Published on Apr 27, 2017 and last reviewed on Aug 22, 2022 - 4 min read
Abstract
Abdominal pain during periods is a very common issue affecting women. Adhering to a healthy lifestyle with a balanced diet, physical activity, mental relaxation, etc., improves the ability to cope with pain. In this article, you will learn about menstruation and its phases, types of menstrual pain, its management, and home remedies.
During the menstrual phase of a menstrual cycle, the lining in a woman's uterus usually sheds, which is called menses, period, or a cycle. The menstrual cycle in fertile females can occur every 28 days, on average. The length of each cycle may also vary between 26 and even 36 days.
The menstrual cycle consists of four phases controlled by the endocrine system, which includes the menstruation phase, follicular phase, ovulation phase, and luteal phase.
The menstrual cycle can be divided into four phases, namely:
Menstruation Phase: On the first day of the menstrual cycle, the uterus lining, prepared for implantation, sheds and may last for about 3 to 5 days typically. This phase is known as the menstrual phase.
Follicular Phase: Follicular phase is the second phase where a mature egg follicle releases an egg from one of the ovaries. At this stage, the uterus starts to prepare for another pregnancy.
Ovulatory Phase: This phase is also called the mid-cycle phase, in which ovulation takes place. It usually occurs from the 13th to the 17th day. The end of the follicular phase, including the ovulation phase, constitutes the fertilization period.
Luteal Phase: Post ovulation phase is the luteal phase, where the fate of the corpus luteum is decided. If fertilization occurs, pregnancy will start. If fertilization does not occur, it marks the onset of another cycle.
Pain during menstruation is usually caused due to prostaglandins, the chemicals your uterus makes. These chemicals tighten and relax your uterus muscles and cause these cramps, which start a day or two before your period.
Period pain can be classified into two types, namely:
Primary Period Pain (Primary Dysmenorrhea): When the uterus structure is normal, and the underlying cause is unknown.
Secondary Period Pain (Secondary Dysmenorrhea): When the pelvic abnormality causes the pain.
Abdominal Pain:
Abdominal pain during periods is a very common issue affecting 40-70% of women in the reproductive age group. In medical terms, we call this a dysmenorrhoea. This is associated with significant psychological, physical, behavioral, and social distress. Usually, it starts with the onset of periods and gets relieved once the flow begins. The exact cause is not known. Sometimes it may be a result of fibroids (lumps), endometriosis, infections, etc. In these cases, we have to first treat the cause along with painkillers to relieve pain.
Women traditionally have been programmed to bear pain instead of seeking ways to relieve pain. This attitude is prevalent even among the educated and more aware, progressive women of our society. As a result, there is a compromise in daily functioning, creativity, and productivity which manifests as social withdrawal, school, and college absenteeism, frequent sick leave at the workplace, etc.
Adhering to a healthy lifestyle, like, a balanced diet, physical activity, mental relaxation, etc., will improve the ability to cope with pain. Painkillers can be taken as advised by your gynecologist after consultation. Non-hormonal preparations are tried first, as second-line hormonal preparations are available.
Treating the cause is as important as treating the pain. In intractable situations, surgery may be the last resort.
PMS - Premenstrual Syndrome:
Premenstrual Syndrome: This group of physical and emotional symptoms may occur two weeks before your period. These symptoms will normally get resolved once your period starts and usually disappear by the end of your period.
Almost all women will have premenstrual symptoms. Each woman's symptoms might be different, but the most commonly occurring symptoms are:
Mood swings.
Feeling depressed, irritable, or bad-tempered.
Feeling upset, anxious, or emotional without any reason.
Sore or tender breasts.
Tiredness or trouble sleeping.
Changes in appetite and food cravings.
Feeling clumsy, fluid retention, and feeling bloated.
Changes in skin or hair.
Every woman may not have all these symptoms, and only a few may experience them. The symptoms form a pattern over time. Symptoms can be the same each month or different sometimes. To assess your symptom's severity and make a diagnosis, your doctor will ask you to fill a symptom diary.
Initially, you can take some positive steps to try and improve the symptoms by doing exercise, eating a healthy balanced diet by decreasing the intake of sugar, salt, caffeine, and alcohol, and increasing the intake of fruits and vegetables. And other ways like reducing the stress and talking with your friends or partner will also help.
