Chronic Menstrual Pain: Seeking Solutions for Relief

Chronic menstrual pain

Hello doctor, I have been suffering from chronic menstrual pain for a long time.
I have seen more than a dozen doctors without any improvement.
My symptoms start about ten days before my period (around ovulation) and last for three to four days, then the pain subsides until two days before my period when it starts again.
The worst pain occurs on the second day of my period, which is so severe that it causes palpitations, trembling, and an overwhelming fatigue that makes me feel like I could fall asleep.
The pain is debilitating, often forcing me to take leave from work.
During my menstrual period, the pain lasts for about four days, and it takes eight days for everything to clear up.
When I visit doctors, they either prescribe painkillers or birth control pills, but there has been no improvement.
Recently, the duration of the pain has increased; it started ten days before my period again, but this time it has lasted for eight days.
Every morning when I wake up, I am in so much pain that it makes me irritable.
I really want to find a doctor who can explain what is happening and provide a definitive solution to this problem.

Ta Er, 40~49 year old female. Ask Date: 2015/11/09

Dr. Lin Wenbin reply Obstetrics and Gynecology

The physician who can solve your problem must also examine the patient in person to determine how to proceed.
It is advisable to seek a trusted physician for an evaluation.

Reply Date: 2015/11/09

More Info

Chronic menstrual pain, often referred to as dysmenorrhea, can significantly impact a woman's quality of life, as you've described. Your symptoms, which include pain starting around ovulation and intensifying just before and during your menstrual period, are indicative of a condition that may require a more comprehensive evaluation and treatment approach.

Firstly, it's essential to understand that menstrual pain can stem from various underlying causes. Primary dysmenorrhea is typically related to the menstrual cycle itself and is often due to the release of prostaglandins, which are chemicals that cause the uterus to contract. Secondary dysmenorrhea, on the other hand, is usually associated with underlying reproductive health issues such as endometriosis, fibroids, or pelvic inflammatory disease. Given that you have seen multiple doctors without relief, it may be beneficial to explore the possibility of secondary dysmenorrhea, particularly endometriosis, which is known to cause significant pain and can often be overlooked.

Your experience of severe pain leading to symptoms like palpitations, fatigue, and the need to take time off work suggests that the pain is not just a typical menstrual cramp but may be more complex. The fact that your pain has increased in duration and intensity is concerning and warrants further investigation.
Here are several steps you might consider taking:
1. Comprehensive Evaluation: Seek a gynecologist who specializes in chronic pelvic pain or endometriosis. A thorough evaluation, including a pelvic exam, ultrasound, or even a laparoscopy, may be necessary to identify any underlying conditions.

2. Pain Management Strategies: While you have been prescribed pain medications and hormonal contraceptives, these may not be sufficient for your specific situation. Discuss with your doctor the possibility of trying different classes of medications, such as NSAIDs (non-steroidal anti-inflammatory drugs) or hormonal therapies tailored to your symptoms.

3. Lifestyle Modifications: Incorporating lifestyle changes can also help manage pain. Regular exercise, a balanced diet, and stress management techniques such as yoga or meditation can be beneficial. Some women find relief through acupuncture or physical therapy focused on pelvic pain.

4. Alternative Therapies: Consider discussing alternative therapies with your healthcare provider. Some women find relief through dietary supplements (like omega-3 fatty acids), herbal remedies, or acupuncture. However, it’s crucial to consult with a healthcare professional before starting any new treatment.

5. Support Groups: Connecting with others who experience similar issues can provide emotional support and practical advice. Look for local or online support groups for women with chronic menstrual pain or endometriosis.

6. Educate Yourself: Understanding your condition can empower you to advocate for yourself in medical settings. Research reputable sources about dysmenorrhea, endometriosis, and other related conditions.

7. Second Opinion: If you feel your concerns are not being addressed adequately, seeking a second opinion from another specialist can provide new insights or treatment options.

In conclusion, chronic menstrual pain is a complex issue that often requires a multifaceted approach. By working closely with a knowledgeable healthcare provider, exploring various treatment options, and considering lifestyle changes, you can find a path toward relief. Remember, you deserve to have your pain taken seriously and to receive the care that addresses the root causes of your symptoms.

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