation and alleviate menstrual pain. Incorporating anti-inflammatory foods and avoiding those that may exacerbate symptoms can make a significant difference in managing severe cramps.
Which foods can help reduce menstrual pain?
- Omega-3 rich foods (fatty fish, flaxseeds, chia seeds)
- Leafy green vegetables
- Ginger and turmeric
- Whole grains
- Fruits high in antioxidants
Which foods should be avoided during menstruation?
- Processed and high-sugar foods
- Excessive caffeine
- Alcohol
- Salty foods
Hormonal Treatments: Balancing Act for Menstrual Pain Relief
For some individuals with severe menstrual cramps, hormonal treatments may provide significant relief. These treatments work by regulating hormonal fluctuations and often reducing the intensity of menstrual bleeding and associated pain.
Birth Control Methods as Pain Management
Various forms of hormonal birth control can be effective in managing severe menstrual cramps. These methods work by suppressing ovulation and thinning the uterine lining, which can result in lighter, less painful periods.
Which birth control methods are most effective for menstrual pain relief?
- Combined oral contraceptives
- Hormonal IUDs
- Contraceptive patch
- Vaginal ring
Gonadotropin-Releasing Hormone (GnRH) Agonists
GnRH agonists are a class of medications that can be used to treat severe menstrual pain, particularly in cases of endometriosis. These drugs work by temporarily suppressing estrogen production, which can reduce pain and slow the growth of endometrial tissue.
How do GnRH agonists affect menstruation?
- Induce a temporary menopausal state
- Reduce or eliminate menstrual bleeding
- Alleviate pain associated with endometriosis
- May be used for short-term treatment before surgery
Alternative Therapies: Exploring Holistic Approaches to Menstrual Pain Management
In addition to conventional treatments, many individuals find relief from severe menstrual cramps through alternative and complementary therapies. While scientific evidence varies for these approaches, many report significant benefits in pain management and overall well-being.
Acupuncture: Ancient Wisdom for Modern Pain Relief
Acupuncture, a key component of traditional Chinese medicine, involves the insertion of thin needles into specific points on the body. This practice is believed to balance the flow of energy or life force and may help alleviate menstrual pain.
How might acupuncture help with menstrual cramps?
- Stimulates the release of endorphins
- Improves blood flow to the pelvic area
- May help regulate hormonal imbalances
- Can reduce stress and tension
Herbal Remedies: Nature’s Approach to Pain Management
Various herbs have been traditionally used to alleviate menstrual pain and associated symptoms. While more research is needed to confirm their efficacy, some individuals find relief through these natural remedies.
Which herbs are commonly used for menstrual pain relief?
- Ginger: Known for its anti-inflammatory properties
- Chamomile: May help reduce muscle spasms
- Fennel: Can help relax the uterus
- Cinnamon: May reduce menstrual bleeding and pain
- Dong Quai: Traditional Chinese herb for menstrual disorders
Mindfulness and Relaxation Techniques
Stress and tension can exacerbate menstrual pain. Practicing mindfulness and relaxation techniques can help manage stress levels and potentially reduce the severity of menstrual cramps.
What are effective relaxation techniques for managing menstrual pain?
- Deep breathing exercises
- Progressive muscle relaxation
- Guided imagery
- Meditation
- Gentle yoga practice
When to Seek Medical Attention: Recognizing Red Flags
While some level of menstrual discomfort is common, severe pain that significantly impacts daily life warrants medical attention. It’s important to recognize when menstrual cramps may be indicative of an underlying condition requiring professional evaluation and treatment.
Signs That Warrant a Healthcare Visit
When should you consult a healthcare provider about menstrual cramps?
- Pain is severe enough to interfere with daily activities
- Over-the-counter pain relievers are ineffective
- Cramps are accompanied by heavy bleeding or large clots
- Pain persists beyond the first few days of your period
- You experience fever or vomiting along with menstrual pain
- There’s a sudden change in your menstrual pattern or pain intensity
Diagnostic Procedures for Severe Menstrual Pain
To determine the underlying cause of severe menstrual cramps, healthcare providers may recommend various diagnostic procedures.
What tests might be conducted to diagnose the cause of severe menstrual pain?
