Woman in painful expression holding hands against belly suffering menstrual period pain, lying sad on home bed, having tummy cramp in female health concept

Period Pains: What’s normal, and what’s not?

Dr. Muthoni Mwangi
Painful periods, medically known as dysmenorrhea, refer to pain during the menstrual cycle, usually in the lower abdomen, which may radiate to the back or inner thighs.

It is a fairly common occurrence. Period pain can be categorized into two types: primary and secondary. Period pains may have a negative effect on activities of daily living, and psychological and emotional stress, not only on the person experiencing it but also on their loved ones.

Primary period pains

Primary period pains typically start about two years after menstruation begins or once the girl/woman starts ovulating. This type of pain starts within a few hours of menstruation and usually resolves within 72 hours. It may be accompanied by symptoms such as nausea, vomiting, fatigue, excessive sleep or lack of sleep, and headaches. The pain is primarily due to prostaglandins, the pain mediators that cause the start of periods.

Secondary period pains

Secondary period pains are due to underlying diseases or abnormalities in or outside the uterus and can affect women at any time after the start of menstruation. These pains can be accompanied by other symptoms, such as bleeding between cycles, and pain or bleeding during or after sex. Possible causes include fibroids, endometriosis, scars from previous surgery, or infections in the urinary or reproductive system. Reproductive organ abnormalities that obstruct menstrual flow can also cause pain.

Signs of secondary period pain

Some signs that may indicate secondary causes of period pains include:

  • Abnormal and foul-smelling vaginal discharge
  • Painful urination
  • Pain during sexual intercourse
  • Heavy menstrual flow
  • The presence of a swelling in the lower abdomen

If period pain affects the quality of life or daily activities, it should be evaluated by a physician, preferably a gynecologist. Additionally, if a woman experiences pain that starts before and lasts after periods, a gynecological evaluation is necessary.

What to expect from a medical visit

History Taking: The physician will inquire about the type of pain, its duration, whether it is cyclical, and any associated symptoms such as changes in urine or bowel movements.

Physical Examination: This may include an abdominal and pelvic examination, potentially using a speculum (the duck bill-shaped instrument), and a manual examination.

Investigations: Tests may include an ultrasound, urine test for infections, sexually transmitted infections, and a pap smear. An MRI may be done to assess for congenital abnormalities of the uterus or when adenomyosis is suspected.

Treatment plan

The doctor will prescribe different treatment modalities depending on the condition diagnosed. Treatment may include pain relief medications, hormonal treatments, or other therapies specific to the underlying cause of the period pain.

Understanding the difference between normal and abnormal period pains can help you take control of your health. Don’t hesitate to seek medical advice if period pains disrupt your daily life or cause significant distress. Proper diagnosis and treatment can lead to a better quality of life.

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