Finding clues to solving problems – Why is it painful?
Though we call a variety of menstrual pains "cramps", the areas of pain and perceptions of it differ slightly from woman to woman. So we compiled a list of the types of pain that people are suffering from, and asked gynecologists questions about all of them!
Why is it painful?
If it is not caused by an illness, you have functional dysmenorrhea
If you do not have any particular illness but still suffer from such severe pain that you have to lie down, that means you have functional dysmenorrhea. This is attributed to a contraction of the uterus as it tries to push menstrual blood out, to pelvic congestions due to hormone imbalances, to impaired blood circulation, and to stress.
Major symptoms are lower abdominal pains at around day 2-3 of the period, when the flow increases. Sometimes you may have shoulder stiffness/aching, swellings, nausea, irritability, and drowsiness. There are sometimes pains other than abdominal pain; pelvic congestions may cause poor blood circulation in the lower body inducing lower back pain, and autonomic insufficiency may lead to brain vasodilatation, causing headaches.
Symptoms and severity of cramps alternate each cycle
Usually an ovulation happens from one ovary at a time, alternately. Hormonal conditions determine the amount of the flow, as well as the severity of pain and accompanying symptoms.
Some people only have cramps every other month. This may be attributed to a high sensitivity of one of the ovaries. This may be due to various reasons such as endometriosis cysts on one of the ovaries.
Age and changes of living environment influence pain as well
It is said that the more your body matures, the less the menstrual pain. However, that is not always the case. Changes in the living environment or stress may lead to severe pain as well. Also, the oft-repeated theory that "childbirth cures cramps" (as childbirth dilates the cervix, thus helping the flow to run smoothly) does not apply to everyone.
Excess hormones that induce labor pains
Quite a few women in their 20s have cramps due to excessive prostaglandin, a hormone that is generated in the Endometrial membrane. This hormone stimulates the uterus to contract. If this hormone is secreted excessively when the uterus tries to push out menstrual blood, the uterus contracts rapidly, causing pain. On a related note, labor pains are also caused by prostaglandin. If you take medicines that interfere with the generation of this hormone, it helps to reduce cramps.
Organic dysmenorrhea caused by illness
Some menstrual pains are attributed to illness. Illnesses such as endometriosis and fibroids, or pains caused by adhesions that result from inflammations are called organic dysmenorrhea. In such cases, you need to treat those underlying illnesses.
Treatments at hospitals
When should you visit a hospital?
If the pain is mild and you can bear it by taking non-prescription drugs once or twice, you need not worry too much. However, if the pain is so severe that you need to lie down and it affects your daily life, we recommend you visit a gynecologist.
Also, if you suddenly have more severe cramps, and along with this pain, you are also bleeding more, or feel pain during sexual intercourse and in bowel movements, this could be the result of an illness. Visit a gynecologist as soon as you can in order to determine the cause.
The key treatment is the alleviation of the pain
The gynecologist first checks to see if there are any underlying illnesses. If tests show no particular illnesses, you will be treated to alleviate the symptoms.
For pain, a pain reliever is prescribed. If you have excessive prostaglandin, a medicine is prescribed to control its composition. If you have powerful psychological symptoms, such as irritability, an antidepressant may be prescribed as well.
Low-dose contraceptive pills are effective against cramps as well. Pills are used for birth control as they control ovulation; they can also alleviate cramps. Pills contain two types of female hormones, namely estrogenic and progestational hormones. Progestational hormones control the growth of the endometrial membrane. By taking the pills, you can also reduce the amount of menstrual flow.
Chinese herbal medicines are effective against cramps too. They warm cold bodies, improve pelvic blood circulation, and alleviate psychological symptoms such as irritability. Chinese herbal medicines are covered by insurance policies, so the costs are about the same as for other medicines.
In any case, you should explain your symptoms to a doctor and discuss appropriate treatments.