Menstrual Pain

 Menstrual  pain



 In most cases, menstrual pain is not severe or complicated.  Therefore, it can be treated at home.



Causes:

 Menstrual or period pain is a common occurrence.  It is a normal part of the menstrual cycle.  Most women face this problem at some point in their lives.

 


 Type of pain:

 Period pain is usually a biting pain in the stomach.  This pain can spread to the waist and thighs.

 Sometimes the abdominal pain comes and goes like a sharp bite or spasm.  Other times there may be a constant dull ache.The pain may vary from period to period.  Some months may feel like little discomfort or no pain at all.  Other menstrual periods can be very painful.But sometimes such pain in the lower abdomen may occur outside of the menstrual period.


 How long do period pains last?

 Period pains usually start at the onset of menstruation.  However, in some cases, the pain starts quite a few days before the onset of menstruation.


 Period pains usually last 48 to 72 hours.  However, the pain may last longer.  Usually the time of menstruation when the bleeding is heaviest is also the time when the pain is the most.


 Adolescents usually experience pain when their period starts for the first time.


 If there is no underlying disease behind period pain, the pain usually lessens with age.  Many people experience less period pain after childbirth.


 Ways to reduce period pain

 In most cases, period pain is not severe or complicated.  Therefore, it can be treated at home.  Treatment options are discussed below-



1.  Bake it

 Bake hot.  Studies have shown that hot poultices are more or equally effective than some conventional medications for reducing period pain.  Hot tea is more effective than paracetamol and as effective as ibuprofen. Another advantage of hot tea is that it has no side effects.


 How to cook: A 'hot water bag' can be wrapped with a towel or a thick towel and placed on the stomach.  Be careful when using hot water bags.  For example –


 Water of tolerable temperature should be used

 Check whether the mouth is well closed

 The bag should be turned over at regular intervals

 Baking can be done by other means including 'electric heating pad' instead of 'hot water bag'.


 2.  Consume ginger

 Ginger can reduce period pains. People who suffer from regular period pains can start consuming ginger before the onset of period pains.  Ginger can be crushed and eaten as it is or mixed with hot water or tea.  For the first 3-4 days of menses, you can eat ginger slices three times a day.


 3.  Do breathing exercises

 A good way to reduce period pain is to do breathing exercises.  How to do breathing exercises -


 Place one hand on chest and other hand on stomach

 Breathe in through your nose.  Breathe in such a way that the air enters deep into the chest and expands the belly.  If you breathe in this way, the hand above the stomach will come up.

 Then exhale through the mouth as if blowing out a candle.

 After exhaling, the hand placed on the stomach will return to its original position


4.  exercise

 Studies have shown that regular exercise or keeping the body active in any way can reduce period pain.  For this reason, 3 days or more in a week for 45 minutes to one hour should be done regularly.  If you want, you can opt for light exercises like swimming, walking, cycling and yoga in addition to heavy exercise.


 Pain during periods may make you unwilling to exercise.  In that case do light exercise like walking if possible.


 5.  Massage the abdomen

 A gentle massage in and around the lower abdomen can help reduce pain.


 6.  Relax

 Try to remain stress-free.  Yoga and meditation can help distract from feelings of pain and discomfort.


 7.  Bathe with warm water

 Taking a bath with warm turmeric water can reduce period pain.  It will also help you relax.


 Medicines to relieve period pain

 Ibuprofen and aspirin

 Ibuprofen is very effective in reducing period pain.  Period pain is caused by a chemical called 'prostaglandin'.  Ibuprofen blocks this chemical, thereby reducing pain.


 Pain usually subsides within 20-30 minutes after taking this medicine.


 Ibuprofen 400 mg tablets should be taken 3 to 4 times a day.  This medicine should be taken after 4 to 6 hours.  Only those who are 12 years of age or above can consume this medicine.


 Ibuprofen is a medicine of the 'NSAID' group.  It should be consumed on a full stomach, otherwise it may cause stomach problems.  You can take the medicine after a meal (eg a glass of milk).  Period pain usually does not need to be taken for more than 1-2 days.


 Ibuprofen is more effective than paracetamol in reducing period pain.  However, in some cases, this medicine should be avoided.  For example –


If you have asthma or asthma

 If you have stomach, liver, kidney and heart problems

 If you have stomach ulcer or gastric problem

 Note that, for period pain, another medication from the NSAID group, called aspirin, can be taken instead of ibuprofen.  It should also be consumed on a full stomach.  However, it should not be consumed by people under 16 years of age.


 Sometimes a 'gastric medicine' (ie: omeprazole) is advised before taking these medicines.  Consult a doctor about this.


 Paracetamol

 Those aged 12 and over can take 500 to 1000 mg of paracetamol.


 500 mg tablets can be taken 1 or 2 times every 4-6 hours.  However, a total of 8 tablets of 500 mg should not be consumed in 24 hours.


 Before buying the medicine, you can read the text on the packet.  It will help to remember the dose according to age.


 For paracetamol dosage for children under 12, read: Paracetamol for children


 Sometimes a medication may not work to ease period pain.  Then you can take both ibuprofen and paracetamol together.


 If the pain does not subside even after taking these medicines, then you should go to the doctor.  He or she may suggest other drugs from the 'NSAID' group, hormonal drugs or birth control pills.  In this case, the correct medicine and dosage will be determined according to the patient's condition.


 When to Consult a doctor:


 If there is unbearable pain during menstruation or a change in the normal pattern of periods (eg: irregular periods or excessive bleeding), a doctor should be consulted.


