Diagnosis of abdominal pain | Stomach ache before the period

Diagnosis of abdominal pain

First, the temporal course of the pain is discussed in a doctor’s consultation and linked to the cycle. For this purpose it can be helpful to keep a symptom diary over a period of a few weeks. In addition, other causes, such as hypothyroidism or irritable bowel syndrome, must be excluded.

The final diagnosis is made on the basis of the clinical symptoms, without the need for instrumental diagnosis. Abdominal pain is not counted among the uncertain signs of pregnancy. More typical are nausea and vomiting.

Also, implantation is usually not felt. Abdominal pain only occurs later in pregnancy, when the uterus is growing and the uterine ligaments are under tension. The abdominal pain is then felt as pulling or stabbing.

In order to be sure whether a pregnancy is present or not, a pregnancy test should always be carried out. An ectopic pregnancy can cause severe abdominal pain in contrast to a regular pregnancy. This pain is much greater than the intensity of the pain caused by the cycle itself. In addition, an ectopic pregnancy would not result in regular menstruation, but rather irregular spotting.

Treatment of abdominal pain

First, substances known to worsen the abdominal pain, but also all other symptoms of premenstrual syndrome, should be avoided. These include alcohol, caffeine and also nicotine, which is contained in cigarettes. If this does not relieve the abdominal pain, an oral contraceptive (“the pill”) can be used to regulate hormone levels.

At first, the symptoms may initially become worse, as the body has to adjust to the hormones first. After a few weeks, however, there should be an improvement. If the abdominal pain cannot be brought under control with the pill or if hormones cannot be taken for other reasons, painkillers can also be used.

The pain medication should be discussed with the gynaecologist, as physical dependencies can quickly arise. An alternative to the classic painkillers is an antidepressant. It is available in a dosage where it only works against the pain and has no effect on mood.

Although this may seem counterintuitive at first, antidepressants are now an important and frequently used drug in pain therapy. The abdominal pain and also the accompanying symptoms begin in the second half of the cycle after ovulation. They can increase over a period of two weeks until menstruation. The pain should subside at the beginning of the menstrual cycle and disappear after the period at the latest.