- Pelvic exam
- Ultrasound
- Laparoscopy
- Hysteroscopy
- Magnetic Resonance Imaging (MRI)
- Blood tests to check hormone levels
Understanding the spectrum of menstrual pain, from normal discomfort to severe cramps, is crucial for proper management and timely medical intervention. By recognizing the signs of severe menstrual cramps and exploring various relief strategies, individuals can work towards finding effective solutions for their menstrual pain. Whether through lifestyle modifications, medical treatments, or alternative therapies, there are numerous approaches to alleviate the burden of severe menstrual cramps and improve quality of life during menstruation.
Normal vs. Severe Pain, Causes, Relief Tips
Severe Menstrual Cramps: Normal vs. Severe Pain, Causes, Relief Tips
- Health Conditions
- Featured
- Breast Cancer
- IBD
- Migraine
- Multiple Sclerosis (MS)
- Rheumatoid Arthritis
- Type 2 Diabetes
- Articles
- Acid Reflux
- ADHD
- Allergies
- Alzheimer’s & Dementia
- Bipolar Disorder
- Cancer
- Crohn’s Disease
- Chronic Pain
- Cold & Flu
- COPD
- Depression
- Fibromyalgia
- Heart Disease
- High Cholesterol
- HIV
- Hypertension
- IPF
- Osteoarthritis
- Psoriasis
- Skin Disorders and Care
- STDs
- Featured
- Discover
- Wellness Topics
- Nutrition
- Fitness
- Skin Care
- Sexual Health
- Women’s Health
- Mental Well-Being
- Sleep
- Product Reviews
- Vitamins & Supplements
- Sleep
- Mental Health
- Nutrition
- At-Home Testing
- CBD
- Men’s Health
- Original Series
- Fresh Food Fast
- Diagnosis Diaries
- You’re Not Alone
- Present Tense
- Video Series
- Youth in Focus
- Healthy Harvest
- No More Silence
- Future of Health
- Wellness Topics
- Plan
- Health Challenges
- Mindful Eating
- Sugar Savvy
- Move Your Body
- Gut Health
- Mood Foods
- Align Your Spine
- Find Care
- Primary Care
- Mental Health
- OB-GYN
- Dermatologists
- Neurologists
- Cardiologists
- Orthopedists
- Lifestyle Quizzes
- Weight Management
- Am I Depressed? A Quiz for Teens
- Are You a Workaholic?
- How Well Do You Sleep?
- Tools & Resources
- Health News
- Find a Diet
- Find Healthy Snacks
- Drugs A-Z
- Health A-Z
- Health Challenges
- Connect
- Breast Cancer
- Inflammatory Bowel Disease
- Psoriatic Arthritis
- Migraine
- Multiple Sclerosis
- Psoriasis
Medically reviewed by Deborah Weatherspoon, Ph. D., MSN — By Adrienne Santos-Longhurst — Updated on February 28, 2023
If you have severe menstrual cramps that disrupt your daily life, regular exercise, heating pads, and some supplements could make a difference. For severe pain, a healthcare professional may be able to recommend strategies for lasting relief.
Menstrual cramps can range from a mild nuisance lasting a day or two to several days of unbearable pain that interferes with everyday activities. They’re one of the most common causes of pelvic pain and many experience them just before and during their period.
The pain is caused by uterine contractions that happen just before or during the onset of your period. But what makes the pain more severe for some people?
Read on to learn more about the potential causes of severe cramps and how to manage the pain.
Menstrual cramps feel like a throbbing or cramping pain in your lower abdomen. You may also feel pressure or a continuous dull ache in the area. The pain may radiate to your lower back and inner thighs.
Cramps usually begin a day or two before your period, peaking around 24 hours after your period starts. They typically last for two to three days.
Menstrual cramps can be accompanied by other symptoms, including:
- nausea
- fatigue
- loose stools
- headache
- dizziness
Typical menstrual cramps are painful, but they usually respond well to over-the-counter (OTC) pain relievers, including ibuprofen.
Severe cramps, however, tend to begin earlier in the menstrual cycle and last longer than typical cramps do.
signs of severe cramps
Not sure if your cramps are typical or severe? Generally, severe menstrual cramps:
- don’t improve when you take OTC pain medication
- interfere with your daily activities
- are often accompanied by heavy bleeding or clotting
During your period, your uterus contracts to help shed its lining. These contractions are triggered by hormone-like substances called prostaglandins. Higher levels of prostaglandins are associated with more severe menstrual cramps.
Some people tend to have more severe menstrual cramps without any clear cause. For others, severe menstrual cramps may be a symptom of an underlying medical condition.
Endometriosis
Endometriosis is a chronic, noncancerous condition where cells that resemble the uterus lining, called endometrial cells, grow outside the uterus.
