Menstrual Pains: Don’t Let Them Cramp Your Style
Menstrual Pain: Are debilitating menstrual pains significantly reducing your productivity levels at school, university, and work? Do you find yourself missing out on an active social life due to menstrual cramps that persist beyond the initial three days of your period?
Have you noticed that even potent pain medication doesn’t alleviate your menstrual pain?
If you answered yes to the above questions, you may be suffering from dysmenorrhea.
Menstrual cramps, medically referred to as dysmenorrhea, manifest as sharp, painful sensations affecting the lower abdomen and back. Our periods come with a range of internal menstrual symptoms, with menstrual pain being the primary one. The intensity of period cramps varies from dull and mildly uncomfortable to excruciating shooting pains. Menstrual cramps typically begin shortly after ovulation commences – when the ovaries release an egg, it travels down the fallopian tube, and menstrual cramps ensue.
Menstrual Pains – Overview
There are two main types of menstrual pains: primary and secondary dysmenorrhea.
Primary Dysmenorrhea: This type of period pain occurs in teenagers and women in their 20s due to an excess of natural prostaglandin hormones in the uterus lining. No external conditions or other illnesses trigger these menstrual cramps. Prostaglandins facilitate the contraction and relaxation of muscles and blood vessels in the uterus, causing menstrual pain. Prostaglandin levels are highest in the first one to two days of your period, but as the uterine lining sheds, the intensity of pain gradually decreases.
Secondary dysmenorrhea is menstrual pain caused by reproductive health disorders such as polycystic ovary syndrome, endometriosis, and uterine fibroids, which affect reproductive organs including the uterus. In this type, cramps begin a few days before menstrual periods and worsen over time. Often, the pain persists even after the period ends. Secondary dysmenorrhea is typically seen in women in their 30s and 40s.
The increase in prostaglandin levels causes the usual painless uterine contractions to become tighter and longer, reducing oxygen supply to muscles. This lack of oxygen in tense muscles leads to pain. The reasons for higher uterine prostaglandins in some women are often unclear, but those with painful periods generally experience significantly lower quality of life.
It’s important to understand your body to differentiate between typical and atypical menstrual symptoms. What may be routine for you could be a cause for concern for someone else.
Many women have internalized the idea that periods are meant to be highly uncomfortable, having witnessed their mothers and sisters endure painful periods without complaint. Shame and embarrassment surrounding menstruation often prevent women from accessing necessary menstrual products and seeking medical help for their pain. Those experiencing period cramps and heavy bleeding are often reluctant to discuss their pain, leading to difficulty in understanding the severity of their symptoms.
The first step in aiding doctors to better diagnose and treat menstrual disorders causing cramps is to eliminate the stigma surrounding menstruation by fostering open conversations about painful periods within families, among friends, and in the workplace.
Supporting policies that promote non-discrimination against menstruators and making menstruation a topic of essential discussion in society and healthcare will encourage more women to voice their concerns and share their experiences with pain. Continuous education and supportive communities can break the silence and taboo surrounding menstruation.
Since menstrual periods reflect overall health, sudden changes in menstrual health should not be ignored as they could indicate underlying issues. It’s crucial to recognize that intense cramping and irregular cycles are not normal and may signal that our bodies are not functioning optimally.
Also Read:
The main symptoms of menstrual cramps to be aware of include:
- Combination of congestive and spasmodic pain
- Severe pressure in the abdomen
- Throbbing pain in the uterus throughout the menstrual period
- Persistent aching in the lower abdomen, which can escalate suddenly
- Heavy menstrual bleeding, often accompanied by the passage of blood clots and tissue
- Spread of menstrual cramps to the inner thighs, hips, and lower back
- Headaches, nausea, and dizziness
- Digestive disturbances such as vomiting, constipation, or diarrhea
Menstrual Pain and its Complexities – Key Challenges
Here are some significant challenges associated with menstrual pain:
- Premenstrual syndrome (PMS) – This encompasses a decline in progesterone and estrogen levels in the week preceding the period, leading to symptoms such as heavy bleeding, severe menstrual pain, weight gain, acne breakouts, fatigue, and changes in appetite. More extreme cases may be diagnosed as premenstrual dysphoric disorder (PMDD).
- Menstrual Disorders – Menstrual pains are often indicative of conditions like endometriosis and adenomyosis. In endometriosis, uterine tissues migrate and implant on organs such as the ovaries, fallopian tubes, and bladder, subsequently breaking down and bleeding during menstruation, exacerbating the pain. Left untreated, these disorders can lead to uterine scarring and the development of painful blood-filled cysts in the ovaries.
- Polycystic Ovary Syndrome (PCOS) – Hormonal imbalances associated with PCOS result in enlarged ovaries and the formation of cysts on their periphery, exacerbating menstrual pain.
- Menopause – Painful period cramps can also indicate the onset of menopause, as hormonal fluctuations during this stage, leading to irregular periods, may cause intensified menstrual cramps.
- Uterine Defects – Menstrual cramps are often correlated with uterine abnormalities such as the presence of two uteri converging into one cervix, or the existence of fibrous tissue bands. Benign uterine fibroids, which develop in and around the uterus, can also cause increased blood flow and pressure, resulting in menstrual pain.
- Ectopic Pregnancy – Complications in pregnancy, such as ectopic pregnancy where the fertilized egg attaches outside the uterus, can manifest as menstrual pain and heavy bleeding.
- Pelvic Inflammatory Disease (PID) – Bacterial infections like PID, affecting the cervix, ovaries, fallopian tubes, and uterus, can cause menstrual cramps.
- Weight Gain – Rapid weight gain prompts increased estrogen release by fat cells, leading to estrogen dominance and subsequently more painful and frequent periods.
- Cervical Stenosis – Menstrual pain is a common symptom of cervical stenosis, where the narrow opening of the cervix impedes blood flow during menstruation, increasing uterine pressure and triggering cramps.
Diagnosis Menstrual Pain
Initially, your doctor will conduct a pelvic examination to identify any abnormalities in your reproductive organs and then review your medical history.
To pinpoint the underlying cause of your persistent menstrual pains, your doctor may recommend additional tests such as:
Ultrasound – This involves creating an image of your uterus, cervix, ovaries, and fallopian tubes using sound waves.
CT scan and MRI – These non-invasive and painless procedures produce detailed cross-sectional images of bones and soft tissues throughout your body.
Laparoscopy – During laparoscopy, a fiber-optic tube with a tiny camera lens is inserted into your abdomen to provide a clearer view of your internal organs. This procedure helps detect conditions like endometriosis, adhesions, fibroids, ovarian cysts, and ectopic pregnancy.
