Severe Menstrual Cramps with Nausea and Sweating: What to Know

On the first day of menstruation, experiencing lower abdominal pain accompanied by vomiting, diarrhea, cold sweats, and slightly rapid breathing?

Hello Doctor: I would like to ask about the reasons for experiencing "lower abdominal pain" on the first day of menstruation, accompanied by "nausea and diarrhea," "cold sweats, and slightly rapid breathing." I started my period around the age of 12, and usually, I do not experience pain during menstruation; I have only had mild pain once or twice, but nothing as severe as this time, which included vomiting, diarrhea, cold sweats, feeling cold, and rapid breathing.
I also passed a blood clot while using the restroom, but now I feel like "the menstrual blood is not coming out," and "the flow is very light." Although I have applied a heating pad, I still feel discomfort in my abdomen, as if there is still something inside that cannot be expelled.
Could there be an issue with my uterus? I did not consume ice or take any medication before my period.
Thank you, Doctor!

Niming, 10~19 year old female. Ask Date: 2016/03/19

Dr. Zhang Kunmin reply Obstetrics and Gynecology

Hello, the symptoms of dysmenorrhea can include not only cramping pain in the lower abdomen during menstruation but also nausea, vomiting, headaches, anxiety, fatigue, diarrhea, dizziness, bloating, breast tenderness, mood swings, back pain, and fainting.
The onset of symptoms can occur 1-2 days before menstruation or during the menstrual period, with the most severe symptoms typically occurring in the first 48 hours.
It is estimated that 80-90% of women experience some form of dysmenorrhea, with varying degrees of severity, which can often impact work or academic performance.
Therefore, accurate diagnosis and treatment can help improve quality of life and work efficiency.
Dysmenorrhea can generally be classified into primary and secondary types:
1.
Primary Dysmenorrhea: This is caused by intrinsic mechanisms within the uterus, with no abnormalities in the pelvic structures; pelvic examinations and ultrasounds are normal.
Symptoms often begin 1-2 years after menarche, peaking between the ages of 23-27.
Women who experience early menarche, have heavy menstrual flow, have never given birth, are obese, have a high socioeconomic status, are single, or are under stress may experience more severe symptoms.
Symptoms usually improve with age or after childbirth.

Causes:
a.
Increased secretion of prostaglandins from the uterus leads to abnormal uterine contractions, causing ischemia and pain.
Prostaglandins can also directly irritate nerve endings, causing discomfort.
b.
An excessive number of adrenergic nerve fibers in the uterus (which decrease after childbirth).
c.
The influence of female hormones, oxytocin, and vasopressin.
d.
Underlying medical conditions such as anemia, malnutrition, diabetes, and tuberculosis can also have an impact.
Treatment:
a.
Prostaglandin inhibitors are the best choice (caution is advised for those with peptic ulcers, asthma, allergies, or liver and kidney dysfunction).
b.
Oral contraceptives.
c.
Intrauterine devices containing progestin.
d.
Surgical treatment (such as resection of certain nerve fibers or the uterus).
e.
Psychological support.
f.
Vitamin B6, caffeine, sweets, calcium, and magnesium may provide relief for some individuals.
g.
Aerobic exercise, environmental changes, meditation, mindfulness, and subcutaneous nerve stimulation may also have some effects.
2.
Secondary Dysmenorrhea: This arises from pathological changes in pelvic organs, such as adenomyosis, endometriosis, uterine fibroids, endometrial polyps, pelvic inflammatory disease, and the presence of intrauterine devices, which can all be contributing factors.
These pathological factors may also be associated with infertility and dyspareunia, and treatment varies depending on the underlying cause.
It is recommended that if symptoms persist, a physician should be consulted to determine the specific cause of dysmenorrhea and arrange appropriate treatment.
Thank you! Wishing you peace and health.
Dr.
Zhang

Reply Date: 2016/03/19

More Info

Severe menstrual cramps, particularly when accompanied by symptoms such as nausea, vomiting, sweating, and shortness of breath, can be quite distressing and may indicate several underlying issues. In your case, the symptoms you are experiencing on the first day of your menstrual cycle are concerning and warrant further investigation.

Firstly, it is important to understand that menstrual cramps, or dysmenorrhea, can vary in intensity from person to person. While many women experience mild discomfort, some may have severe cramps that can lead to significant distress and associated symptoms. The severe pain you describe, along with gastrointestinal symptoms like vomiting and diarrhea, may suggest a more systemic response to the pain, possibly due to the release of prostaglandins. Prostaglandins are hormone-like substances that help the uterus contract to shed its lining, but they can also cause increased pain and gastrointestinal upset.

The presence of cold sweats and shortness of breath could indicate a vasovagal response, which is a sudden drop in heart rate and blood pressure leading to fainting or near-fainting. This can occur in response to severe pain or stress. The blood clots you mentioned are not uncommon during menstruation, but if you are experiencing a significant change in your menstrual flow or if the blood clots are larger than usual, this could be a sign of a more serious condition, such as uterine fibroids or endometriosis.

Given that you have not experienced such severe symptoms in the past, it is crucial to consider other potential causes. Conditions such as pelvic inflammatory disease (PID), ovarian cysts, or even ectopic pregnancy can present with severe abdominal pain and systemic symptoms. Additionally, if you have a history of gastrointestinal issues, the combination of menstrual cramps and gastrointestinal symptoms could suggest a connection that needs to be explored.

Here are some steps you should consider:
1. Consult a Healthcare Provider: It is essential to seek medical attention, especially since your symptoms are severe and different from your usual menstrual experience. A healthcare provider can perform a thorough evaluation, including a physical examination and possibly imaging studies, to determine the cause of your symptoms.

2. Keep a Symptom Diary: Documenting your symptoms, including the timing, intensity, and any associated factors (like diet or stress), can help your healthcare provider understand your condition better.

3. Pain Management: Over-the-counter pain relief medications, such as ibuprofen or naproxen, may help alleviate cramps. However, it is important to discuss with your doctor before taking any medication, especially if you have other health conditions or are on other medications.

4. Hydration and Nutrition: Ensure you stay hydrated, especially if you are experiencing vomiting or diarrhea. Eating small, bland meals may help if you are feeling nauseous.

5. Follow-Up: If your symptoms persist or worsen, or if you experience new symptoms such as fever, severe vomiting, or fainting, seek immediate medical attention.

In conclusion, while menstrual cramps can be severe, the combination of symptoms you are experiencing suggests that a thorough evaluation is necessary to rule out any serious underlying conditions. Your health and well-being are paramount, and addressing these symptoms with a healthcare provider will help ensure you receive the appropriate care and treatment.

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