Menstruation is a natural, and essential part of every woman’s reproductive cycle, and pain due to menstrual cramps/period cramps has been around since women have existed on earth. It is not a taboo or curse but too often it is shrouded in secrecy, leading to exclusion, neglect, and discrimination.
From childhood girls are told to hush about these pains and that they should wear a strong facade and bear the pain. Period cramps and pain are often considered ‘normal’ and neglected by society, up to 20% of women suffer from cramping severe enough to interfere with daily activities and contribute to the loss of working hours. Most of these women grimace through it without ever speaking up.
Many women with reproductive health problems ignore severe period pain as JUST period pain every month and take painkillers to ignore the pain.
Undiagnosed self-medication is harmful in two ways.
One, it causes masking of the real underlying problem and second it may lead to unwanted effects of self-medication. There is a need to educate women about period pain and self-care to manage the pain symptoms associated. Excruciating period pain can take a toll on the quality of life and is not something that a woman should have to suffer through in silence
Menstruation is normal but for it to cause extreme pain isn’t. Extreme period pain could be a sign of an underlying condition such as endometriosis, PCOS, Endometrial polyps or even Uterine Fibroids. When a woman has extreme pain while menstruating it is called Dysmenorrhea. In this, there is throbbing or cramping pain in the lower abdomen or pelvic area. Cramps are caused by the uterus contracting to help expel its lining, which is the purpose of menstruation.
PCOS could be an underlying condition that can be a reason for extreme pain. PCOS is a hormonal disorder where women experience irregular periods, they often experience heavy bleeding, clots, and severe period pain. It also results in physical changes due to hormone imbalances, and this is the most common disorder found in most women practising unhealthy lifestyles.
Endometriosis is another condition where there is a stabbing pain that begins days before your period and persists long after. The cause of this pain is the forceful contraction of the uterus and other organs as the endometrium sheds at the time of menstruation. In the patients of endometriosis, the shed tissue can retrogradely pass to the pelvic cavity, where it can deposit outside the uterus, over ovaries, pelvic nerves, causing severe pain. This is a serious problem that is often neglected by doctors too at the initial stage and addressed as menstrual cramps which results in a delay of diagnosis for 10-12 years.
Uterine fibroid is a condition in which there are non-cancerous growths in the wall of the uterus which are the reason for extreme pain.
While all these conditions are linked to women’s reproductive health, this definitely impacts a woman’s fertility along with other problems. PCOS is caused by a hormone imbalance that disrupts ovulation. In this condition, ovaries fail to undergo the normal ripening and maturing one egg each cycle, this, in turn, leads to infertility.
Endometriosis too is an important factor in infertility, as it can cause tubal blockages, ovarian cysts and decreases the quality and quantities of egg reserve. Uterine fibroid present on the outer wall of the uterus may not be a problem, but severe pain, increasing size of fibroids and presence of multiple fibroids is something that should not be ignored.
As we see, is important not to overlook the period pain and brush it aside as this can impact reproductive health and fertility.
Symptoms of all these conditions are somewhat similar to extreme pain and heavy blood flow with irregular menstruation. Women should consult their respective doctors as soon as they experience any of the above-listed symptoms.
While practising a healthy lifestyle and consuming a balanced diet can be a good start towards keeping extreme pain at bay, it is better to not ignore the pain and seek necessary help. Moreover, society should not consider period pain as taboo and should help in every way they can. Thus it’s high time we realise that menstrual pain is not just another thing that the women have to bear. There is a need for educating women about the underlying causes, their diagnoses and timely treatment.
About the author: Dr. Richa Jagtap, Clinical Director & Consultant (Reproductive Medicine), Nova IVF Fertility.
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