Pelvic pain is the most common symptom. Others include:
- heavy periods
- periods that last longer than seven days
- bleeding between periods
- gastrointestinal pain
- pain with intercourse
- painful bowel movements
- trouble getting pregnant
Polycystic ovary syndrome (PCOS)
PCOS is a common hormone disorder affecting approximately 1 in 10 women of childbearing age. Higher levels of androgens, which are male hormones, and irregular periods are common symptoms.
Other symptoms of PCOS include:
- heavy periods
- prolonged periods
- excessive facial and body hair
- weight gain and trouble losing weight
- acne
- thinning hair or hair loss
- multiple skin tags
- dark patches of skin, especially in the creases of the neck and groin
Fibroids
Fibroids are noncancerous growths that develop inside or outside of the uterus. They range in size from as small as a seed to large masses that can cause an enlarged uterus. You can have one or more fibroids, often without symptoms.
When fibroids do causes symptoms, the symptoms vary depending on the number of fibroids, their size, and location.
In addition to severe mensural cramps, fibroids can also cause:
- pelvic pressure
- lower back pain
- leg pain
- heavy periods
- periods that last more than a week
- constipation
- frequent urination
- difficulty emptying the bladder
Pelvic inflammatory disease (PID)
PID is a bacterial infection of the female reproductive organs. It’s usually caused by sexually transmitted infections (STIs), such as chlamydia and gonorrhea. Other infections that aren’t sexually transmitted can also cause it.
Pelvic pain is the most common symptom of PID. Other symptoms include:
- painful intercourse
- bleeding during or after sex
- foul-smelling vaginal discharge
- burning sensation when urinating
- fever
- spotting between periods
Cervical stenosis
Cervical stenosis, which is also called a closed cervix, happens when the opening of your cervix is narrow or completely closed. You can be born with a cervical stenosis or develop it later.
A closed cervix can prevent menstrual blood from exiting your body, making your periods very light or irregular. It can also lead to fertility issues.
Adenomyosis
Adenomyosis is a thickening of the uterus. It occurs when the endometrial tissue that lines your uterus grows into the muscles of your uterus.
The tissue continues to function as it usually would throughout your cycle — thickening, breaking down, and exiting your body. This causes your uterus to grow two to three times its normal size.
Adenomyosis doesn’t always cause symptoms. When it does, you may notice severe menstrual cramps that get increasingly worse, as well as heavy or prolonged menstrual bleeding.
Intrauterine device (IUD)
An IUD is a small birth control device that’s inserted into your uterus. There are different types of IUDs available, some containing hormones while others are hormone-free.
They’re safe for most people, but they can occasionally cause side effects, including:
- severe menstrual cramps
- irregular periods
- heavy menstrual bleeding
There’s also a small risk of the IUD perforating your uterus during insertion or bacteria entering your uterus during insertion, causing PID. Expulsion is another rare possibility, which is when the IUD moves out of place. All of these can cause severe pelvic pain.
If you have very painful menstrual cramps or cramps that last longer than two or three days, make an appointment with your healthcare provider.
They’ll likely start by reviewing your medical history and performing a physical exam, including a pelvic exam. They may also give you a Pap test.
Depending on your other symptoms, they may recommend additional tests, including:
- an ultrasound to check the size and thickness of your uterus as well as detect fibroids or cysts
- a CT scan, which can provide a detailed view of your reproductive organs
- gynecologic laparoscopy, a minimally invasive surgical procedure, to confirm a diagnosis of endometriosis
Severe menstrual cramps are typically hard to treat on your own, but these tips may help while you work with your healthcare provider to narrow down an underlying cause:
- Get regular exercise. Results of a 2015 study showed that doing 30 minutes of aerobic exercise three times a week significantly reduced the severity of menstrual cramps over the course of 8 weeks.
- Use a heating pad. There’s evidence that heat may be as effective as ibuprofen for relieving menstrual cramps. Place a heating pad on your lower abdomen for relief.
- Manage your stress. Work and general life stress has been linked to menstrual cramps. Breathing exercises, yoga, and spending time doing things that you enjoy can help keep your stress down.
- Soak in a hot bath. Soaking in a hot bath soothes your lower abdomen and back. It’s also relaxing and a great way to relieve stress.
- Take supplements. Certain supplements may help reduce the severity of menstrual cramps. These include omega-3 fatty acids, magnesium, and vitamins B-1 and B-6.