 A gynecologist should be consulted if the condition does not improve after three months of using painkillers or a suitable birth control method.  He will suggest some tests.  If there is a hidden reason behind period pain through examination, it will come out.  These tests include—


A urine or blood test

 Pelvic ultrasound

 Laparoscopy

 Hysteroscopy

 Treatment of period pain

 Period pain relief machine

 TENS or 'transcutaneous electrical nerve stimulation' machine can be used to reduce period pain.  This small machine uses electric current to reduce period pain.  Studies have shown that using this machine on the 'high-frequency' setting reduces period pain.  Before using it at home, you need to learn how to use it from a physiotherapy or pain clinic.[8]


 Birth control methods

 The 'Combined Oral Contraceptive Pill' or birth control pill (ie: Sukhi) is a popular method of birth control.  However, it can also be effective in treating period pain.[9]


 These pills contain hormones called estrogen and progestogen.  These are—


 Reduces the release of chemicals called prostaglandins

 Thins the lining of the uterus

 Prostaglandins stimulate uterine wall contractions.  Decreased secretion of prostaglandins reduces the contraction of the uterine wall and reduces the intensity of pain.


 On the other hand, the thickness of the lining of the uterus decreases, so during menstruation, the uterine wall does not need to contract as strongly as before.  As a result, period pain is reduced.  Along with this, the amount of blood loss also decreases.


 Thus, birth control pills can help reduce period pain.


 If birth control pills aren't right for you, your doctor may suggest using a stick method (implant) or birth control injection as an alternative.  In some cases, the use of Mirena (intrauterine system) may also be recommended.


 Treatment of the underlying disease

 Period pain can be caused by an underlying disease.  In this case, the treatment method will be different according to the disease.  For example, the treatment of 'Pelvic Inflammatory Disease' requires the use of antibiotics.  Again, fibroids may require surgery to treat.



Period pain and fertility

 Having period pain as a normal part of the menstrual cycle does not affect a woman's ability to conceive.  However, if there is an underlying disease behind period pain, it is likely to affect fertility.


 For example, period pain can be caused by diseases like endometriosis and pelvic inflammatory disease.  These diseases cause inflammation in the uterus, fallopian tubes and ovaries.  If left untreated, these organs can be repeatedly damaged.


 Flesh may grow during wound healing.  When the flesh inside the fallopian tube increases, the movement of sperm is obstructed.  As a result, fertilization with the egg becomes difficult.  Which affects fertility.


 Therefore, if the symptoms of these diseases appear, it is necessary to start treatment on time.  If the symptoms do not improve even after taking period pain treatment for a long time, a gynecologist should be contacted immediately.


 Causes of period pain

 Menstruation is caused by a sudden drop in the levels of hormones associated with reproduction at a specific time.  During this time, under the influence of hormones, the inner lining of the uterus sheds and comes out with the menstrual blood.  The walls of the uterus contract strongly to shed this lining and expel it properly.


 Due to such contraction, the blood vessels on the surface of the uterus are also constricted.  As a result, blood and oxygen supply to the uterus is temporarily stopped.  Due to the lack of oxygen, certain chemicals are released from the uterus.  Period pain starts under the influence of these substances.


 Along with these chemicals that cause pain, another type of chemical called prostaglandin is released from the body.  Prostaglandins strengthen the contraction of the uterine wall.  As a result, the intensity of pain increases.


 Good to know-


Uterine contractions occur due to various physiological reasons.  The uterus continues to have gentle contractions all the time.  These contractions are usually so mild that most women do not feel them.


 However, the degree of compression may vary due to various reasons.  Factors such as fluctuations in reproductive hormones and pregnancy are responsible for such variations.


 But during menstruation, the walls of the uterus contract strongly to expel menstrual blood and other harmful substances from the uterus.  It causes the walls of the uterus to become tight.  As a result women feel pain.


 Note that it is still unknown why some women experience more period pain than others.  In some cases, increased prostaglandins are thought to increase the severity of contractions.  As a result, the level of pain also increases.


 Diseases that cause period pain

 Some diseases can cause period pain.  However, the incidence of period pain due to these reasons is relatively less.  Diseases that cause period pain include—


 Endometriosis: In this disease, tissue like the lining of the uterus develops outside the uterus (eg, fallopian tubes or ovaries).  These tissues transplanted outside the uterus also shed during menstruation.  At this time there may be severe pain.  Along with pain, menstruation can also cause excessive bleeding.

 Fibroids: These are tumors that grow from the muscular layer of the uterus and develop inside or around the uterus.  These tumors usually do not turn into cancer.  Fibroids can cause abdominal pain and excessive bleeding during menstruation.

 Pelvic Inflammatory Disease: It is a disease of female reproductive system.  It causes bacterial infection of the uterus, fallopian tubes and ovaries.  As a result, severe inflammation or burning occurs in these organs.


Adenomyosis (Adenomyosis): In this disease, some tissues or cells like the lining of the uterus also grow on the walls of the uterus.  Bleeding occurs from these cells which are formed in the walls of the uterus during menstruation.  But this blood has no way to get out.  As a result, there is a lot of stomach pain during menstruation.  There may also be excessive bleeding.

 Period pain due to these diseases is most common in women aged 30-45 years.


 Menstrual pain due to birth control methods

 The intrauterine device or IUD is a popular long-term birth control method.  It is called Copper-T.  It is a small object made of copper and plastic.  It is inserted into the uterus for birth control purposes.


 Sometimes using this method can cause period pain.  The first few months after the IUD is inserted into the uterus can be especially painful.


 IUD use or a medical condition associated with period pain may cause a change in the normal pattern or timing of periods.  For example, period pains are more severe than before or periods last longer than other months.


 Apart from this the following health problems may occur-


 Irregular menstruation

 Bleeding between periods

 Thick and foul-smelling vaginal discharge

 Pain during intercourse

 A doctor should be consulted if these symptoms appear along with pain during menstruation.


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