What are severe menstrual pain treatment options?

Question

Hi doctor,

I am a 22-year-old female. Why does the area, which I believe is my ovaries, hurt when I stretch? The pain would be in both the left and right sides. When I sit down for a long time or when I defecate, it hurts a lot in the area. During my periods, why do my legs go numb?

Every month around that time, I experience leg numbness, back pain, pain in the butt area, and pain in my stomach. I understand the stomach pain, but why do I have pain in other areas? When all this pain starts, I get panicked, as I do not know what to do. I try sitting down for a few seconds, which helps, but then my back pain starts. I try to walk, but the pain is not relieved. I start feeling sick and throw up. I start getting suicidal thoughts, and I just want to put myself out of this misery.

When I take two painkillers for the pain, I end up sleeping the entire day and get up only to use the restroom. I do not eat, and I would end up going days without eating until I feel better. So, I just want to know what the cause of this is. This will help me explain to my physician to help me better. I feel like this would affect me trying to go to work. I am trying to find a job, but I feel that if I take so many days off for the pain, my boss will fire me.

I was thinking of getting a partial hysterectomy to stop it, maybe, so I will have to deal with the pains, and I can stay on the job. But I am not sure if my insurance will cover it. Do you have any suggestions? Sorry for the long query, I just really need help. The last physician I had could not help me in the way that I needed help, so I stopped going to her.

Please help.

Thank you.

Answer 1

Hi,

Welcome to icliniq.com.

From the history you have given, it sounds like something is affecting the neuromuscular area on both sides at the pelvis, or may I say the deep groin area. If I may further explain, the uterus is a 2.7-inch-long muscular structure, which is being held in position, folded onto itself by fascia, but more importantly, there are muscles and ligaments, which fix it to the surrounding bones and strong areas.

Mainly to the pelvic bone, sacrum, and backbones. So, if something in or around the uterus is making it heavy or congested, as occurs during periods, these supports will get stretched and create pain radiating to the back and legs. The blood vessels and nerve supply to the limbs are compressed due to this congestion or weight. This can cause numbness and all the discomfort you have mentioned.

The bowel is a loose structure inside the abdomen. So when it is distended, the ligaments and muscles will get stretched and cause discomfort. Performing a surgery, as you mentioned, would be a heinous crime at your age. The cause of the pain is not the uterus; it is something around it, so that has to be treated, not just the uterus removed. You are too young; removal of the uterus will cause premature menopause, as the blood flow to the ovary also falls after surgery.

Hot flushes, menopausal symptoms, and complications will be more distressing than these complaints. Vaginal infections are transmitted during sex, so the partner is the source. Both have to be treated at the same time, or else you will get infected next time you have sex. You may have white, yellow, or grayish discharge with or without itching, a foul smell, or pain at the beginning of sex due to dryness. This pain may radiate to the back and thighs.

Bleeding of periods will be thicker, darker clots or fleshy-mass-like, may smell bad, and may have more days with spotting after the periods too. When you have an infection inside the uterus, the blood flow increases as the inner lining is inflamed, and the blood mixed with the inner lining of the uterus forms a thick, doughy, or fleshy mass. As the healing of the lining is not complete, it keeps spotting, or you have blood-stained discharge. Pain is throbbing even before periods and lasts after periods are over, too.

Usually, infection is mixed and not just due to yeast fungus. There will be a family of aerobic and anaerobic bacteria, all of which cannot be detected by culture. When one is treated and cleared, others will grow. Before treatment, confirm that you are not pregnant.

I suggest you and your partner try taking the following:

Tablet Fluconazole 150 mg stat (only one tablet and no repetition), after lunch.
Tablet Azithromycin 1 g stat (only one tablet and no repetition), one hour before food.
Tablet Secnidazole forte (two tablets stat and no repetition), after dinner.

After this, I suggest you try taking the following:

Capsule Doxycycline 100 mg, twice a day for a week.
Vaginal wash twice a day.
Vaginal pessaries, like capsule Clingen Forte or Candid-CL or Cansoft CL (Clindamycin and Clotrimazole), once at night for five nights.

I suggest your partner use any antibiotic and antifungal cream, like Candid B or Candiderma (Clotrimazole and Beclomethasone) on the penis twice a day after washing for seven days. Do not have sex till the infection is fully gone. Do treat it, as delay may send the infection inwards and may affect both you and your partner's future fertility.

Endometriosis means every month your blood flows out of the cervix, but a small fraction flows out of the tubes into your abdominal cavity; this settles on the ovary, muscles, and ligaments that I had mentioned. This causes inflammation of the surrounding structure; every time you have periods, the pain increases.

Main symptoms are severe pain during periods and bleeding slightly more than normal. Severe pain during sex, deep pain that is the stabbing type. The solution for this is to have a pelvic scan to see if there are any cysts. Stop the periods using pills or injections; as long as you stop the periods, endometriosis will be quiet. If pregnancy is on the cards, have as many babies as you want as soon as possible. These adhesions can later block the fallopian tubes in the future.

I hope this helps.

Please revert in case of further queries.

Thank you.