Painful Cramps Lower Abdomen! – never mess with it, And why?

Menstrual cramps are pulsating or cramping pains in the lower abdomen (Dysmenorrhea). It prevents a woman from performing the normal activity. Painful cramps lower abdomen during periods may be an indication of many serious problems. There is a misconception that painful cramps in the lower abdomen during menstruation are normal. Ovarian cyst, ovarian cancer, endometriosis, cervical dysplasia, uterine fibroid, cervical stenosis also sometimes produce painful cramps(secondary dysmenorrhea).

We can classify “Painful Cramps Lower Abdomen” into two groups (Dysmenorrhea):

1. Primary dysmenorrhea: (Spasmodic):

• Also called idiopathic or true dysmenorrhea. 
• It starts with the onset or just before menstruation.
• Intensity is the same in every period.
• No identifiable pelvic pathology.
• Mostly in teens.
• Cause – Prostaglandins are released with maximum production during the shedding of the endometrium. It is a strong vasoconstrictor, which causes ischemia of the myometrium. Prostaglandins stimulate the smooth muscle to contract. For the same reason, prostaglandin also triggers nausea and vomiting.
• Tension and Anxiety are one of the most important reasons.
• The pain is usually cured following vaginal delivery and pregnancy.
• Prostaglandin synthesis inhibitors (NSAIDs) are very effective.

2. Secondary dysmenorrhea:(Congestive):

• Develop after a phase of pain-free menstruation (after 25 years).
• It starts (3-5 days) before the onset of menstruation.
• Increase with time.
• Painful sex.
• Pelvic pathology usually present.
• The patient may get some discomfort even between periods.
• No systemic discomfort.

Cause of secondary dysmenorrhea (Painful Cramps Lower Abdomen): 

A.) Intrauterine cause of secondary dysmenorrhea :

1.Adenomyosis-

The term adenomyosis is derived from the terms adeno-(meaning gland), myo- (meaning – muscle), and -osis (meaning condition). Adenomyosis is a condition where the uterine wall grows thicker as endometrial tissue moves into the muscle of the uterus. Parous women between the age of 35 and 50 are commonly affected.

 It results in heavy and longer bleeding than usual. It is not life-threatening, but sometimes it causes uterine infection after childbirth. The exact reason behind adenomyosis is unknown, but it depends on the estrogen level.

2.IUD- 

IUD may increase menstrual cramps during your period for the first few months of use. If the lower abdomen cramp persists or gets worse, you may need to consider having the IUD removed and choosing another birth control method.

3.Cervical stenosis-

Cervical stenosis can be defined as narrowing or blocking the cervix. Sometimes it has no symptoms. It may occur before menopause. Cervical stenosis can cause infertility because of the narrowing of the cervix and pus accumulation in the uterus. Cervical stenosis can result in many critical conditions like menopause, abnormal bleeding, Cancer of the cervix.

B.)Extrauterine cause of secondary dysmenorrhea (Painful Cramps Lower Abdomen):

1.Endometriosis:

Endometriosis is a painful disorder in which the tissue from the lining of the uterus grows outside of the uterus, commonly on the fallopian tube, ovary. The fallopian tube may block due to endometriosis. In endometriosis, tissue like endometrium acts as endometrium, and it breaks down in each menstruation. Endometriosis of ovary can cause endometriomas. Menstrual cramp is a primary symptom of endometriosis. You may also face low back and abdominal pain. Endometriosis can be one of the reasons for impotence for otherwise healthy couples.

2.Ovarian cyst or tumor:

Maximum women haven’t idea about their ovarian cyst. Menstrual cramps, abdominal pain can be the primary symptom of ovarian cyst that may lead to infertility because it prevents ovum maturation. In an ovary cyst, the ovary may enlarge that and increase the chance of painful twisting of your ovary( ovarian torsion ). Even tumors can develop. One of the best things you do to protect and improve your health is to stay informed.

3.PID(Pelvic inflammatory disease):

 PID is an infection and inflammation of the upper genital tract organs, typically involving the uterus (endometrium), fallopian tubes, ovaries, and pelvic peritoneum. It usually occurs for sexually transmitted bacteria. In PID  – Bilateral lower abdominal and pelvic pain, backache, fever, lethargy, purulent vaginal discharge.

C.)Non-gynecological cause of secondary dysmenorrhea:

1.Psychosomatic disorders:

Psychosomatic factors are widely believed that emotional stress can increase the intensity of menstrual cramps. Anxiety, depression, and tension may significantly increase the intensity of the pain by decreasing the pain threshold.

2.Irritable bowel syndrome:

It is the most common cause of chronic pelvic pain (CPP). It is a functional disorder and idiopathic. Women with Irritable bowel syndrome most frequently report dysmenorrhea.

Conclusion of Painful Cramps Lower Abdomen :

If you notice prolonged painful menstruation or severe menstrual cramps. You should take proper steps as it deals with your future life, physical and mental health conditions. You should know that continuous menstrual cramps may indicate a critical problem. Consult with the health care professionals or doctor for proper help.

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