Menstrual Cramps: Is Abdominal Pain Normal?

During menstruation, applying pressure to the lower abdomen can cause pain?

Hello Dr.
Wu: I have given birth to two children, aged 12 and 16.
Two months ago, I had my intrauterine device (IUD) removed, which I had for eight years.
I have always experienced heavy menstrual bleeding, which led to a discovery of low hemoglobin levels (11) during my health check earlier this year.
My previous health checks were normal, and I even donated blood once (500cc) last year.
Currently, I cannot donate blood due to low hemoglobin levels.
I thought the IUD might have caused my long-term heavy bleeding, which is why I decided to have it removed.

Now, during my menstrual period, I experience pain when pressing on my lower abdomen, which feels like it’s coming from the uterus.
Is this normal? When I suddenly sit down forcefully, I feel a vibration in my uterus and a cramping sensation.
Is this normal? When lying down and feeling my lower abdomen, I notice a tender, swollen area that feels like my uterus.
Is this a normal response during menstruation? Is it safe to perform circular massages on the uterus during my menstrual period, similar to postpartum care? Thank you, Dr.
Wu.
🙏

Shala, 30~39 year old female. Ask Date: 2022/05/26

Dr. Wu Xianghui reply Obstetrics and Gynecology

1.
"Vaginal infections" can cause abnormal discharge, perineal itching, unusual odor, burning sensation during urination, frequent urination, and bleeding.
In more severe cases, it may lead to abdominal pain or fever.
"Treatment methods" vary depending on the symptoms and require proper health education.
It is recommended to visit an outpatient clinic for examination and evaluation by a specialist in obstetrics and gynecology.
2.
During menstruation, it is possible to massage the uterus.

Reply Date: 2022/05/26

More Info

Menstrual cramps, or dysmenorrhea, are a common experience for many women during their menstrual cycle. The symptoms you describe, including abdominal pain, a sensation of pressure in the lower abdomen, and discomfort when pressing on the area, can indeed be normal during menstruation. However, it is essential to understand the underlying mechanisms and when to seek further medical advice.

During menstruation, the uterus contracts to help shed its lining, which can lead to cramping and pain. This pain is often caused by the release of prostaglandins, hormone-like substances that promote uterine contractions. Higher levels of prostaglandins are associated with more intense cramps. The pain can vary in intensity and may be felt in the lower abdomen, lower back, and even the thighs.

Your experience of feeling a "bump" or a "hard" sensation in the lower abdomen when lying down could be related to the normal anatomical structure of the uterus, especially if you have recently stopped using an intrauterine device (IUD). The IUD can sometimes cause changes in menstrual flow and cramping, and its removal may lead to a temporary adjustment period as your body recalibrates its hormonal balance.

Regarding your concern about the pain when pressing on your abdomen, it is not uncommon for women to experience increased sensitivity in the lower abdomen during their menstrual period. However, if the pain is severe, persistent, or accompanied by other symptoms such as heavy bleeding, fever, or unusual discharge, it is crucial to consult a healthcare provider. These could be signs of conditions such as endometriosis, fibroids, or pelvic inflammatory disease, which may require further evaluation and treatment.

As for your question about massaging the uterus during menstruation, gentle abdominal massage can sometimes provide relief from cramps. However, it is essential to be cautious and listen to your body. If the massage causes increased pain or discomfort, it may be best to stop. Additionally, after childbirth, the uterus can be more sensitive, and while gentle massage can help with recovery, it is advisable to consult with a healthcare provider for personalized advice.

In summary, while some abdominal pain during menstruation can be normal, it is essential to monitor the severity and accompanying symptoms. If you have concerns about your menstrual health, especially given your history of heavy bleeding and low hemoglobin levels, it would be wise to discuss these issues with your healthcare provider. They can help determine if further investigation or treatment is necessary to ensure your reproductive health and overall well-being.

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