Persistent Abdominal Pain After Two Weeks of Menstruation: What to Do?

Menstruation has lasted for two weeks, with persistent abdominal pain?

Hello, doctor.
I would like to ask you a question: My sister told me today that she has been experiencing severe abdominal pain.
Her period has lasted for two weeks, and she has been in pain during her menstruation.
Even now that her period has ended, she is still in pain.
She is in the ninth grade and has been menstruating for less than two years.
Could this be due to her menstrual cycle being unstable since she just started? Additionally, she has a problem with being overweight; could that also be a factor? Each time she menstruates, it lasts about 9 to 10 days, and she has a habit of drinking cold beverages.
She just informed me today that she has been in pain for such a long time, but it is now evening, and we cannot go to see a doctor.
Could you please help me clarify my doubts? Our local clinic does not have an obstetrics and gynecology department; would it be acceptable to see an internist instead? Thank you for your response, I really appreciate it.

Zi Ling, 10~19 year old female. Ask Date: 2010/02/22

Dr. Chen Changfu reply Obstetrics and Gynecology

There are many causes of abdominal pain, and menstrual cramps or pain during menstruation are just one of the reasons for abdominal pain in women.
It is advisable to first consult an internal medicine physician for diagnosis and treatment.
If the abdominal pain in women may be related to gynecological issues, then follow the physician's recommendation to seek evaluation and treatment from an obstetrician-gynecologist.

Reply Date: 2010/02/22

More Info

Persistent abdominal pain after menstruation can be concerning, especially in a young individual like your sister, who is only in the ninth grade and has recently started menstruating. It’s important to understand that menstrual cycles can vary significantly, especially in the first few years after menarche (the first menstrual period). This variability can lead to irregular cycles and associated symptoms, including pain.

In your sister's case, the fact that she is experiencing abdominal pain two weeks after her menstrual period has ended raises several possibilities. One common cause of persistent abdominal pain in young females is dysmenorrhea, which refers to painful menstruation. However, since the pain is continuing beyond her menstrual period, it may not be solely related to her menstrual cycle. Other potential causes could include:
1. Hormonal Imbalances: Young women often experience hormonal fluctuations that can lead to various symptoms, including abdominal pain.

2. Ovarian Cysts: These fluid-filled sacs can develop on the ovaries and may cause pain, especially if they rupture.

3. Pelvic Inflammatory Disease (PID): This is an infection of the reproductive organs that can cause significant pain and discomfort.

4. Gastrointestinal Issues: Conditions such as irritable bowel syndrome (IBS) or constipation can also manifest as abdominal pain.

5. Endometriosis: Although less common in younger adolescents, endometriosis can cause significant pain and is characterized by the presence of endometrial tissue outside the uterus.

Regarding her weight, being overweight can contribute to hormonal imbalances and may exacerbate menstrual symptoms. Additionally, lifestyle factors such as diet (including the consumption of cold beverages) can influence gastrointestinal health, although the direct impact of cold drinks on menstrual pain is not well-established.

Since your sister is experiencing significant discomfort and the local hospital does not have a gynecologist, it would be advisable to seek care from a general practitioner or an internist. They can perform a physical examination, take a detailed history, and possibly order imaging studies or lab tests to rule out any serious conditions. If the pain is severe or accompanied by other symptoms such as fever, vomiting, or changes in bowel habits, it is essential to seek medical attention promptly.

In the meantime, there are some general recommendations that may help alleviate her discomfort:
- Pain Relief: Over-the-counter pain relievers such as ibuprofen or acetaminophen can help manage pain. However, it’s important to follow the dosage instructions on the packaging.

- Heat Therapy: Applying a heating pad to the abdomen may provide relief from cramping and discomfort.

- Hydration: Encourage her to stay hydrated, as dehydration can exacerbate abdominal pain.

- Dietary Adjustments: A balanced diet rich in fruits, vegetables, and whole grains can support overall health and may help regulate menstrual cycles.

- Physical Activity: Gentle exercise, such as walking or stretching, can sometimes help alleviate pain.

In conclusion, while it is possible that your sister's symptoms are related to her menstrual cycle, the persistence of pain warrants further evaluation. Seeking medical advice from a general practitioner is a prudent step to ensure that any underlying issues are addressed appropriately.

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