Have you ever felt that your period cramps last longer than your period? Have you had cramps even when you are not on your period? Have your cramps started before your actual period? Have your cramps bothered you even after your periods were over?
If you said yes to any of those questions, then read on.
Just to avoid confusion later on, cramps are the persistent pain in your lower abdomen, and back that sometimes find a way to migrate to your hips and thighs.
Cramps are very normal during periods, and every woman knows that. It starts to become concerning when it starts before your period or stays long after your bleeding stops. There are multiple reasons for these extra-large cramps, let's see what they are.
Endometriosis
This is caused when cells that are similar to the uterus lining grow outside the uterus. Endometriosis not only causes severe cramps before, during and after the period but also during sex and bowel movements. It could also hurt your lower back in some cases. Other symptoms include excessive bleeding during periods or between periods, infertility, fatigue, diarrhoea or constipation, bloating, and nausea.
The good news is that it can be treated with medication, hormone therapy, or surgery.
Adenomyosis
This happens when the endometrial tissue ( tissue that normally lines the uterus) grows into the muscular wall of the uterus. The displaced tissue continues to act normally — thickening, breaking down and bleeding — during each menstrual cycle. The result is an enlarged uterus and painful, heavy periods. Even though you may not know that you have an enlarged uterus, you may notice tenderness or pressure in your lower abdomen.
The symptoms include heavy or prolonged menstrual bleeding, severe cramping or sharp, knifelike pelvic pain during menstruation known as dysmenorrhea, chronic pelvic pain, and painful intercourse known as dyspareunia.
The symptoms can be treated with pain medications, Hormonal medications, Nonhormonal medication to reduce the amount of vaginal bleeding, Adenomyomectomy to remove adenomyosis from your uterine muscle or Hysterectomy to remove your uterus.
This condition doesn’t usually cause any serious complications but it can lead to difficulty in conceiving or miscarriage. It is best to consult your gynaecologist if you experience extremely heavy periods, severely painful cramps, painful intercourse, or a feeling of fullness or heaviness in your abdomen.
Pelvic inflammatory Disease (PID)
It is an infection of the female reproductive organs. It usually happens when sexually transmitted bacteria spread from your vagina to your uterus, fallopian tubes or ovaries.
The signs and symptoms of the pelvic inflammatory disease might be mild and difficult to recognize. Some women don't have any signs or symptoms. Observable symptoms of PID include:
- Pain — ranging from mild to severe — in your lower abdomen and pelvis
- Unusual or heavy vaginal discharge that may have an unpleasant odour
- Unusual bleeding from the vagina, especially during or after sex, or between periods
- Pain during sex
- Fever, sometimes with chills
- Painful, frequent or difficult urination
- It is time to consult your gynaecologist when you experience severe pain low in your abdomen, nausea and vomiting, fever, with a temperature higher than 101 F (38.3 C) or a foul vaginal discharge
Uterine Fibroids
It is a non-cancerous tumour that grows in and around the womb (uterus). It is also known as a myoma. Uterine fibroids develop from the muscle tissue of the uterus. They may also grow in the fallopian tubes, cervix, or tissues near the uterus.
The symptoms include:
- Heavy menstrual bleeding
- Periods lasting more than a week
- Pelvic pressure or pain
- Frequent urination
- Difficulty when urinating
- Constipation
- Backache or leg pains
It is time to consult your doctor if you have:
- Pelvic pain that doesn't go away
- Overly heavy, prolonged or painful periods
- Spotting or bleeding between periods
- Difficulty emptying your bladder
- Unexplained low red blood cell count (anaemia)
The good news is that it can be treated and, by making healthy lifestyle choices, such as maintaining a healthy weight and eating fruits and vegetables, you may be able to decrease your fibroid risk.
Ovarian Cysts
An ovarian cyst is a fluid-filled sac that develops on an ovary. They're very common and do not usually cause any symptoms. It usually only causes symptoms if it splits (ruptures), is very large or blocks the blood supply to the ovaries.
