Most women experience some amount of discomfort during the time of menstrual flow. A few experiences severe pain. Menstrual pains can roughly be divided into three types:
- Spasmodic menstrual pain. This occurs in most young women. The pain would usually start a day or 2 before the menstrual flow starts and become quite prominent on the first day of the period then ease off after the flow is properly established. The rest of the days the flow would then be painless. This pain is usually due to the very small and tight cervix that the uterus has to push the menstrual blood through. In about 80% of all women with spasmodic pain, relief is brought about by the birth of a child.
- Congestive menstrual pains. This pain usually starts after the onset of menstruation and continues through-out the flow and may even take several days after the flow is over to ease. This congestive pain is usually associated with an underlying abnormality, for example, pelvic inflammatory disease (PID), endometriosis, and on rare occasions uterine fibroids.
- A combination of both spasmodic and congestive which starts before the onset of periods to after the stoppage of the flow.
The way to determine what type of menstrual pain is:
- From the history in that spasmodic pain starts in youth, it will begin just before the period starts and the pain will stop with the free flow of blood unlike congestive menstrual pain which starts later in life and the pain will start after the onset of menstrual flow.
- A pelvic ultra-sound which would generally give a guide as to the presence of any abnormality in the pelvis.
Management of the pain will be:
- Pain relief medication as prescribed by your doctor.
- Specific management of any abnormality detected in the pelvis in the course of ultra-sound investigations that could be causing the pain.