- OTC pain medication. OTC pain relievers, such as ibuprofen and acetaminophen, often aren’t enough to completely eliminate severe menstrual cramps. If you take them a day before you usually start to experience cramps, they may be more effective.
You don’t have to power through severe menstrual cramps. If your pain interferes with your ability to go on about your day or lasts longer than two or three days, talk to your healthcare provider. They can help you get to the bottom of what’s causing your severe cramps and recommend a plan to keep the pain under control.
Last medically reviewed on May 10, 2019
How we reviewed this article:
Healthline has strict sourcing guidelines and relies on peer-reviewed studies, academic research institutions, and medical associations. We avoid using tertiary references. You can learn more about how we ensure our content is accurate and current by reading our editorial policy.
- Adenomyosis. (2017).
my.clevelandclinic.org/health/diseases/14167-adenomyosis - Dehnavi ZM, et al. (2018). The effect of aerobic exercise on primary dysmenorrhea: A clinical trial study. DOI:
10.4103/jehp.jehp_79_17 - Dysmenorrhea. (2014).
my.clevelandclinic.org/health/diseases/4148-dysmenorrhea - Intrauterine device (IUD). (2017).
hhs.gov/opa/pregnancy-prevention/birth-control-methods/iud/index.html - Ju H, et al. (2014). The prevalence and risk factors of dysmenorrhea. DOI:
10.1093/epirev/mxt009 - Mayo Clinic Staff. (2018). Uterine fibroids.
mayoclinic.org/diseases-conditions/uterine-fibroids/symptoms-causes/syc-20354288 - Osayande AS, et al. (2014). Diagnosis and initial management of dysmenorrhea.
aafp.org/afp/2014/0301/p341.html - Parasar P, et al. (2017). Endometriosis: Epidemiology, diagnosis and clinical management.
ncbi.nlm.nih.gov/pmc/articles/PMC5737931/ - Pelvic inflammatory disease (PID) – CDC fact sheet. (2015).
cdc.gov/std/pid/stdfact-pid.htm - Polycystic ovary syndrome. (2019).
womenshealth.gov/a-z-topics/polycystic-ovary-syndrome - Rigi N, et al. (2012). Comparing the analgesic effect of heat patch containing iron chip and ibuprofen for primary dysmenorrhea: a randomized controlled trial. DOI:
10.1186/1472-6874-12-25
Our experts continually monitor the health and wellness space, and we update our articles when new information becomes available.
Current Version
May 10, 2019
Written By
Adrienne Santos-Longhurst
Edited By
Phil Riches
Medically Reviewed By
Deborah Weatherspoon, Ph.D., MSN
Share this article
Medically reviewed by Deborah Weatherspoon, Ph.D., MSN — By Adrienne Santos-Longhurst — Updated on February 28, 2023
related stories
How to Get Rid of Period Cramps: 14 Remedies to Try
What Do Period Cramps Feel Like?
What Helps Menstrual Cramps: 6 Home Remedies and OTC Options to Manage Pain
What’s the Link Between Tampons and Cramps?
9 Best Heating Pads for Cramps and Menstrual Pain Relief
Read this next
- How to Get Rid of Period Cramps: 14 Remedies to Try
Medically reviewed by Valinda Riggins Nwadike, MD, MPH
Period cramps are very common, but sometimes they can interfere with your daily life. Try these strategies to kick pain to the curb.
READ MORE
- What Do Period Cramps Feel Like?
Medically reviewed by Valinda Riggins Nwadike, MD, MPH
During menstruation, hormone-like chemicals called prostaglandins trigger the uterus to contract to help your body get rid of the uterine lining. This…
READ MORE
- What Helps Menstrual Cramps: 6 Home Remedies and OTC Options to Manage Pain
Medically reviewed by Valinda Riggins Nwadike, MD, MPH
Looking for quick relief from your menstrual cramps? From scientifically proven to popular treatments, find out what can work for you.
READ MORE
- What’s the Link Between Tampons and Cramps?
Medically reviewed by Deborah Weatherspoon, Ph.D., MSN
Do tampons really make cramps worse? We break down why they don’t and offer tips for soothing cramps — regardless of what’s causing them.
READ MORE
- 9 Best Heating Pads for Cramps and Menstrual Pain Relief
Medically reviewed by Deborah Weatherspoon, Ph. D., MSN
Cramps are a pain, but a heating pad may help. Here are nine options, including electrical, microwaveable, and more.
