Menstrual Pain: Causes and Factors Behind Discomfort

Q: Menstrual Pain: Causes and Factors Behind Discomfort

Hello, here is the response to your inquiry：<br>I. <br>Introduction： Dysmenorrhea, in addition to cramping pain in the lower abdomen during menstruation, may be accompanied by symptoms such as nausea, vomiting, headaches, anxiety, fatigue, diarrhea, dizziness, bloating, breast te

Why does menstruation cause pain?

Why does menstruation cause pain? What components in the menstrual discharge contribute to the pain experienced by some women?

steve, 10~19 year old female. Ask Date: 2015/09/16

Dr. Zhang Kunmin reply Obstetrics and Gynecology

Hello, here is the response to your inquiry:
I.
Introduction: Dysmenorrhea, in addition to cramping pain in the lower abdomen during menstruation, may be accompanied by symptoms such as 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 within the first 48 hours.
It is estimated that 80-90% of women experience some form of dysmenorrhea, with varying degrees of severity, often impacting 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 or secondary dysmenorrhea.
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 heavier menstrual flow, have never given birth, are obese, have high socioeconomic status, are single, or are under stress may experience more severe symptoms; however, symptoms often improve with age or after childbirth.
II.
Etiology:
a.
Increased secretion of prostaglandins from the uterus leads to abnormal uterine contractions, resulting in ischemia and pain.
Prostaglandins can also directly stimulate nerve endings, causing discomfort.
b.
An excessive number of adrenergic nerve fibers in the uterus (which decreases after childbirth).
c.
The influence of female hormones, oxytocin, and vasopressin.
d.
Medical conditions such as anemia, malnutrition, diabetes, and tuberculosis can also have an impact.
III.
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 (removal of part of the sacral nerve or uterine sacral nerve).
e.
Psychological support.
f.
Vitamin B6, caffeine, sweets, calcium, and magnesium may provide improvement for some individuals.
g.
Aerobic exercise, environmental changes, meditation, mindfulness, and subcutaneous nerve stimulation may have some effect.
2.
Secondary Dysmenorrhea: This arises from pathological changes in pelvic organs, such as adenomyosis, endometriosis, uterine fibroids, endometrial polyps, pelvic inflammatory disease, and intrauterine devices, which may all be contributing factors.
These pathological factors may also be associated with infertility and dyspareunia, with treatment methods varying according to the underlying cause.
Thank you! Wishing you peace and health.
Dr.
Zhang

Reply Date: 2015/09/16

More Info

Menstrual pain, also known as dysmenorrhea, is a common experience for many women during their menstrual cycle. Understanding the causes and factors behind this discomfort can help in managing and alleviating the pain.

Causes of Menstrual Pain
1. Prostaglandins: One of the primary causes of menstrual pain is the production of prostaglandins, which are hormone-like substances produced by the lining of the uterus. Prostaglandins help the uterus contract to shed its lining during menstruation. Higher levels of prostaglandins are associated with more intense contractions, which can lead to increased pain. This pain can manifest as cramps in the lower abdomen, back, and thighs.

2. Uterine Conditions: Certain medical conditions can exacerbate menstrual pain. These include:
- Endometriosis: A condition where tissue similar to the uterine lining grows outside the uterus, causing severe pain, especially during menstruation.

- Fibroids: Noncancerous growths in the uterus that can cause heavy bleeding and pain.

- Adenomyosis: A condition where the inner lining of the uterus breaks through the muscle wall of the uterus, leading to painful periods.

3. Pelvic Inflammatory Disease (PID): This infection of the reproductive organs can cause significant pain during menstruation and may be accompanied by other symptoms such as fever and unusual discharge.

4. Cervical Stenosis: In some women, the cervix may be narrower than usual, which can restrict menstrual flow and increase pressure within the uterus, leading to pain.

5. Hormonal Imbalances: Fluctuations in hormone levels, particularly estrogen and progesterone, can influence the severity of menstrual pain. Conditions like polycystic ovary syndrome (PCOS) can lead to hormonal imbalances that may contribute to dysmenorrhea.

Factors Influencing Menstrual Pain
1. Age: Younger women, particularly those in their teens and early twenties, may experience more severe menstrual pain. This is often due to higher levels of prostaglandins and the body’s response to hormonal changes.

2. Lifestyle Factors: Stress, lack of exercise, and poor diet can contribute to the severity of menstrual pain. Regular physical activity can help reduce the intensity of cramps by improving blood circulation and reducing stress levels.

3. Genetics: A family history of dysmenorrhea can increase the likelihood of experiencing menstrual pain. If your mother or sisters had severe menstrual cramps, you might be more prone to them as well.

4. Psychological Factors: Anxiety and depression can amplify the perception of pain. Women who are more anxious about their menstrual cycles may experience heightened pain levels.

Management and Relief
To manage menstrual pain, several strategies can be employed:
- Over-the-Counter Pain Relief: Nonsteroidal anti-inflammatory drugs (NSAIDs) like ibuprofen can help reduce pain and inflammation.

- Heat Therapy: Applying heat to the lower abdomen can help relax the muscles and alleviate cramps.

- Lifestyle Modifications: Regular exercise, a balanced diet, and stress management techniques can help reduce the severity of menstrual pain.

- Hormonal Birth Control: For some women, hormonal contraceptives can help regulate or even eliminate menstrual periods, thereby reducing pain.

- Alternative Therapies: Acupuncture, yoga, and dietary supplements such as omega-3 fatty acids may provide relief for some women.

In conclusion, menstrual pain is a multifaceted issue influenced by biological, lifestyle, and psychological factors. Understanding the underlying causes can empower women to seek appropriate treatment and make lifestyle changes that may alleviate discomfort. If menstrual pain is severe or persistent, it is essential to consult a healthcare provider for a thorough evaluation and tailored management plan.

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