Pain, Pain, Go Away! How to Handle Menstrual Discomfort

By Lynn Pattimakiel, M.D.


Pain, Pain, Go Away! How to Handle Menstrual Discomfort

Few women are untouched by uncomfortable periods. As with most painful events, the severity of pain is a subjective experience. There are numerous reasons why a woman may experience menstrual pain, such as:

A thorough history, physical examination and ultrasound might be required to determine the cause of the menstrual pain in some case. Many women may require simple solutions to pain relief, such as nothing more than over-the-counter medications.

Fibroids are found in 80 percent of women. They are benign growths formed of muscle and tissue from the uterine wall, and their cause is unknown. They can be as small as a pea or as large as a watermelon. Most fibroids occur in women of reproductive age, and according to some estimates, are diagnosed in black women far more often than in white women.

Luckily, most women have no symptoms. The symptoms of fibroids may differ according to their location within the uterus. The most common symptoms of fibroids are:

  • Change in menstrual bleeding (intensity, quantity and duration)
  • Cramps
  • Infertility
  • Cosmetic effects (such as a markedly enlarged abdomen)
  • Urinary frequency
  • Constipation
  • Pelvic pain/pressure

As you can imagine, there are many conditions that can mimic fibroid-related symptoms. It is best to check with your doctor to determine if fibroids are the culprit for symptoms. We believe “if fibroids do not bother you, we do not bother them.”

An ovarian cyst is a collection of fluid within a thin membrane that is found within an ovary. Unlike fibroids, ovarian cysts are found within the ovaries of almost all pre-menopausal women. They can also be tiny, or as large as a baseball. In most cases, they appear during the childbearing years and are made monthly.

This is normal. Cysts are usually not cancerous and are small. Some ovarian cysts cause problems, such as bleeding and pain. When they enlarge more than five centimeters doctors may advise birth control pills and a repeat transvaginal ultrasound to determine if the cyst resolves. In the case of larger ovarian cysts, surgical removal may be necessary.

Endometriosis is a condition where the tissue of the uterine lining grows outside the uterus. That tissue still behaves as the tissue still within the uterus does, except that after the usual menstrual cycle of building up and eventually breaking down of uterine lining, the tissue normally expelled as a period has nowhere to go. This can cause pain, scarring and even infertility. Endometriosis occurs in about five to 10 percent of women.

Most women have menstrual pain or cramps with menstrual cycles. If the pain is not easily relieved with over-the-counter medications such as Aleve, Motrin, or Tylenol, or if you are unable to participate in work, travel, hobbies, or sports as a result of the discomfort, then you should see your physician. One of these simple-to-diagnose conditions may be the cause!