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Q. Can I try continuous pill-taking to stop my persistent and severe period pain?

Answered by
Dr. Donalyn S. Barcial
and medically reviewed by iCliniq medical review team.
This is a premium question & answer published on Apr 17, 2022

Hi doctor,

I experienced severe pain every time I had my periods. I am experiencing pain during the first day of my period. The pain usually takes three to four hours. But when I have tablet Mefenamic acid, the pain only lasts for one to two hours, but sometimes the medicine does not work. I had a consultation with a doctor, and she told me to do an ultrasound test to see if I had endometriosis, but the test came back negative. One of my friends recommended that I try continuous pill-taking to stop my period so I would not have the pain anymore because that is what other doctors recommended. Is it also a good option for my situation? Please help.

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#

Hi,

Welcome to icliniq.com.

I understand your concern.

Cyclic pelvic pain or cramps during your period is most often caused by pelvic endometriosis. The probable cause might be endometriotic implants. Ultrasound is not sensitive in its diagnosis. Hence clinical evaluation and history are of utmost importance in the diagnosis. Taking tablet Mefenamic acid every eight hours during your period is an excellent option, or I suggest you may take tablet Ibuprofen. In addition, I would suggest you can take other medications which can relieve the pain, tablet Visanne 2 mg (Dienogest 2 mg) every day. I suggest you take it continuously for six to 12 months. Another way of diagnosis is through direct visualization by laparoscopic surgery, but it is not practical since the management is just symptomatic relief. I suggest if you have no dienogest pills in your country, you can ask your doctor to give you other medications such as gonadotropin-releasing hormone (GnRH) antagonists injections or simple depot medroxyprogesterone. The endometriosis becomes active only during menstruation. Hence the depot will help you not have a regular menstrual period by inactivating it for a while.

I hope this helps.


The Probable causes:

Endometriotic implants

Investigations to be done:

None

Differential diagnosis:

Menstrual cramps

Probable diagnosis:

Endometriosis

Treatment plan:

Dienogest pills

Gnrh injection

Depomedroxyprogesterone

Preventive measures:

Pain meds during pwriod

Hi doctor,

Thanks for your reply. You suggested taking dienogest for six to 12 months. Can I stop after, or am I supposed to take tablet Dienogest forever? Also, I saw online that I could not use any hormonal birth control method if I take tablet Dienogest. What is the best option that would treat my problem and allow me to have a birth control method? Please help.

#

Hi,

Welcome back to icliniq.com.

I understand your concern.

Tablet Dienogest can be stopped after six months. If you observe pain persists in the first or succeeding periods, then I suggest you continue or resume it for another six months. Another option for birth control is IUD (intrauterine device). Not the hormonal type, just the copper T. If you have issues with copper IUD, the only way I suggest is to take your regular combined OCPs (oral contraceptive pills), then choose a GnRH injection rather than tablet Dienogest.

I hope this helps.


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