What are the causes of cramps during periods?

Question

Hello doctor,

I am 18 years old, and from the time my periods started, they have always been unbearable. Even missed school in those days due to pain. I consulted a gynecologist for that and she said that I have PCOS and prescribed me medications for that but it got worse after that. Currently, I am having pain in my lower abdomen and lower back, and it is constant and regular. I consulted another gynecologist for this but she said it's nothing. I also have consulted a gastroenterologist, and general physician but they are unable to find out any reason behind this. I want to know if this pain is because of gynecological problems. One more thing: I recently had an ultrasound test and the reports were normal. Kindly suggest. Thank you.

Answer 1

Hello,

Welcome to icliniq.com.

I have read your query and understand your concern. First of all, let me assure you that you do not have PCOS (polycystic ovarian syndrome). You are in the normal weight range and also the scan does not show any PCO (attachment removed to protect patient's identity). I could not get full details from history. So I would like to know if you have had any sexual exposure, vaginal discharge, periods details, and relation of pain increasing and decreasing in relation to periods would have been helpful. Here let me explain the possibilities:

1. Spasmodic dysmenorrhea- this is seen in normal ladies. The blood that has to come out of the uterus will dilate the cervix, this will be relieved only after many years, especially after a vaginal delivery.

2. Endometriosis- Periods blood flows out of the cervix, a small amount of it flows through the fallopian tube onto the ovaries and the surrounding muscles and ligaments. This may not be seen on the scan. Your main problem will be severe pain, stabbing like along with periods, pain less just before periods, keep increasing with periods, and will disappear as periods get over. The amount of bleeding in periods may be slightly more. You may have constipation or diarrhea during periods. Pain will be towards the back, radiating to the legs.

3. If you are sexually active, then pelvic infection has to be ruled out, and needs examination and a course of antibiotics.

For first and second have three to six cycles of cyclical birth control pills like tablet Novelon (Desogestrel and Ethinyl Estradiol) or Ovral-G (Norgestrel and Ethinyl Estradiol) or Dear 21 or Duoluton-L or Intimacy plus 3 - have one tablet every night once from the first day of periods for 21 days, give a gap of seven days, then from the eighth day start having the next packet, you will get periods in between. Do not wait for the periods to start to begin the next packet of pills. From the first cycle itself, you will be relieved of the pain. This is a good method to diagnose the cause too.

Hope I have been of help to you. Thank you.