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Painful menstruation

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Painful menstruation can significantly affect quality of life and daily functioning. At the same time, the problem is often downplayed, and many a woman hears during a visit to the gynecologist that “such is their charm” and there is little that can be done. Meanwhile, severe pain before and during menstruation can be a symptom of serious diseases. It is worth learning to recognize situations when you can manage the problem on your own, and when the support of a doctor and medicine is necessary.

Natural perimenstrual symptoms

Monthly bleeding is associated with a specific pain in the lower abdomen, which most menstruating women feel. It is caused by uterine contractions that occur during this time. It can also appear a few days before the period, signaling its arrival. The intensity of the pain is greatest during the first 2-3 days, and then gradually subsides. The pain can radiate to the thighs, groin, and even to the back and sacrum. These are natural symptoms that should not cause concern.

In the case of severe menstrual pain that prevents normal functioning, which may occur just before the period or on the remaining days of the cycle, as well as during intercourse, the reason may be a disease called endometriosis. It is characterized by the occurrence of endometrium, or mucous membrane of the uterine cavity, outside the uterus, such as on the ovaries, fallopian tubes, intestines and in the peritoneum. Due to the lack of specific symptoms, making a definitive diagnosis is not always easy. A proper history and gynecological examination (performed optimally during the first days of menstruation) is very helpful in making a preliminary diagnosis and undertaking appropriate treatment (usually pharmacological), which often significantly improves quality of life and relieves symptoms.

However, this is not the only cause of discomfort experienced by women. Painful menstruation can be a symptom of uterine myomas and intraperitoneal adhesions, which are increasingly common in patients who have had a cesarean section. A detailed diagnosis is necessary in this regard. Pain can also be the result of anatomical defects of the reproductive organs, but as a rule, symptoms are already observed in pubertal girls and are diagnosed quite quickly.

Methods of relieving menstrual pain

A well-known method is to apply warm compresses or baths to the lower abdomen to relieve muscle tension. Herbs with calming and diastolic effects can also provide relief, these include mint, lemon balm, chamomile or calendula. When dealing with moderate pain, we can reach for over-the-counter medications.

Having undergone a natural childbirth can also have an impact on the cessation of bothersome discomfort, due to the stretching of the cervix, which facilitates the outflow of menstrual blood.

Regular physical activity can also help relieve menstrual pain. Exercise (about 3 x weekly for 45 min each) often has an effect analogous to the use of painkillers.

Is it time to see a specialist?

What should cause concern? Firstly, severe menstrual pain that prevents daily functioning is alarming, including that which appeared suddenly or which a woman has not experienced before. Heavy bleeding, as well as other symptoms, i.e. vomiting, fainting, or diarrhea during menstruation, should also prompt consultation with a specialist.

Irregularity of menstruation is also one reason to make a medical appointment. After taking a history, conducting an ultrasound, and, if necessary, performing additional hormonal tests, the doctor will be able to make a diagnosis and suggest effective management.

Severe, prolonged menstrual pain is not the norm. In many cases, making the right diagnosis allows the implementation of treatment that is effective. It is therefore worthwhile not to underestimate the problem.

Autor: prof. dr hab. n. med. Krzysztof Łukaszuk