Why Are My Periods So Painful?

Painful menstrual cramps, also called dysmenorrhea, are common among women of childbearing age. More than half of menstruating women report at least some period-related pain lasting 1–2 days each month. Many factors, including diet and exercise habits and alcohol, tobacco, and caffeine intake, can influence the intensity of menstrual pain, and many women experience dysmenorrhea without any underlying condition. In fact, the release of prostaglandins, the naturally occurring substances that cause the uterus to contract during menstruation, is a primary cause of menstrual pain. 

Sometimes, however, menstrual pain (or worsening menstrual pain) results from another issue. Fibroids and endometriosis are two of the main conditions can cause or exacerbate painful periods:

Uterine Fibroids

Fibroids are non-cancerous, muscular tumors that form in the uterus. They are extremely common, affecting up to 70–80% of women by age 50. Many women can have fibroids without ever noticing them, but for others, fibroids can cause pain, heavy menstrual bleeding, constipation, urinary frequency, and other symptoms.

Fibroids are typically diagnosed using ultrasound (either transabdominal or transvaginal). Depending on how fibroids are impacting a woman’s life, her doctor may recommend treatment, which can range from dietary changes and supplements to pharmaceuticals or surgery. Because recommendations can vary widely, you may wish to discuss your options with more than one health care provider.

Endometriosis

Endometriosis is a condition in which the uterine lining (endometrium) begins to grow outside the uterus, commonly on the ovaries, fallopian tubes, and/or the tissue that lines the pelvis. This lining thickens, breaks down, and bleeds during the menstrual cycle like the lining inside the uterus, but it has no way to exit the body. This can cause the development of cysts, scar tissue, and adhesions as well as pain, which can be severe. Endometriosis can also cause heavy bleeding during periods and infertility.

If your doctor suspects endometriosis, they will likely order a transvaginal ultrasound. While this test cannot positively identify endometriosis, it can identify signs of its presence. The only way to be certain that you have endometriosis is through surgery. Endometriosis is not curable, but a wide range of treatments is available depending on the severity of symptoms. For example, treatment options include

• Warm baths
• Exercise
• Acupuncture
• Over-the-counter pain medication
• Hormonal therapies
• Surgery

Again, because of the wide range of possible approaches to treating endometriosis, it’s wise to consult more than one health care professional.

How Can I Reduce Period Pain?

Fortunately, there are several steps you can take to reduce the pain you feel around your period.

• Use a heating pad or take a warm bath
• Avoid caffeine, alcohol, and fatty foods
• Try herb teas that include chamomile or ginger
• Eat more high-fiber, plant-based foods
• Get gentle exercise
• Drink plenty of water
• Take recommended amounts of over-the-counter pain medication
• Work with acupressure points

Should I See a Doctor?

If menstrual pain prevents you from engaging in everyday activities, and especially if it isn’t controllable with recommended doses of over-the-counter pain medication, it’s a good idea to talk with your doctor. Also be sure to consult a doctor if

• You have pelvic pain at times other than around your period
• Menstrual pain lasts longer than 2–3 days
• You experience bleeding between periods
• Menstrual bleeding is very heavy

Iowa Radiology provides a broad range of women’s imaging services, including transvaginal ultrasound, sonohysterography, and hysterosalpingography in addition to MRI and state-of-the-art 3-D mammography. 

Our interventional radiologists also provide consultations for uterine fibroid embolization (UFE), a minimally invasive surgical treatment for fibroid tumors. 80–90% of women who undergo this procedure report symptom relief. During UFE, the patient is sedated but remains awake. Using a thin catheter and X-ray guidance, the radiologist delivers blocking agents to the blood vessels that supply blood to the tumors, causing them to shrink and alleviating pain. 

We’re dedicated to helping our patients be as comfortable as possible during their time with us, and we’re happy to provide information to help you understand your health care options. Click the link below to contact us today.

Sources

“Endometriosis.” MayoClinic.org. Mayo Foundation for Medical Education and Research, 24 July 2018. Accessed 19 Nov 2018.

“Endometriosis.” WomensHealth.gov. Office on Women’s Health, 16 March 2018. Accessed 19 Nov 2018. 

Gurevich, “6 Signs Your Period Cramps Are Not Normal.” VerywellFamily.com. Dotdash Publishing, 12 Nov 2018. Accessed 19 Nov 2018.

“Home Remedies to Relieve Menstrual Pain.” Healthline.com. Healthline Media, 3 Feb 2017. Accessed 19 Nov 2018.

“How to Treat Uterine Fibroids Yourself.” Healthline.com. Healthline Media, 17 May 2018. Accessed 19 Nov 2018. 

“Menstrual Cramps.” MayoClinic.org. Mayo Foundation for Medical Education and Research, 14 April 2018. Accessed 19 Nov 2018.

Stoppler, Melissa, MD. “Uterine Fibroids (Benign Tumors of the Uterus).” MedicineNet.com. MedicineNet Inc., 28 Feb 2018. Accessed 19 Nov 2018.

“Uterine Fibroids.” MayoClinic.org. Mayo Foundation for Medical Education and Research, 6 March 2018. Accessed 19 Nov 2018.