Menstrual Cramps: Causes of Abdominal Pain and Nausea

Dysmenorrhea

Hello, I would like to ask why I feel discomfort in my stomach on the first day of my menstrual cycle? Generally, the pain is tolerable, but when it becomes very painful, I pass a lot of blood clots and also experience nausea.
What could be the reason for this? Thank you.

lilian, 20~29 year old female. Ask Date: 2001/03/06

Dr. Li Guanghan reply Obstetrics and Gynecology

Menstrual pain can feel similar to stomach pain because it is caused by uterine contractions that expel blood clots.
The more blood clots there are, the stronger the uterine contractions, leading to increased pain.
Since the pain center is adjacent to the vomiting center, severe pain can trigger nausea and vomiting.
During menstruation, it is advisable to avoid cold foods and to keep warm to reduce blood clot formation.
Additionally, applying heat to the lower abdomen can be beneficial.

Reply Date: 2001/03/06

More Info

Menstrual cramps, also known as dysmenorrhea, can cause a variety of symptoms, including abdominal pain, nausea, and vomiting. Understanding the underlying causes of these symptoms can help in managing them effectively.

Causes of Menstrual Cramps and Associated Symptoms
1. Hormonal Changes: During menstruation, the body releases prostaglandins, which are hormone-like substances that help the uterus contract to shed its lining. High levels of prostaglandins can lead to more intense contractions, resulting in increased pain and discomfort. This can also lead to nausea and vomiting, particularly if the pain is severe.

2. Uterine Contractions: The contractions of the uterus can sometimes be strong enough to cause referred pain in the lower abdomen and even in the upper abdomen, which may feel like stomach discomfort. This can be particularly pronounced on the first day of menstruation when the flow is typically heaviest.

3. Blood Clots: The presence of blood clots during menstruation can also contribute to discomfort. When the uterus contracts to expel the lining, it may push out clots, which can cause additional pain and discomfort. If you notice that you are passing larger clots or experiencing significant pain, it may be worth discussing with a healthcare provider.

4. Gastrointestinal Symptoms: The hormonal changes during menstruation can affect the gastrointestinal tract, leading to symptoms such as nausea, diarrhea, or constipation. This is due to the interplay between the reproductive and digestive systems, which can be influenced by the same hormonal signals.

5. Underlying Conditions: In some cases, severe menstrual cramps and associated symptoms may indicate underlying conditions such as endometriosis or fibroids. Endometriosis occurs when tissue similar to the uterine lining grows outside the uterus, leading to significant pain and discomfort. Fibroids are non-cancerous growths in the uterus that can also cause heavy bleeding and pain.

Management Strategies
1. Pain Relief: Over-the-counter pain relievers such as ibuprofen or naproxen can help alleviate menstrual cramps. These medications work by reducing the production of prostaglandins, thereby decreasing the intensity of uterine contractions.

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

3. Hydration and Diet: Staying hydrated and maintaining a balanced diet can help manage symptoms. Some women find that reducing caffeine and salt intake before and during their period can help minimize bloating and discomfort.

4. Exercise: Regular physical activity can help reduce the severity of menstrual cramps. Exercise releases endorphins, which are natural pain relievers.

5. Consultation with a Healthcare Provider: If menstrual cramps are severe or accompanied by other concerning symptoms such as excessive bleeding, severe nausea, or vomiting, it is important to consult a healthcare provider. They may recommend further evaluation to rule out conditions like endometriosis or fibroids.

Conclusion
Menstrual cramps can be uncomfortable and may present with various symptoms, including abdominal pain and nausea. Understanding the causes can help in managing these symptoms effectively. If you experience severe pain or other concerning symptoms, it is advisable to seek medical attention for a thorough evaluation and appropriate management.

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