Severe Cramps and Nausea During Menstruation: Causes and Solutions

On the second day of my menstrual period, I experienced vomiting and diarrhea, and there was a mild pain when I pressed on my stomach, making it feel like I could hardly breathe?

Hello, doctor: I would like to ask about my condition.
On the second day of my menstrual period, I suddenly had diarrhea in the middle of the night, followed by persistent vomiting.
My abdomen started to hurt, and it was painful to walk, lie down, or even when pressure was applied while sleeping.
I felt like I couldn't catch my breath, had goosebumps, and experienced a throbbing headache, but I did not have a fever.
What could be the cause of this? In the past, I have occasionally experienced similar symptoms during my menstrual period.
I take pain relief medication (EVE) every month.
There are certain factors during my period that make me particularly sensitive to menstrual pain.
When I don't eat, my abdomen hurts, and I also experience pain when I need to have a bowel movement.
Sometimes, it's hard to distinguish between menstrual pain and stomach pain; even light pressure on my stomach causes pain, and eating also leads to discomfort.
I can't walk straight and have trouble sleeping in any position.
My menstrual flow has become very thick recently, and I notice stringy discharge after using the restroom.
I would like to know if there is an issue with my uterus or if I might have gastritis.
Thank you, doctor!

Chun Chun, 30~39 year old female. Ask Date: 2022/11/08

Dr. Lin Lixuan reply Obstetrics and Gynecology

Severe abdominal pain during menstruation may be caused by endometriosis, uterine fibroids, or pelvic inflammatory disease.
A proper evaluation of the underlying cause requires gynecological ultrasound and a pelvic examination.
Please visit a nearby gynecological clinic for assessment.

Reply Date: 2022/11/08

More Info

Severe cramps and nausea during menstruation can be distressing and may indicate underlying issues that require attention. Based on your description, it appears that you are experiencing significant discomfort during your menstrual cycle, particularly on the second day, which is often when menstrual cramps (dysmenorrhea) can be most intense.

Possible Causes
1. Primary Dysmenorrhea: This is the most common cause of menstrual cramps and is due to the release of prostaglandins, which are chemicals in the body that cause the uterus to contract. High levels of prostaglandins can lead to more severe cramps, nausea, and even gastrointestinal symptoms like diarrhea.

2. Secondary Dysmenorrhea: This type of pain is caused by underlying reproductive health issues such as endometriosis, fibroids, or pelvic inflammatory disease (PID). These conditions can lead to more severe symptoms and may require medical intervention.

3. Gastrointestinal Issues: The symptoms you describe, such as nausea and abdominal pain, could also be related to gastrointestinal issues. Conditions like irritable bowel syndrome (IBS) can be exacerbated during menstruation due to hormonal changes.
4. Hormonal Imbalances: Changes in hormone levels can affect both the menstrual cycle and gastrointestinal function. For example, fluctuations in estrogen and progesterone can lead to increased sensitivity and pain perception.

5. Diet and Lifestyle Factors: Not eating regularly or having a diet low in essential nutrients can contribute to increased menstrual pain and gastrointestinal discomfort.

Symptoms to Monitor
- Severity of Pain: If your cramps are debilitating and interfere with daily activities, this is a sign that you should consult a healthcare provider.

- Duration of Symptoms: If your symptoms last longer than a few days or worsen over time, it’s essential to seek medical advice.

- Associated Symptoms: Symptoms such as fever, severe vomiting, or changes in bowel habits (like persistent diarrhea) should prompt immediate medical evaluation.

Solutions and Management
1. Pain Relief: Over-the-counter pain relievers like ibuprofen or naproxen can help alleviate menstrual cramps. However, if you find that you need to take pain medication frequently, it may be worth discussing with your doctor.

2. Dietary Changes: Eating a balanced diet rich in fruits, vegetables, whole grains, and lean proteins can help manage symptoms. Staying hydrated and avoiding excessive caffeine and alcohol may also be beneficial.

3. Heat Therapy: Applying heat to the abdomen can help relax the muscles and reduce pain. A heating pad or hot water bottle can be effective.

4. Exercise: Regular physical activity can help reduce the severity of menstrual cramps and improve overall well-being.

5. Consultation with a Healthcare Provider: Given the severity of your symptoms and the changes in your menstrual flow (such as increased viscosity), it is advisable to consult a gynecologist. They may perform a pelvic exam, ultrasound, or other tests to rule out conditions like endometriosis or fibroids.

6. Hormonal Treatments: If your symptoms are severe and persistent, hormonal treatments such as birth control pills may be recommended to help regulate your menstrual cycle and reduce pain.

Conclusion
Your symptoms of severe cramps, nausea, and abdominal pain during menstruation warrant a thorough evaluation to determine the underlying cause. While primary dysmenorrhea is common, the presence of additional symptoms and changes in your menstrual flow suggests that a more detailed assessment is necessary. It’s important to communicate openly with your healthcare provider about your symptoms and any concerns you have regarding your reproductive health. They can help you find an effective treatment plan tailored to your needs.

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