Painful and/or heavy periods – Causes, Diagnosis & Treatment

Causes:

• Primary Dysmenorrhea: Painful periods without an identifiable underlying condition, often starting soon after menstruation begins. May involve increased production of prostaglandins, hormone-like substances that cause uterine contractions.
• Secondary Dysmenorrhea: Painful periods caused by an underlying medical condition. Examples include:
  • Endometriosis: Tissue similar to the uterine lining grows outside the uterus.
  • Uterine Fibroids: Noncancerous growths in the uterus.
  • Adenomyosis: Endometrial tissue grows into the uterine muscle.
  • Pelvic Inflammatory Disease (PID): An infection of the reproductive organs.
  • Cervical Stenosis: Narrowing of the cervix.
• Menorrhagia: Heavy menstrual bleeding, defined as soaking through a pad or tampon every hour for several consecutive hours, or bleeding lasting longer than seven days. Can be caused by hormonal imbalances, uterine fibroids, or other conditions.

Diagnosis:

• Medical History: Detailed information about menstrual cycles, pain, and other symptoms.
• Physical Exam: Including a pelvic exam.
• Pelvic Ultrasound: To visualize the uterus, ovaries, and other pelvic structures.
• Hysteroscopy: A procedure to examine the inside of the uterus.
• Endometrial Biopsy: A tissue sample from the uterine lining may be taken for examination.
• Blood Tests: To check for hormonal imbalances or other potential causes.

Treatment:

• Pain Relievers: Over-the-counter NSAIDs (like ibuprofen or naproxen) can help manage pain.
• Hormonal Birth Control: Pills, patches, rings, or injections can regulate hormones and reduce pain and bleeding.
• Hormone Therapy: May be used in some cases.
• Medications: Tranexamic acid can help reduce heavy bleeding.
• Surgery: May be necessary for conditions like endometriosis, fibroids, or adenomyosis. Surgical options range from minimally invasive procedures to hysterectomy (removal of the uterus).

Important Considerations:

• Consult a healthcare professional for persistent or severe pain or heavy bleeding.
• Early diagnosis and treatment can improve quality of life.