Unbearable menstrual pain:
Menstrual pain is a common experience for many women, but some women experience unbearable menstrual pain due to several reasons. It can be so severe that it interferes with daily activities. Many women have complained that “my period cramps are unbearable”.
In this blog, we will explore the causes behind this unbearable pain, discover practical treatments to ease the pain and share tips on when to seek medical help. If you ever find yourself extremely worried about unbearable pain around this time of the month, you are not alone. Here we will discuss several ways to manage it effectively.
What causes severe menstrual cramps?
Severe menstrual cramps also known as dysmenorrhea result from excessive uterine contractions during menstruation, while mild pain is a normal part of the menstrual cycle. It would be best if you are concerned about severe pain during menstruation and have you have a question about why my period cramps are unbearable: there are several underlying health reasons for this. Here are some common causes:
Primary dysmenorrhea:
Primary dysmenorrhea is a menstrual pain that occurs without any pelvic pathology. It is the most common cause of painful menstruation, among young women, unlike secondary dysmenorrhea which is caused by underlying medical conditions.
There are several causes of primary dysmenorrhea. One of the most common causes is prostaglandin overproduction. During menstruation endometrium which is the lining of the uterus, produces high levels of prostaglandins, especially P-F2 alpha. These prostaglandins cause the uterus to contract leading to pain during menstruation. Uterine contractions reduce the blood flow contributing to pain. Uterine hypercontractility is another cause of primary dysmenorrhea. Other risk factors include Early onset menstruation, obesity, smoking, and family history.
A patient with primary dysmenorrhea may suffer from lower abdominal pain. Cramps usually start 1-2 days before menstruation, other symptoms include headache, fatigue, and sometimes diarrhea. You can manage this condition through lifestyle changes such as regular exercise, heat therapy, and a balanced diet.
Secondary dysmenorrhea:
Secondary dysmenorrhea refers to painful menstruation caused by underlying medical conditions, unlike primary dysmenorrhea, which typically begins in adolescence. Secondary dysmenorrhea often develops later in life. It is associated with specific gynecological disorders such as endometriosis, adenomyosis, uterine fibroids, pelvic inflammatory disease, and more. Let’s discuss all of these causes in detail.
1. Endometriosis:
Endometriosis is a chronic condition in which endometrium grows outside the uterine cavity such as in ovaries, fallopian tubes, pelvic peritoneum, bowel, and bladder. This endometrium is similar to the endometrium in the uterine cavity.
This condition is often associated with pelvic pain, menstrual irregularities, and infertility. Pain during menstruation does not indicate infertility in females.
There are several causes and treatments of infertility in females. The exact cause of endometriosis is unclear but several theories are recognized such as retrograde menstruation, immune dysfunction, and genetic predisposition. This condition is diagnosed with the help of ultrasound but the gold standard is laparoscopy which is a minimally invasive surgery with the help of that, we can directly visualize the lesions of the endometrium.
2. Adenomyosis:
Adenomyosis is a benign condition in which endometrial tissue invades the uterus’s myometrium (the muscular layer). This ectopic growth can lead to uterine enlargement, inflammation, and thickening of the myometrium. Adenomyosis is usually diagnosed between the ages of 35 and 50. It mainly resolves after menopause.
Adenomyosis can be caused by factors such as a history of dilatation and curettage or previous surgical scars in women. It can also be caused by chronic inflammation or trauma.
The severity of symptoms varies among individuals but common symptoms include menorrhagia (heavy menstrual bleeding), unbearable menstrual pain also known as dysmenorrhea, pelvic pain, or palpable uterus. It is mainly diagnosed with history and imaging studies. Ultrasound shows a muscular layer thickening and ectopic endometrial tissue.
3. Uterine fibroids:
Uterine fibroids are non-cancerous growths that develop in the myometrium of the uterus. They can cause discomfort and health issues. The exact cause is unknown, but several factors contribute to their development, such as hormonal, genetic, and lifestyle factors (obesity, hypertension, and a high diet of red meat). Symptoms may include heavy menstrual bleeding, pelvic pain, and urinary incontinence due to pressure on nearby organs. Imaging tests are most commonly used to confirm uterine fibroids.
4. Pelvic inflammatory disease:
Pelvic inflammatory disease is an infection that affects the uterus, fallopian tubes, and ovaries. This infection of female reproductive organs is a serious condition that can lead to long-term complications if left untreated.
Its complications include infertility, ectopic pregnancy, and chronic pelvic pain. Pelvic inflammatory disease is more common among sexually active females because its most common causes are sexually transmitted infections and post-procedure infections.
The most common risk factors include multiple sexual partners, unprotected sexual intercourse, and douching ( cleaning and washing of vagina with water and other mixture of fluids. Common symptoms during this infection are lower abdominal pain, abnormal vaginal discharge, and period cramps.
Tips to manage and prevent menstrual pain:
Heat therapy:
Heat therapy can be effective for mild to moderate pain.
Applying a heating pad to the lower abdomen improves the blood flow and relaxes uterine muscles.
Lie down or sit comfortably.
Place the heating pad or hot water bottle over your lower abdomen.
Use the barrier between your skin and the heating pad to prevent skin irritation.
Keep this pad in place for 15 to 20 minutes at a time. Heat therapy is effective against dysmenorrhea.
Massage therapy:
Massaging the lower abdomen with essential oils such as coconut and almond oils during unbearable menstrual pain is effective. It can improve the blood circulation and reduce muscle tension.
Medications:
Painkillers are quite effective against period cramps. You can use naproxen and ibuprofen on the first day of menstrual cramps. These medications can reduce inflammation by blocking prostaglandins.
Herbal remedies:
Herbal remedies are a safe alternative to medications that have been used for centuries to reduce menstrual cramps. Natural herbs have anti-inflammatory, anti-spasmodic, and soothing properties. One of the most popular remedies that can be widely used during unbearable menstrual pain is ginger tea. Ginger tea works similarly to NSAIDs. It can reduce inflammation and pain during periods. Another effective remedy is turmeric. You can use turmeric with hot milk.
When to seek medical help for unbearable menstrual pain:
Mild to moderate pain can be relieved by taking medications and home remedies but unbearable menstrual pain that interferes with daily activities and can not be relieved even by taking medications require medical attention.
Signs that warrant medical attention:
- Continuous pain for two or more days
- Heavy menstrual bleeding
- Pain persists despite home remedies or medications.
- Fainting or rapid heartbeat during period pain.