Why do I have such severe menstrual pain, and how do I help relieve it?

Question

Ever since I have had my period I have experienced severe menstrual pain in my lower abdomen pelvic area. What could be causing this? I endure this pain each and every period that I get. I've tried Aleve and Midol and they don't seem 2 work, so are there any other methods 2 stop this chronic pain? Please help :-)

Answer 1

Look into a diagnosis of Endometriosis. For info, see www.endocenter.org.

Derived from the Greek words dys, meaning “difficult,” meno, meaning monthly, and rrhea, meaning “flow,” dysmenorrhea is the term used to describe painful menstrual cramping.

Almost all menstruating women experience some cramping during their periods, referred to as either primary dysmenorrhea, which refers to "normal" menstrual pain, or secondary dysmenorrhea, which arises as a result of an underlying disease or disorder. The condition is among the leading complaint in women who present to their physicians for gynecologic pain. More than half of all menstruating women have pain associated with menses, and studies have shown that dysmenorrhea is one of the most common reasons women miss work and/or school. Nearly 10% of women with the condition are incapacitated for up to three days each month[1].

"Normal" menstrual cramps occur in almost all women due to the release of hormones known as prostaglandins. These are hormones produced by the endometrium (the lining of the uterus), which cause the uterus to contract, sometimes quite painfully, in order to expel the menstrual debris. Some women produce higher levels of prostaglandins than others, so they may hurt more. Increased prostaglandin production can also cause the distressing gastrointestinal symptoms some women may experience. Primary dysmenorrhea most commonly occurs within a few years of menarche (a woman’s first period), while secondary dysmenorrhea can occur years after the onset of menarche.

Pain with primary dysmenorrhea usually begins on or about the first day of a woman’s period and can last up to 72 hours. In a woman with secondary dysmenorrhea, she may have painful symptoms occurring a week or more prior to her period and lasting even after her flow has stopped. In the case of a woman who has secondary dysmenorrhea, there are other reasons for her pain, including diseases or conditions like Endometriosis, Adenomyosis, Pelvic Inflammatory Disease, cervical stenosis, structural abnormalities in the vagina or uterus itself, fibroids, or similar concern.

Dysmenorrhea can be diagnosed based on symptoms, patient history, physical findings, and when appropriate, diagnostic tests such as vaginal or pelvic ultrasound, hysteroscopy (an examination of the inside of the uterus) and/or hysterosalpingogram (an evaluation of the uterus and fallopian tubes). In cases of secondary dysmenorrhea, laparoscopic surgery can be very beneficial at affording a diagnosis and treatment of the underlying cause. Symptoms often include painful pelvic or abdominal cramping, headache, suprapubic cramping (an area of the pelvis overlying the bladder), backache, pain radiating down into the thigh area, nausea/vomiting/diarrhea and even syncope (a temporary of consciousness). Upon physical exam, those with primary dysmenorrhea exhibit normal vital signs and a tender uterus, but no cervical or ovarian abnormalities. Patients with secondary dysmenorrhea may exhibit varied vital signs depending on the underlying cause and may be found to have tenderness, nodules, and/or enlargement of the uterosacral ligaments, the rectovaginal septum or other adnexa (the region of the pelvis that encompasses the ovary, fallopian tube and surrounding broad ligament).

Treatment options are based on the underlying cause of the pain (primary v. secondary dysmenorrhea) and range from medical to alternative therapies. Commonly, Non-Steroidal Inflammatory Drugs (NSAIDs) like aspirin or ibuprofen may be recommended to help with cramping, and more recently, COX-2 inhibitors have also been approved for treatment of dysmenorrhea. Prescription painkillers may also be recommended where appropriate. Combination (ethynylestradiol and progestin) oral contraceptives can also help reduce prostaglandin production, thereby alleviating the cramps. Heating pads can also offer temporary resolve of the pain. Avoidance of smoking (which has been shown increase cramps) and reduced intake or total avoidance of salt, sugar, high fat and dairy products, alcohol and caffeine can also afford relief, as can increasing the intake of fiber, calcium and complex carbohydrates. Recent studies also indicate that Vitamin B6 complex, calcium and magnesium supplements, and Omega III fatty acids (fish oil supplements) also may help relieve cramping. Pelvic massage, exercise (which releases endorphins, the body’s own natural painkillers), Yoga (the cat stretch and the pelvic tilt), visualization techniques, aromatherapy, acupuncture and herbs like Dong Quai, Ginseng, Stragalus root, Ligusticum root and White Peony root are also said to be helpful alternative techniques for managing the pain.

If Endometriosis or another disorder is the underlying or secondary cause for dysmenorrhea, you will benefit most from having the disease diagnosed and effectively removed. It is important to determine if the cramps are "normal," or if they could be due to another cause. Pain that is crippling or incapacitating is never normal and should be investigated as soon as possible so that appropriate diagnosis and subsequent treatment can be rendered.

Reference:
[1] Jamieson DJ, Steege JF. The prevalence of dysmenorrhea, dyspareunia, pelvic pain, and irritable bowel syndrome in primary care practices. Obstet Gynecol. 1996;87(1):55-58.

Answer 2

Certain birth control pills can help with the pain and flow of blood.

Hot water bottles are also good at lessening pain

Doing squats or bunny hops can help as it works the affected muscles

I swear by a machine called a tens machine which you put pads on the affected area where the pain is and it gives extremely slight shocks which stimulate the body's natural pain relievers.
Women use these in childbirth as well nowadays and they really help to control pain

Answer 3

There is a new birth control pill on the market that helps you with just that. My best friend has the same problem and she is going to be starting this soon. You will only have your period once every 4 months, so you don't have to go through that pain every month. Consult your Doctor for more information.

Answer 4

This is what I have found to help (preventive)
get plenty of exercise
drink plenty of water
eat a healthy diet...when my diet is bad my cramps are usually worse.

There are herbal teas and homeopathic medicines that will help relieve the cramps(check at the health food store or natural market) and I have also found stretching to help.

Check with your doctor just to make sure everything is a okay.

Answer 5

ooch...I truly understand. try a heating pad with the Midol, and drink alot of water. water will help flush out your system and help all of your body parts work better. it will also help with the tiredness during that time. so.... heating pad, midol, and water. I know you may not want to, but regular excercise will help future .'s also. hope you feel better.

Answer 6

a few days before your period, try this exercise: sit on the edge of a chair, hold on to both sides of your seat, raise your knees and bring them down (repeat 10 times). your abdominal muscles will contract during the process. try this everyday before and even the first few days of your period. i hope this works for you.