READ MORE
- What Helps Menstrual Cramps: 6 Home Remedies and OTC Options to Manage Pain
Medically reviewed by Valinda Riggins Nwadike, MD, MPH
Looking for quick relief from your menstrual cramps? From scientifically proven to popular treatments, find out what can work for you.
READ MORE
- The Best Positions to Help Period Cramps at Work, in Bed, or on the Mat
Medically reviewed by Valinda Riggins Nwadike, MD, MPH
If you’re experiencing period pain, a few adjustments can go a long way.
READ MORE
- Dutasteride is Being Offered Off-Label To Treat Hair Loss. Does It Work?
Many brands are now offering oral and topical dutasteride (a medication approved to treat BPH) off-label directly to consumers to help prevent hair…
READ MORE
- The Ketogenic Diet: A Detailed Beginner’s Guide to Keto
By Rudy Mawer, MSc, CISSN
The ketogenic diet (keto) is a low-carb, high-fat diet that causes weight loss and provides numerous health benefits. This is a detailed beginner’s…
READ MORE
- Blood Clots After Birth: What You Need to Know
It’s normal to have blood clots after giving birth, but sometimes too many or very large blood clots can be cause for concern. Bleeding can continue…
READ MORE
Period Pain: Could It Be Endometriosis?
Reviewed By:
No woman looks forward to “that time of the month.” Most of us deal with mood swings, bloating and cramps, which are never fun. But women with endometriosis often find getting a period particularly unbearable. For them, an average period is anything but average, with debilitating cramps.
During a typical menstrual cycle, the lining inside your uterus — the endometrium — builds up and is then shed. And, well, you know what happens then. In women with endometriosis, that lining grows outside the uterus, usually around the ovaries or beneath the uterus in an area called the posterior cul-de-sac. As it builds up and breaks down, it causes small amounts of bleeding inside the pelvis. This leads to pain, inflammation, swelling and scarring.
If you think you might have endometriosis, know that you aren’t alone. The condition affects hundreds of thousands of women every year. Even Lena Dunham, star of the television show Girls, brought widespread attention to this condition by talking about her own diagnosis and subsequent surgeries to correct it.
Watch Out for These Five Symptoms
Johns Hopkins gynecologist Mindy Christianson, M.D., says there are five common signs of endometriosis. Here’s what you should watch out for:
- Painful periods. Most of us have cramps during our periods, but women with endometriosis often have debilitating pain.
- Chronic pelvic pain. Sometimes women have chronic and severe pelvic pain even when they don’t have their periods, Christianson says. This can be due to prolonged disease and scarring.
- Painful intercourse. This common symptom, also known as dyspareunia, is due to endometriosis beneath the uterus. During penetration, women might have intense, localized pain.
- Ovarian cysts. These cysts, known as endometriomas, are another hallmark of endometriosis. They can become large and painful, and often need to be removed.
- Infertility. Infertility is defined as not conceiving within one year despite regular sexual intercourse without contraception. About 10 percent of women living with infertility have endometriosis. “This is the leading cause of infertility because it can cause scar tissue as well as damage and inflammation to the fallopian tubes, which are needed to conceive naturally,” Christianson explains. “Research also shows that endometriosis can affect egg quality and reduce the number of eggs in the body.”
The symptoms above aren’t exclusive to endometriosis, Christianson says. Painful periods don’t always point to endometriosis; sometimes they’re a separate condition known as dysmenorrhea. Pelvic pain can also be caused by scar tissue, previous infections or a history of appendicitis. Irritable or inflammatory bowel syndromes can also cause pelvic pain.
Diagnosing and Treating Endometriosis
If you have any of the above symptoms, see your gynecologist. Women with infertility might be referred to a reproductive endocrinologist or a fertility specialist. Some doctors also specialize in pelvic pain and endometriosis.
To confirm a diagnosis, your doctor will likely perform a minimally invasive laparoscopy. During this procedure, a thin, lighted tube will be put into a tiny abdominal incision. This allows your doctor to see your pelvic organs and take a small amount of tissue for biopsy to make a diagnosis.
Often, symptoms can be controlled with medications like birth control pills or leuprolide acetate. Both suppress the pituitary from releasing hormones that make endometriosis grow.
Sign Up for Our Free Newsletter
One of the best things you can do to protect and improve your health is to stay informed. Your Health is a FREE e-newsletter that serves as your smart, simple connection to the world-class expertise of Johns Hopkins.
