What can be the cause for severe cramps during periods?

Question

Hi doctor,

When I was in high school, I had horrible periods. Very heavy bleeding, big clots and they would last longer than a week sometimes. I never told anyone because I was embarrassed and eventually, it calmed down and they were more normal. I still had awful, awful cramps every month though until about two years ago when I went on birth control. Since then they have been super easy, light, only lasting a few days with manageable cramps. But slowly every month my cramps are getting worse and worse again. Any idea, why?

Answer 1

Hi,

Welcome to icliniq.com.

Your symptoms can have two causes, one is low pain threshold (pain sensitivity varies among individuals) or endometriosis. Endometriosis is less likely in your case as oral contraceptives are known to suppress it. If you are taking low dose oral contraceptive (Estrogen 20/30 mcg), you can take a high dose (Estrogen 35/50 mcg) for two to three months (if your doctor permits or if you have no risk factor for high dose pill. You can see package insert for risk factors) and see if pain reduces or disappears. Other option would be to take same birth control pills continuously without a break for menses (it can be safely taken continuously for nine months) if it is acceptable to you. Normally, such pain of dysmenorrhoea reduces or disappears after childbirth. So you may have to bear some pain till then.

What can be the cause for severe cramps during periods?

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