In such cases, the symptoms are:
- pelvic pain – this can range from a dull, heavy sensation to a sudden, severe and sharp pain
- pain during sex
- difficulty during bowel movements
- a frequent need to urinate
- heavy periods, irregular periods or lighter periods than normal
- bloating and a swollen tummy
- feeling very full after only eating a little
- difficulty getting pregnant – although fertility is usually unaffected by ovarian cysts
The treatment will depend on factors like your age, your symptoms and what’s likely causing your cyst.
Cervical Stenosis
It is when the cervix (narrow opening in the lower end of the uterus) is either too narrow or completely closed, which leads to blockage of passage between the uterus and vagina. This will affect the pregnancy and menstrual cycle of the women.
The symptoms include:
- Irregular periods and abnormal bleeding
- No periods (amenorrhea)
- Pain during your period (dysmenorrhea)
- Infertility, if the stenosis is completely blocking the sperm’s path to the uterus
- Chronic pelvic pain or bulging in the pelvic area (occurs with pyometra and hematometra)
Cervical stenosis can be treated by physically widening the cervix with instruments called dilators.
Ectopic Pregnancy
It is when a fertilised egg implants itself outside the womb, usually in one of the fallopian tubes. The fallopian tube isn’t made to hold a growing embryo. This condition can lead to bleeding in the birth parent. An ectopic pregnancy is a life-threatening condition that requires emergency treatment. It occurs in about 2% of all pregnancies.
The symptoms include:
- Vaginal bleeding.
- Pain in your lower abdomen, pelvis, and lower back.
- Dizziness or weakness.
If your fallopian tube ruptures, the pain, and bleeding could be severe enough to cause additional symptoms like:
- Fainting.
- Low blood pressure (hypotension).
- Shoulder pain.
- Rectal pressure or bowel problems.
It can be treated with medication or surgery.
Implantation
When you become pregnant, your uterine lining may shed and cause light spotting. This is known as implantation bleeding. It usually occurs 7 to 14 days after conception.
Uterine cramping can also occur, especially in the first part of your pregnancy.
Take a pregnancy test to ensure that you’re pregnant.
Ovulation Cramps (Mittelschmerz)
Mittelschmerz is lower abdominal pain on one side that’s caused by ovulation. It can last up to 2 days. You may feel a dull, cramp-like sensation on one side. The pain may come on suddenly and feel very sharp.
You may also experience vaginal discharge or light bleeding.
Consult your doctor if the pelvic pain worsens, or if you also have a fever or nausea.
Now let's talk about the most important issue.
How to manage your cramps?
Tried and tested solutions include
- Heat - Using a heating pad or soaking in a warm bath are great ways to ease period pain, but you can also use heating patches if you're looking for a discrete, on-the-go way to get relief.
- Pain Medication - Anti-inflammatory medicines stop your body from producing prostaglandins. They work best if you start taking them as soon as the pain starts, or 48 hours before you expect to get your period. They are available over the counter from a pharmacy. If you are concerned about the safety aspects, talk to your gynecologist before taking them.
- Hormone Treatments - To manage period pain in the longer term, your doctor might prescribe the combined oral contraceptive pill or the contraceptive vaginal ring. Long-acting contraceptives, such as the progestogen implant or hormonal intrauterine device (IUD), can also reduce period pain. Many people who use these find that their periods become lighter or stop.
- Exercise - It stimulates the release of endorphins, which are chemicals produced by the body that help block the perception of pain.
- Reduce Stress - Self-care methods like meditation and yoga can help you as stress lowers your threshold for pain.
- Nutritious Diet - Eating a healthy diet may be yet another way to relieve period pain since certain vitamins and minerals have been suggested to help reduce cramps.
The most important takeaway here is that you have to take care of yourself not just when you have your cramps - keeping you happy, healthy and stress-free can go a long way in managing cramps. And if you feel any excessive pain or bleeding it is better to consult your doctor right away so that they can guide you in the right direction to manage your discomfort.