In high school health classes, embarrassed students watch movies featuring menstruating teens and women living happily active lives. In truth, some of us are crippled by severe cramps during each cycle, which affects our quality of life.
That is not right. You shouldn’t feel so exhausted from your period that you miss school, work, or family responsibilities because of it.
Be your own advocate. If you experience severe pain during menstruation, find the cause and ways to fix the problem.
Why are periods painful?
Painful periods can begin as early as the first menarche, a girl’s first cycle. In most cases, they start sometime after that during the reproductive years, during the 20s and 30s, or even when women are in their 40s and perimenopausal.
Painful periods are called dysmenorrhea and can be caused by a variety of factors, including:
- endometriosis. The uterine cavity is lined with tissue called the endometrium, which is what is shed when you menstruate. With endometriosis, that tissue begins to grow on the outside of the uterus, possibly reaching the ovaries, fallopian tubes, intestines, bladder, or other organs. That can cause pain during menstruation, and at other times as well.
- Adenomyosis. With adenomyosis, the lining grows into the muscular layer of the uterus, called the myometrium, which can cause painful periods.
- a combo With advances in imaging, doctors are now finding crossroads where women have endometriosis and adenomyosis at the same time.
- fibroids. Fibroids are noncancerous growths, or tumors, of the uterine muscle cells. Some are asymptomatic and therefore do not bother. Others cause heavy bleeding, including blood clots. The uterus is a muscle (technically a muscular organ) and it contracts to expel those clots. Contractions are cramps that can cause painful menstrual cycles.
- Primary dysmenorrhea. When doctors can’t find a specific cause for painful periods, they use the term “primary dysmenorrhea” as a diagnosis. In these cases, your pain may come from “inflammatory mediators” caused by substances like prostaglandins, in which when the uterine muscle contracts, it causes cramps.
How Doctors Diagnose Painful Periods
If your doctor doesn’t ask you if you have pain when you menstruate, provide the information. Usually a general practitioner or gynecologist can help you find a solution. Otherwise, find a specialist.
In most cases, your doctor will ask for a complete history of your health. Then, during a physical exam, look for fibroids or an enlarged uterus. You may be sent for an imaging test, such as an ultrasound or MRI, to take a closer look at your reproductive organs. If the doctor needs more information, he or she may suggest exploratory laparoscopic surgery. In that case, during an outpatient treatment, the doctor will make small incisions in the abdomen and then use a camera to look inside for possible problems.
How to prevent and treat painful periods
This is what you really need to know. Depending on the cause and your preference, you can often treat your painful periods with holistic treatments, non-surgical medical solutions, and minimally invasive surgical alternatives.
Non-surgical ways to treat painful periods. If you’re not too incapacitated by painful periods, any of these simple steps can make you feel better:
- Over-the-counter pain relievers such as aspirin, ibuprofen, naproxen, or acetaminophen, which decrease pain and/or reduce inflammation
- Diet changes, such as less caffeine and alcohol.
- Foods that reduce inflammation, including turmeric.
- A heating pad over the midsection
- Acupuncture and acupressure treatments
- Aerobic exercise, which reduces stress hormones that can increase pain
- Hydration, as studies have shown that menstruation pain is less when women are well hydrated.
- Certain herbal teas and supplements
- Nerve stimulation using a TENS (transcutaneous electrical nerve stimulation) device, which can temporarily relieve pain. They are sold to consumers in stores and online.
Medical ways to treat painful periods. These common treatments often significantly reduce menstrual cramps:
- Birth control pills, contraceptive vaginal rings, and hormonal IUDs contain estrogen and progesterone/progestin, or progestin alone. These items may cause less pain, or even cause you to skip some monthly cycles altogether.
- Minimally invasive surgeries may remove the cause of the pain. For example, during a myomectomy, your doctor will remove the fibroids robotically and laparoscopically, but leave the uterus in place. In the case of endometriosis disease, the doctor will remove the endometriosis.
- In certain cases, women who plan to have no more children may choose to have a hysterectomy, a surgery that removes the uterus.
Knowledge is power. Talk loud. Find out what is causing your painful periods. Then take steps, big or small, until you no longer feel terribly uncomfortable during your monthly cycles.
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