Diagnosis
If a woman experiences recurrent and/or particularly severe pain during menstruation/period, a gynecologist should be consulted urgently. In many cases, the symptoms can be relieved in the long term after successful diagnosis. The most important step in the diagnosis of pain during menstruation/period is the detailed doctor-patient consultation (anamnesis) during which the quality and localization as well as the accompanying symptoms of the pain should be revealed.
In addition, the doctor-patient consultation serves to uncover certain risk factors in the patient’s own and family anamnesis. This discussion is usually followed by a gynecological examination. During this examination, the treating gynaecologist tries to exclude possible physical illnesses that could be responsible for the occurrence of pain during menstruation/period.
Especially the mucous membranes, vagina, uterus and ovaries are examined during this examination. In addition, the fit of this contraceptive should be checked in patients with a coil. Depending on the findings, further examinations should then be carried out.
One of the most common examination methods for women with pain during menstruation/period is a blood test, an ultrasound scan and/or an abdominal endoscopy (laparoscopy).If endometriosis is present, the diagnosis is often very complicated. This is due to the fact that especially small foci of the detached endometrium are not always easy to find. If there is a conclusive suspicion of endometriosis, imaging procedures (magnetic resonance tomography; MRT) can help to confirm the diagnosis.
Primary pain during menstruation/period Primary menstrual pain does not need to be treated at all in most cases. However, if women suffer from severe pain during menstruation, various painkillers (analgesics) can be used. In particular, those active ingredients that can be assigned to the group of non-steroidal anti-inflammatory drugs (NSAIDs; NSAIDs) are particularly suitable for the treatment of primary pain during menstruation/period.
The most frequently used painkillers in this context contain the active ingredient ibuprofen. These drugs exert their effect by inhibiting the formation of prostaglandins and thus by reducing the contractions of the uterine muscles. Furthermore, paracetamol-based drugs are also particularly suitable for treating primary pain during menstruation/period.
In addition, antispasmodic drugs can be used for pronounced pain during menstruation/period. There is good experience in this field with the use of spasmolytics such as butlyscopolamine (Buscopan), which relaxes the uterine muscles and thus relieves menstrual pain. Hormone preparations such as the pill can also help to significantly relieve primary pain during menstruation/period.
In cases of light to moderate pain, even simple changes in behaviour can help to improve the well-being of the woman concerned. Pain that occurs during menstruation can be specifically treated by exercise. The reason for this is the fact that the pain-inducing contractions of the uterine muscles are accompanied by reduced blood circulation.
In this way, the perception of pain is increased. Gentle sports such as yoga, walking or cycling increase the blood circulation in the uterus and thus counteract the development of pain. The use of hot-water bottles is also perceived as beneficial by many women suffering from pain during menstruation.
Direct heat on the lower abdomen relaxes the cramped uterine muscles and alleviates the pain. Especially young women who suffer from severe pain during menstruation should consider taking hormonal contraceptives (for example the pill). The artificially supplied hormones have an inhibiting effect on the expansion potential of the uterine lining during the cycle.
In this way, less mucous membrane has to be shed during menstruation. The menstrual period is significantly weaker and the intensity of pain also decreases noticeably. In many cases, the use of hormonal contraceptives can even relieve women completely from the pain during menstruation/period.
In everyday clinical practice, the active ingredient chlormadinone acetate (CMA for short) is particularly suitable for women who suffer from severe menstrual pain. In addition, nature has some miracle cures for menstrual pain. Especially infusions with yarrow, monk’s pepper, St. John’s wort or balm can help to alleviate the complaints significantly.
However, women taking the pill should be aware that the oral application of St. John’s wort can negatively influence the effectiveness of hormonal contraceptives. For this reason, affected women should rather use yarrow, monk’s pepper or balm. Another simple method of relieving pain during menstruation/period is to perform acupressure.
Pressing an acupressure point about one hand’s breadth below the navel can alleviate unpleasant menstrual pain. Secondary pain during menstruation/period For secondary menstrual pain, treatment depends on the underlying condition.
