Menstrual Pelvic Pain

It is normal for women to experience some mild cramps for a day or two each month. However, dysmenorrhea is the experience of severe, debilitating pain. Treatments exist for severe menstrual pain and are very effective in most cases. A physician at The Veranda can help you determine which treatment is best for you.

What happens during the menstrual cycle?

Menstrual cycles last about 28 days (cycles of 23 to 35 days are usually considered normal as well.) During this cycle, the hormones estrogen and progesterone send messages to the lining of the uterus. About day five of the cycle, the estrogen causes the lining of the uterus to grow and thicken. Around day 14, an egg is released from the ovary. After this, progesterone causes the glands to release nutrients and blood vessels swell to prepare for the possibility of pregnancy. If the egg is not fertilized, it moves to the uterus and is absorbed or disintegrates. Estrogen and progesterone levels decrease and the lining of the uterus breaks up and is shed as menstrual fluid.

What causes menstrual pain?

The uterus, like other muscles, contracts and relaxes. Most of these contractions are not even noticed, but strong ones can be painful. During menstruation, the uterus contracts more strongly than at other times and produces the uncomfortable feeling we know as menstrual cramps.

What is primary dysmenorrhea?

When contractions are strong enough to temporarily cut off blood and oxygen supply, extreme and debilitating pain can be experienced, known as primary dysmenorrhea. Although painful, primary dysmenorrhea is not a sign that something is wrong. It frequently begins during adolescence, but could begin later in life. Frequently it disappears after a full-term pregnancy.

What is secondary dysmenorrhea?

Secondary dysmenorrhea differs from primary dysmenorrhea in that the pain lasts longer than the usual 2-3 days during the monthly flow. It may also occur during other times of the month. This is typically an indication of an underlying cause of the pain, such as endometriosis or pelvic inflammatory disease.

What treatments are available for dysmenorrhea?

Severe menstrual cramps, in all but rare cases, can and should be treated. Medication can help with menstrual cramps and other symptoms such as nausea, diarrhea, and general aching. Only treating the underlying condition that causes the pain can relieve secondary dysmenorrhea. For example, a woman with fibroids requires different treatment than a woman with endometriosis.