Sign Up
Painful menstruation – causes, diseases, diagnosis and treatment
I confirm
More
- INVITRO
- Library
- Symptoms
- Painful menses
Dysmenorrhea
Endometriosis
Myoma
PCOS
Tumor
26666
05 July
Painful menstruation – the causes of occurrence, in which diseases occur, diagnosis and methods of treatment.
Almost half of girls and women experience painful menstruation (dysmenorrhea). For many of them, pain and discomfort lead to disability within 1-3 days. Clinicians do not attribute this condition to an independent disease, but associate it with a menstrual cycle disorder, which is manifested by cramping or pulling pains in the lower abdomen and in the lumbar region during menstrual bleeding. Pain can be aggravated by other unpleasant symptoms: headache, nausea, fainting. The cause of pain is spastic uterine contractions, during which the endometrium is rejected.
Dysmenorrhea can be based on neurogenic, metabolic and psychological disorders, which must be taken into account in the diagnosis.
Varieties
Dysmenorrhea can be primary (not associated with pathology of the pelvic organs) or secondary (against the background of pathologies of the pelvic organs, due to urogenital diseases and inflammatory processes). Depending on the stage of the disease, there are compensated (the intensity of pain is constant for a long time) and decompensated (symptoms become more pronounced every year) forms.
What diseases cause dysmenorrhea
Adolescent girls are characterized by primary dysmenorrhea, the cause of which is difficult to identify. The basis of primary dysmenorrhea is the accumulation of prostaglandins – physiologically active substances – in the endometrium of the uterus, which cause its spastic contractions.
Excess production of prostaglandins is the result of hormonal changes during puberty.
The occurrence of menstrual pain can provoke the hormone vasopressin. An increase in its level in the blood leads to stagnation of blood in the tissues of the small pelvis.
Secondary dysmenorrhea is caused by various gynecological and infectious diseases.
Sometimes inflammatory processes and adhesions in the pelvic organs lead to dysmenorrhea.
Diagnostics and examination
When diagnosing dysmenorrhea, the woman’s age, concomitant or past diseases, data from a general examination, and ultrasound are taken into account. If the age of the patient does not exceed 25-30 years and the examination did not reveal other diseases, the diagnosis of primary dysmenorrhea is most likely. To confirm the diagnosis, the doctor prescribes a series of tests and tests. It is necessary to assess the hormonal background, first of all, the determination of estradiol levels
Estradiol (E2, Estradiol)
Synonyms: Blood test for estradiol. 17-beta-estradiol.
Brief description of the analyte Estradiol
Estradiol is a steroid hormone with maximum estrogen…
Up to 1 business day
Available with house call
715 RUB
Add to cart
and progesterone.
Progesterone
Synonyms: Progestin; Gestagen. P4; Pregn-4-ene-3,20-dione.
Brief description of the analyte Progesterone
Progesterone is produced in the ovaries and in a small. ..
Up to 1 business day
Available with house call
705 RUB
Add to cart
If pain during menstruation appeared in a woman 30 years of age or older, this may indicate the development of endometriosis or the growth of a myomatous node.
Endometriosis is the growth of endometrial cells (the inner layer of the uterine cavity) on its surface and / or in the tissues of nearby organs.
The disease can occur both in women who have given birth, who have undergone abortions or diagnostic curettage, and in nulliparous women suffering from infertility.
If the cause of dysmenorrhea is inflammatory diseases, then the pain is characterized by a different temporary appearance. They increase before the onset of menstruation, and after the first day their intensity decreases. In addition, pulling and aching pains also occur in the pelvic area. In this case, the study of the smear and the identification of the pathogen in the discharge of the cervical canal and vagina confirms the diagnosis.
Ultrasound of the pelvic organs is also prescribed to clarify the diagnosis,
Ultrasound of the soft tissues
Examination of soft tissues to detect pathological changes and diagnose neoplasms.
RUB 1,790
Sign up
hysterosalpingography
Hysterosalpingography (Hysterosalpingography)
Hysterosalpingography (HSG) is a method of radiographic examination of the state of the uterine cavity and patency of the fallopian tubes using a contrast agent …
RUB 9,490
Sign up
hysteroscopy.
When diagnosing the causes of dysmenorrhea, one should not exclude such a pathological process as genital tuberculosis, the prevalence of which has increased significantly in recent years. Sometimes the first sign of the disease is infertility. Accompanying symptoms may include lack of appetite, unreasonable weight loss, night sweats, constant body temperature in the range of 37.1-38.0 ° C.