Keep track of your symptoms by tracing your period's cycle and your emotions during menstruation.
Add some necessary lifestyle changes.
Exercise every day to release happy hormones.
PMS symptoms can be reduced by the following medications:
Nonsteroidal anti-inflammatory drugs (NSAIDs): Used in relieving pain in primary dysmenorrhea.
Mefenamic acid.
Oral contraceptives: Improves symptoms of primary dysmenorrhea.
Women can get relief from PMS symptoms using herbs like ginkgo, ginger, chaste berry (Vitex Agnus), and evening primrose oil. According to a study, it has been stated that herbs are adequate for the relief of PMS symptoms. Other remedies to relieve PMS symptoms are:
Heat application.
Warm bath.
Abdomen massage with essential oils.
Herbal tea.
Conclusion:
5–10% of women get PMS which is severe enough to prevent them from getting on with their daily lives. A minimal number of women get a more intense form of PMS, known as premenstrual dysphoric disorder (PMDD), which can be treated with medicines.
A period is the normal vaginal bleeding, a part of the monthly menstrual cycle. A normal period lasts for about two to seven days but it varies from woman to woman.
An average menstrual cycle is for about 28 days, and you need to start calculating from the first day of the period till the day your next period starts. The day before your next period is the last day of your menstrual cycle, and that is when you need to stop counting.
There are four stages in the menstrual cycle such as menstrual phase, follicular phase, ovulation phase, and luteal phase. The length of each menstrual stage varies from woman to woman, which can change over time.
Day 21 is considered to be a marker day when you have a normal menstrual cycle of 28 days. Day 21 is considered to be the middle of the luteal phase. In a normal 28 day menstrual cycle, it takes around 14 days to grow and to develop a follicle, and ovulation of the egg occurs around day 14. The luteal phase begins once the follicle releases the egg and lasts for 14 days. Progesterone rises after ovulation and enters the luteal phase, the second half of the menstrual cycle, and reaches a peak around day 21 in a 28-day menstrual cycle.
A period is a normal part of the menstrual cycle when the woman bleeds from the vagina, and the normal period lasts for about three to seven days, and the bleeding is known to be heavier in the first two days.
There are certain foods that can actually cause your periods to be heavier and longer than normal. Some of which are:
- Beetroots.
- Honey.
- Chocolates.
- Dairy products.
When you are having blood clots it is indicative of heavy menstrual bleeding. You can wear a tampon and a pad on your heavy flow days or you can even wear two pads together because high-absorbency pads can help catch the blood flow and clots.
It is possible for fibroids to come out during periods, but this does not happen very often. Fibroids cause bleeding in between periods which is called breakthrough bleeding.
When the period blood smells bad, it indicates an infection. There are different kinds of odors. Even healthy periods can have this smell of blood. The strong smell can be due to the exiting of the blood and tissues along with bacteria. A rotten smell can occur when the tampons have not been changed for too long.
During the days when your period is heavy, the blood seems extra thick, sometimes like jelly because there can be some menstrual clots. Menstrual clots are the mixture of blood and tissue that is being released out from the vagina during the period.
A normal menstrual cycle lasts for about 28 days, but it varies from woman to woman. A healthy period means having a regular cycle, same length every month, no cramping, and no clotting and spotting in between periods.
The estrogen levels rise and drop twice during the menstrual cycle. The levels of estrogen increase in the mid-follicular phase and drop after ovulation, followed by a rise during the mid-luteal phase, and the levels fall at the end of the menstrual cycle.
The four hormones that are responsible for menstruation are follicle-stimulating hormone (FSH) for stimulation of the egg development and to release the estrogen, luteinizing hormone (LH) for ovulation, progesterone for maintaining the uterine lining, and estrogen for the growth of uterine lining.
The menstrual cycle is a series of natural changes in the production of hormones and the structure of the uterus and the ovaries that makes pregnancy possible. The main purpose is to prepare the body for a possible pregnancy.
Last reviewed at:
22 Aug 2022 - 4 min read
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Obstetrics And Gynecology
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