General Practice 2022

7 main causes of menstrual pain outside the menstrual period and what to do

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7 main causes of menstrual pain outside the menstrual period and what to do
7 main causes of menstrual pain outside the menstrual period and what to do

Colic outside the menstrual period can be quite uncomfortable and have several causes, being normal during ovulation or early pregnancy, however it can also be indicative of diseases such as endometriosis, myoma or pelvic inflammatory disease, especially if happen often or every month.

This type of colic is characterized by pain in the abdomen, mild discomfort, or even cramping severe enough to interfere with day-to-day activities, for a few days each month. Therefore, it is important to consult the gynecologist, if the colic outside the menstrual period happens every month or worsens in intensity, to identify the cause and start the most appropriate treatment.

The main causes of colic outside the menstrual period are:

1. Ovulation

Ovulation can cause cramping outside of the menstrual period because when the egg is released by the ovary, which usually occurs 14 days after menstruation, a little fluid that protects the egg and blood is also released, which can cause irritation in the abdominal cavity, leading to the appearance of colic.

This type of colic gets better soon after the egg is released or as soon as the body absorbs the fluid or blood.

What to do: ovulation cramping usually gets better within 24 hours, requiring no treatment. However, if the cramping is severe, you can take an anti-inflammatory like Ponstan, use a hot water bottle on your belly, or take a hot bath to help ease the discomfort. In some cases, in which the woman has very painful ovulation, one should consult the gynecologist who may indicate treatment with the contraceptive pill.

2. Endometriosis

Endometriosis consists of the implantation of tissue from the endometrium, which is the inner layer of the uterus, in other organs of the woman's body, such as the ovaries, bladder and intestine, causing inflammation, abdominal pain and intense cramping, which usually occurs during menstruation, but can also occur outside the menstrual period.

In addition, abdominal pain and cramping caused by endometriosis can be very severe and can often be confused with other conditions, such as irritable bowel syndrome, pelvic inflammatory disease, or urinary tract infection.

What to do: you should consult the gynecologist to evaluate the characteristics of pain and menstrual flow and for physical and imaging exams, such as transvaginal ultrasound or, in some cases, a laparoscopy to confirm endometriosis. Endometriosis is usually treated with birth control and/or surgery.Learn more about treating endometriosis.

3. Fibroids

Myoma, also called uterine fibroma or leiomyoma, is a benign tumor that forms in the muscle of the uterus and usually does not cause symptoms, but depending on the size, location and amount of myoma, a woman can experience abdominal pain or cramping and bleeding outside of your period.

What to do: you should consult the gynecologist so that the diagnosis can be made through physical examination and imaging, such as transvaginal ultrasound and start the most appropriate treatment that can be from medical follow-up to hormone use or progesterone IUD use. Learn more about fibroid treatment.

4. Pelvic inflammatory disease

Pelvic inflammatory disease, also known as PID, is an inflammation that originates in the vagina and can affect the cervix, uterus, fallopian tubes and ovaries, and which can lead to the appearance of some symptoms, such as vaginal discharge, bleeding and cramping outside the menstrual period.

This inflammation can mainly be caused by infection transmitted through unprotected sexual intercourse with a partner infected with gonorrhea or chlamydia, but it can also occur by infection during vaginal delivery, or after performing an endometrial biopsy, for example. Learn about other causes of pelvic inflammatory disease.

What to do: in the presence of signs and symptoms of PID, it is recommended to consult the gynecologist who may indicate a treatment with antibiotics orally or by injection into the muscle, to treat the bacterial infection that caused the pelvic inflammatory disease. In addition, intimate contact should be avoided during treatment to allow time for the tissues to heal. Learn more about treating pelvic inflammatory disease.

5. Pregnancy

Colic outside the menstrual period can also be indicative of pregnancy and happens due to the implantation of the embryo and the growth of the uterus.This cramping is usually mild and transient and does not cause other symptoms or discomfort. However, if colic is frequent, painful and does not stop even at rest or occurs in later stages of pregnancy, it may be indicative of a tubal pregnancy or placental abruption, for example, it is important to consult a doctor

What to do: An HCG test should be performed if your period is late and pregnancy is suspected. If confirmed, prenatal consultation should be carried out and follow-up with the obstetrician gynecologist should be started, which should be done throughout the pregnancy. Find out how prenatal care is done.

6. Adenomyosis

Adenomyosis is a disease that occurs due to a thickening of the wall of the uterus, forming small nodules that may have no symptoms in the initial phase, but can cause bleeding or cramping outside the menstrual period in later stages.

What to do: you should consult the gynecologist who should indicate treatment with anti-inflammatory drugs or hormones and, in more advanced cases where the symptoms cannot be controlled with medicines, the doctor may recommend surgery to remove the uterus. Learn more about treating adenomyosis.

7. Cervical stenosis

Cervical stenosis is the narrowing of the cervix caused by uterine malformation, vaginal infection, presence of a cyst or cancer in the cervix or by surgical procedures such as cauterization, for example. These conditions may have no symptoms and may be discovered during routine gynecological exams, or they may cause menstrual changes such as heavy bleeding during your period or no period and cramping outside of your period.

What to do: you should have a routine consultation, at least once a year, with the gynecologist to perform the Pap smear and assess the he alth of the uterus.The treatment of this disease must be indicated by the gynecologist according to its cause, and can be done with dilation of the cervix, in the simplest cases or chemotherapy in the case of cervical cancer, for example.

Watch the video with Dr. Helizabet Ribeiro, a gynecologist specializing in endometriosis who clarifies all doubts about this disease:

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