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Severe period pain on the first day

Menstruation is a physiological process by which a typical female of reproductive age has a menstrual flow for 6-7 days of a normal menstrual cycle. The menstrual flow might be associated with pain which is then called Dysmennorhea or a painful period. Period pain usually occurs in the pelvic area mainly due to active contraction of the uterine walls. For some people, abdominal discomfort, nausea, vomiting, and diarrhoea may also tag along with period cramps.

Painful Periods (Menstrual Cramps)

Almost every girl of early reproductive age has to go through painful menstruation which is why it is now commonly associated. The point of concern is to assess the severity of painful periods. Painful periods or dysmenorrhea is therefore divided into two main groups for convenience:

1. Primary Dysmenorrhea

Primary dysmenorrhea is the cramping pain that sets in just before or during the first days of menstrual flow which is the normal type. Prostaglandins are lipid chemicals that act just like hormones on the uterine wall during menstruation. These chemicals are involved in the active contraction of uterine musculature and blood vessels. The level of these chemicals is high on the first 1-2 days of menstruation and lessens later which presents with a decrease in pain during the later days.

2. Secondary Dysmenorrhea

Secondary dysmenorrhea is the kind of painful menstrual cramps that sets in a few days before the menstrual flow begins and might last even after the menstruation ends. This type is more severe and always associated with underlying medical conditions in reproductive organs in a female of any age.

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Causes of Severe Painful Periods

Certain underlying disease conditions are usually associated with painful cramps in menstruation thus it should be thoroughly investigated by an expert OB/GYN. Following are some of the commonly suspected conditions that cause secondary dysmenorrhea.

1. Endometriosis

It is the deposition of uterine inner lining tissues in areas other than the uterus. The endometriosis female can have a regular menstrual cycle which is why they are usually unaware of it unless the pelvic pain gets unbearable and they seek medical attention. This condition is associated with excruciating pain and heavy bleeding since the endometrium (inner lining of the uterine cavity) has a rich blood supply. Endometriosis most commonly impacts the ovaries which can cause infertility if not treated well on time.

2. Uterine Fibroids

Uterine fibroids are fibrous, glandular, and muscular outgrowths in the uterus. Females with fibroids complain of heavy bleeding and pelvic pain for days. Heavy bleeding is due to the fact that it involves the endometrium as well which has a rich blood supply. Some of the symptoms of fibroids are the following:

- Heavy Menstruation (lasting for more than a week)

- Anaemia

- Difficulty in both peeing & pooping

- General body weakness and fatigue

3. Sexually Transmitted Infection

Certain bacteria and viruses are bound to stay in the genital tract or in the overall body after being acquired from other sources. These sources may include certain animals, unhygienic places and equipment, sexual relationships with multiple or a single but diseased partner, etc. Sexually Transmitted Infections(STIs) are a class of infections that are transmitted from one human to another via the genital tract. STIs in females can cause unpleasant PMS like a bad headache, irritation, fatigability, and pelvic pain that sets in a week or more before menstruation.

4. Polycystic Ovary Syndrome

Polycystic Ovary Syndrome(PCOS) is a reproductive organ condition in young females that involves multiple cysts on one or both ovaries with evident hormonal imbalances. Now one of the most debatable and concerning syndromes in young females, PCOS has quite some association with pelvic pain as well. The following are some of the commonly found symptoms are found in females with PCOS.

- Pelvic Pain

- Excess Facial Hair(Hirsutism)

- Irregular Period

- Weight Gain

In cases of the above symptoms, one should opt for medical attention since PCOS at some point can lead to female infertility.

Treat Painful Periods

Mild to moderate levels of period cramps can be treated with various conventional methods and medications which are discussed below.

1. Hot Fomentation

Apply warmth on the lower belly where it hurts the most using a hot water bottle or heating pad. Hot Fomentation can be of great help as it softens the tenderness and relieves severe cramps.

2. Warm Drinks Intake

Although it is not proven scientifically, many women still believe that taking warm fluids can ease their period pain while cold beverages do the opposite for them. Warm drinks like tea and milk are highly encouraged to relieve stress. Minimize the intake of caffeine as it acts on blood vessels that might cause interference with normal menstrual flow and cause period pain.

3. Medications

The main line of medicines used for pelvic pain due to menstruation is NSAIDs(Non- Steroidal Anti-Inflammatory Drugs). This class of drugs will block the production and secretion of prostaglandins which are the chemicals contracting the uterus muscle wall during menstruation. Once the channel is blocked, prostaglandins won't be able to cause the resultant pain. Paracetamol and other over-the-counter painkillers can also be taken on a doctor's prescription for period pains.

4. Surgical Intervention

Severe pelvic pain can halt daily life routine and anxiety before the onset of periods. A surgical approach is a must if medicines won't work for a certain patient with a painful period.

a. Intrauterine Device

Recent advancements in medicine can now ensure the relief of pelvic pain due to menstruation for a long period of time. Hormonal Intrauterine Devices(IUDs) are used to treat heavy menstrual flow and the cramps that tag along with it. These devices are placed in the neck of the uterus through the vaginal route. IUDs can help with birth control, heavy menstruation, and intense period pain for more than 5 years.

b. Uterine Artery Embolization(UAE)

This is a commonly practised surgical procedure in females with fibroid. As the fibroids thrive on a constant blood supply, the OB/GYN will aim for those arteries. Once these arteries are embolized and closed, the fibroids may regress on their own resulting in period pain relief.

c. Hysterectomy

Hysterectomy is the partial or total removal of the uterus and its counterparts. It is a reluctant choice to make for females of reproductive age who plan to give birth later in life. However, females in their menopause can relieve their pelvic pain due to different underlying conditions in the reproductive organs with this surgical procedure.

For more tips on how to manage your menstrual cycle, visit the Welzo Women's Health Hub.