Dysmenorrhea can be caused not only by hormonal imbalance and diseases of the pelvic organs. Intrauterine devices (IUD)
sometimes set without taking into account contraindications and additional examinations.
If the spiral is chosen incorrectly, this can lead to menstrual irregularities and dysmenorrhea.
Which doctors to contact
With the exception of dysmenorrhea caused by genital tuberculosis, women with complaints of painful menstruation are treated by a gynecologist. If a neurogenic and psychosomatic component of dysmenorrhea is detected, a psychotherapist can be involved in the treatment.
What to do
Many women think that painful periods are normal and limit themselves to taking painkillers for a long time. Without establishing a correct diagnosis, these measures often lead to a gradual increase in pain. Even if it is possible to stop pain with the help of anti-inflammatory drugs, it is necessary to find out its cause, which is especially important in secondary dysmenorrhea.
Treatment
In primary dysmenorrhea, treatment is aimed at restoring the hormonal background and stopping the pain syndrome.
The first task is solved by the use of hormonal drugs, the choice of which is determined by the severity of dysmenorrhea.
The doctor can individually select combined oral contraceptives (COCs). The results of studies show that after a year of using COCs, the menstrual cycle normalizes, and the effect persists even after stopping these drugs.
Physiotherapeutic procedures serve as an additional method of treatment: magnetotherapy, transcutaneous electrical nerve stimulation, ultrasonic waves, ultraviolet rays, laser radiation, acupuncture, gynecological massage, etc. Local impulse effect on the pelvic organs leads to an acceleration of recovery and compensatory processes in the body . Positive results are obtained by non-drug methods of treatment: physiotherapy exercises (exercise therapy), proper nutrition with the mandatory inclusion of products containing vitamins B1, B6 and E.
A number of studies have noted the importance of introducing magnesium preparations into the therapeutic course, since it is involved in the regulation of muscle contractions. If the analysis reveals a lack of magnesium in the blood,
Serum magnesium (Magnesium, Serum; Mg)
Synonyms: Blood test for magnesium; total magnesium; Magnesium ions. Serum Magnesium Test; Magnesium test; Magnesium, blood; serum magnesium.
Brief description of the analyzed analyte Magnesium
…
Up to 1 business day
Available with house call
420 RUB
Add to cart
Your doctor may recommend taking a combination of magnesium and vitamin B6 to normalize your menstrual cycle.
Pregnancy and childbirth in most cases lead to the weakening or disappearance of primary dysmenorrhea.
Treatment for secondary dysmenorrhea depends on the cause of the pain.
Endometriosis, as the most common cause of secondary dysmenorrhea, requires complex and long-term treatment. Removal of the endometrium does not eliminate the recurrence of the disease after a few years. Based on the results of clinical trials, doctors recommend long-term drug therapy after surgery. As a rule, in mild forms of endometriosis, combined oral contraceptives, progestogen preparations are prescribed. The clinical efficacy of dienogest in endometrioid lesions has been proven. This drug well relieves pain associated with endometriosis and pain in the pelvic organs.
Cervical stenosis (narrowing of the cervical canal) is treated by dilating the cervix. A stable result is given by pregnancy and vaginal delivery.
Treatment of adhesions, which may be due to diseases such as cervicitis (inflammation of the cervix) and pelvic inflammatory disease, includes a range of measures from symptomatic therapy (non-steroidal anti-inflammatory drugs) to surgical excision of adhesions. In some cases, antiprostaglandin drugs are effective.
Sources:
- Clinical guidelines “Endometriosis”. Developed by: Russian Society of Obstetricians and Gynecologists. – 2020.
- Clinical guidelines “Hyperplasia of the endometrium”. Developed by: Russian Society of Obstetricians and Gynecologists. – 2021. Tags: dysmenorrhea, endometriosis, infertility
IMPORTANT!
The information in this section should not be used for self-diagnosis or self-treatment. In case of pain or other exacerbation of the disease, only the attending physician should prescribe diagnostic tests. For diagnosis and proper treatment, you should contact your doctor.
For a correct assessment of the results of your analyzes in dynamics, it is preferable to do studies in the same laboratory, since different laboratories may use different research methods and units of measurement to perform the same analyzes.
Recommendations
Hypervitaminosis A
49
June 18
Narrow basin
30751
12 June
Increased thirst
83
May 18
Show more
Colpitis
Cystitis
Chlamydia
Prostatitis
Urethritis
Trichomoniasis
Cervicitis
Fungus 9000 3
Thrush
Urolithiasis
Tumor
Pain during urination
Pain during urination is a symptom of a number of diseases and should be reason for a thorough investigation.
