Feeling slight strain or cramps in the lower abdomen and waist during menstruation is a natural biological process. When the muscles contract to expel the inner layer of the uterus, the hormone ‘Prostaglandins’ causes mild pain. But this conservative belief has persisted in the society for years that “there is pain during periods, learn to tolerate it.” Due to this thinking, lakhs of women silently tolerate the unbearable and life-threatening pain every month, considering it normal or manage by taking painkillers without medical advice.
Gynecologists clearly say that if the pain is so intense that it completely stops your normal daily work, office going or college routine, then ignoring it can be fatal. This severe pain, which is called ‘Secondary Dysmenorrhea’ in medical language, can be a clear alarm of some hidden serious disease developing in the uterus and reproductive organs.
The leading cause of unbearable period pain is endometriosis, which affects 1 in 10 women worldwide.
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What happens in this: When the endometrium-like layer that forms inside the uterus starts growing outside the uterus—on the fallopian tubes, ovaries, intestines, or pelvic tissues.
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symptoms: During menstruation, severe pain extending to the bones in the stomach, back and legs, prickling sensation while urinating or defecating, extreme pain during intercourse and difficulty in conceiving a child for a long time (risk of infertility).
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challenge: It is not easily visible in sonography at the initial stage, due to which it takes an average of 7 to 8 years to be diagnosed.
Fibroids are non-cancerous tumors or lumps of flesh that grow in the wall of the uterus.
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Pressure and Cramping: As these fibroids increase in size, they exert constant pressure on the uterine muscles, causing severe cramps and contractions in the uterus during periods.
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Heavy Bleeding: Due to fibroids, periods can drag on for more than 7 to 10 days, large blood clots fall and women suffer from severe anemia (blood deficiency). Apart from this, there is heaviness in the pelvic area all the time.
This problem is often seen in women above 30 years of age.
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Internal expansion in walls: In this disease, the inner layer of the uterus (Endometrium) starts growing inside the outer muscular wall of the uterus (Myometrium).
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Identification: Due to this, the uterus swells to double or triple its normal size. During periods, there is not only intense pressure and cramps in the abdomen, but there is also a dull strain and pain in the pelvic area throughout the month.
PID is a serious bacterial infection that spreads to the female reproductive organs (uterus, fallopian tubes, and ovaries).
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Effect of infection: This inflammation is often caused by sexually transmitted infections (STIs) or an overgrowth of normal vaginal bacteria.
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symptoms: Its main signs are pain many times more than normal during periods, unusual smelly vaginal discharge, spotting between periods, persistent pain in the waist and sometimes mild fever. If not treated on time, it can block the fallopian tube.
| symptoms | Normal Period Pain (Primary) | Sign of disease (secondary) |
| beginning | a few hours before bleeding starts | Starting several days before the arrival of periods |
| Duration | Calm in the first 24 to 48 hours | Continues throughout the period or even after it ends |
| Effect | Relief from heating pads or general rest | Pain ineffective even after taking painkillers |
| spread of pain | only in the lower middle part of the abdomen | lower back, thighs and legs |
| daily life | Slightly uncomfortable, but work goes on | Impossible to get out of bed, dizziness and vomiting |
If you notice the following ‘red flag’ symptoms in your menstrual cycle, you should immediately get a pelvic ultrasound and examination from a qualified gynecologist without any hesitation:
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The pain may cause frequent dizziness, vomiting, or fainting.
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Pad becoming completely wet and large clots (larger than the size of a coin) coming out every 1-2 hours.
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Persistent pain in the pelvic area, lower abdomen or waist even after periods are over.
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No relief even after taking over-the-counter painkillers (Mefenamic Acid etc.) regularly.
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After the age of 25, period pain suddenly increases manifold, whereas earlier the cycle was normal.
Remember that accepting pain as just a matter of luck can be a major compromise with your fertility and long-term health. These diseases can be controlled by getting tests like sonography and MRI done at the right time.