Menstrual Cramps

Why do I have bad menstrual cramps?

Menstrual cramps are lower abdominal aches and pains which many women may experience just before or during their periods. The pain can extend to your lower back, hips and inner thighs. Menstrual cramps occur because of uterine contractions during your period – strong contractions can cut off oxygen supply to your uterus and causes pain.

Bad or severe menstrual cramps may last throughout the period or linger on even when the period is over. Associated symptoms may include heavy periods, upset stomach, vomiting or loose stools.

If you have bad menstrual cramps that persist and is not relieved by normal painkillers, do see your gynaecologist as it may be a sign of something wrong.

What are some causes of bad menstrual cramps?

• Endometriosis
  This is a condition where tissue from the womb lining is found outside the womb, most commonly in the pelvis, where it can affect the ovaries, fallopian tubes and intestines. These tissues respond to hormonal changes and bleed during periods, causing pain, inflammation, scarring.

• Uterine fibroids
  These are non-cancerous growths that come from the muscle layer of the uterus (womb). They can result in the uterus to be larger than normal. Some fibroids can cause heavier periods than others depending on their location.

• Adenomyosis
  This is a condition where the tissue from the womb lining grows into the muscle wall of the womb, causing the womb to be enlarged and resulting in heavy periods.

• Pelvic inflammatory disease (PID)
  This is a condition where there is pain and inflammation of a woman’s uterus, fallopian tubes and ovaries, usually caused by sexually transmitted infections (STIs).

What tests do I need?

Your gynaecologist will take a detailed medical history and perform a pelvic examination to check your cervix and uterus. Depending on your symptoms, you may require an ultrasound scan, vaginal swabs or blood tests.

How to treat bad menstrual cramps?

This depends on what the cause of your cramps is. You should speak to your gynaecologist about the treatment options suitable for your condition. These may include:

• Painkillers: Panadol, non-steroidal anti-inflammatory drugs (NSAIDs) to be taken as soon as the bleeding/pain starts
• Heat pack: place this on your lower abdomen or back
• Lifestyle changes: rest, avoid smoking and drinking, massage, regular exercise, stress management, traditional Chinese methods such as acupuncture
• Hormonal medications: this can range from oral tablets (e.g. birth control pills, Visanne), implants (IUD, implanon) and injections