More
Menopause
Acne (acne)
Thyrotoxicosis
Climax
Pregnancy
Delayed menstruation
Delayed menstruation is a problem that every woman has faced at least once in her life. The main thing is to understand what caused the delay, and then decide what to do next.
More
Gastritis
Tumor
Volvulus
Constipation
Constipation is a violation of regular bowel movements. Doctors believe that the diagnosis of “chronic constipation” can be made if bowel movements occur less than three times a week, or if the amount of stool during bowel movements is extremely small.
More
Diabetes mellitus
Angina
Tonsillitis
Epiglottitis
Pharyngitis
Diffuse goiter
Thyroiditis
9000 2 Tumor
Dyskinesia of the esophagus
Lump in the throat
Feeling of a lump in the throat is not uncommon. Many have experienced this painless but uncomfortable condition at least once in their lives.
More
Fungus
Allergy
Sulfur plug
Adenoids
Hearing loss
Tumor
Ear congestion
For Ear deformity: causes, diagnosis and treatment.
More
Nothing found
Try changing your query or select a doctor or service from the list.
Doctor not found
Try changing your query or select
doctor from list
Medical office not found
Try changing your query or select
medical office from the list
Therapist
Traumatologist-orthopedist
Endocrinologist
Urologist
Gynecologist
Ultrasound doctor
Cardiologist
Pediatrician
Nothing found
Please try editing your query
Thank you!
You have successfully made an appointment
Detailed information has been sent to your e-mail
Subscribe to our newsletters
Enter e-mail
I consent to
processing of personal data
Subscribe
PAIN DURING MENSTRUCTION AND HORMONAL FAILURE: HOW IS IT RELATED? – Toast
Painful periods are sometimes considered normal. Statistics say that severe pain during menstruation (dysmenorrhea) is regularly experienced by 10-15%, periodically – up to 70% of women of childbearing age. In fact, this is not the norm, but a violation of the menstrual function, by correcting which, you can get rid of the pain.
For many of them, pain and discomfort lead to loss of working capacity within 1-3 days. Clinicians do not refer to this situation as an independent disease, but associate it with a menstrual cycle disorder, which is manifested by cramping or pulling pains in the lower abdomen and in the lower back during menstrual bleeding. Pain can be aggravated by other unpleasant symptoms: headache, nausea, fainting. The cause of the pain is spastic uterine contractions, during which the rejection of the endometrium occurs.
Dysmenorrhea may be based on neurogenic, metabolic and psychological disorders that must be taken into account in the diagnosis.
WHAT DISEASES CAUSE DYSMENORRHEA?
Adolescent girls are characterized by primary dysmenorrhea, the cause of which is difficult to identify. The basis of primary dysmenorrhea is the accumulation of prostaglandins – physiologically active substances – in the endometrium of the uterus, which cause its spastic contractions. Excess production of prostaglandins is the result of hormonal changes during puberty.
The occurrence of menstrual pain can be triggered by the hormone vasopressin. An increase in its level in the blood leads to stagnation of blood in the tissues of the small pelvis.
DIAGNOSTICS AND EXAMINATION
When diagnosing dysmenorrhea, Zdravitsa doctors take into account the woman’s age, concomitant or past diseases, general examination data, and ultrasound examination. If the patient’s age does not exceed 25-30 years and no other diseases are found during the examination, the diagnosis of primary dysmenorrhea is most likely. To confirm the diagnosis, the doctor prescribes a list of tests and samples. An assessment of the hormonal background is necessary, first of all, the determination of the level of estradiol. If pain during menstruation appeared in a woman 30 years of age or older, this may indicate the development of endometriosis or the growth of a myomatous node.
TREATMENT:
Many women think that painful periods are normal and limit themselves to taking painkillers for a long time. Without establishing a correct diagnosis, these measures often lead to a gradual increase in pain. Even if pain can be treated with anti-inflammatory drugs, it is necessary to find out its cause, which is especially important in secondary dysmenorrhea.
In primary dysmenorrhea, treatment is aimed at restoring hormonal levels and reducing pain. The first task is solved by the use of hormonal drugs, the choice of which is determined by the severity of dysmenorrhea.
Menstrual pain should not be ignored. If the cause that causes them is not eliminated, in addition to the unpleasant sensations and consequences of a possible gynecological disease, you can get a decrease in sexual desire and even infertility.