What should I do if I have severe menstrual cramps?

Written by Liu Jian Wei

Obstetrics and Gynecology

Updated on September 13, 2024

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In clinical practice, dysmenorrhea can be divided into primary dysmenorrhea and secondary dysmenorrhea. If the patient has primary dysmenorrhea, there are no specific effective treatment plans available clinically. It is recommended that the patient take oral painkillers to alleviate the symptoms of dysmenorrhea. If it is secondary dysmenorrhea, the patient needs to immediately undergo gynecological ultrasound and examinations at a local hospital to determine the cause of the dysmenorrhea. Once the cause is identified, an effective treatment plan can be developed based on the cause. Once the cause is addressed, the symptoms of dysmenorrhea will naturally be alleviated.

Other Voices

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How is dysmenorrhea caused by adenomyosis treated?

Adenomyosis is a condition in which active endometrial tissue invades the muscular layer of the uterus. The main symptom of adenomyosis is progressively worsening dysmenorrhea. When symptoms are mild, conservative treatments such as physical therapy, traditional Chinese medicine, or pain relief medication can be adopted. However, if the symptoms are severe and conservative treatments fail to alleviate the dysmenorrhea, surgical options may be considered. There are several surgical methods available: one is presacral neurectomy for pain relief, and another, for patients who do not require fertility, is total hysterectomy.

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What causes menstrual cramps?

Dysmenorrhea is generally caused by endometriosis in the majority of cases. If the endometrium is misplaced in the ovaries, it can form ovarian chocolate cysts; if misplaced into the myometrium, it can lead to adenomyosis, which generally presents with dysmenorrhea that tends to worsen over time. In most cases, this condition is considered to be caused by endometriosis. Additionally, the occurrence of dysmenorrhea should not exclude the possibility of being caused by a cold uterus. Patients with a cold uterus might experience lower abdominal pain and a cold lower abdomen during menstruation; in such cases, treatment can involve warming the meridians to dispel cold and using warming and pain-relieving medicines for symptomatic treatment. Moreover, if dysmenorrhea is caused by Qi stagnation and blood stasis, there might be a large volume of menstrual blood accompanied by large blood clots during the bleeding process. Treatment in this scenario would involve using medicines that invigorate the blood, break up stasis, soften hardness, and disperse conglomeration for symptomatic management.

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Obstetrics and Gynecology

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Why does it not hurt when lying down during menstrual cramps?

Dysmenorrhea is generally caused by a cold uterus or catching a cold, which can be alleviated by lying down to press and shape the abdomen, thus reducing the pain. During menstruation, it is important to rest more and avoid vigorous activities, getting cold, and consuming raw, cold, or spicy foods which are irritating. Do not drink cold water, but use a hot water bottle to apply heat to the abdomen. One can seek treatment in hospitals or Traditional Chinese Medicine clinics for a diagnosis to promote blood circulation and remove blood stasis through medication. During menstruation, women should not take baths or cold showers as it can easily harm physical and mental health, and it is also important to maintain vaginal cleanliness and hygiene. Additionally, attention should be given to getting more rest and eating nutritious foods.

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Written by Shen Li Wen

Obstetrics and Gynecology

1min 16sec

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What should I do if the menstrual pain is very severe?

If women experience severe dysmenorrhea, they should first undergo routine examinations to rule out organic lesions, which are the possibility of secondary dysmenorrhea. For example, we should initially conduct gynecological examinations, pelvic ultrasounds, or combine other auxiliary examinations such as pelvic CT and MRI scans to rule them out. Some women may suffer from conditions such as endometrial polyps, ovarian chocolate cysts, or uterine fibroids, leading to severe dysmenorrhea. The treatment methods vary depending on the different causes. For instance, if a woman has endometrial polyps, hysteroscopic electrosurgical resection of the polyps can be performed. If it has been ruled out that the woman has organic lesions of the reproductive system and the possibility of secondary dysmenorrhea, it is possible that she has primary dysmenorrhea. She can take non-steroidal anti-inflammatory drugs orally during menstruation to relieve the pain, or regularly take short-acting contraceptive pills to suppress ovulation and alleviate the symptoms of dysmenorrhea.

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Written by Zhang Xiu Rong

Obstetrics and Gynecology

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Causes of Dysmenorrhea

The general causes of dysmenorrhea include endometriosis or cold in the uterus, or stagnation of qi and blood stasis, all of which can lead to painful menstruation. Clinically, if dysmenorrhea is generally mild abdominal discomfort without affecting study or work, this mild dysmenorrhea is generally not a big problem. If dysmenorrhea shows a gradually worsening trend, it generally requires a visit to the hospital for a color ultrasound to check for endometriosis. If dysmenorrhea caused by endometriosis is present, it will show a worsening trend and in severe cases, may include symptoms of nausea and vomiting, so this situation is generally caused by a displacement of the endometrial lining. Additionally, some patients may experience cold hands and feet, and cold abdominal pain during the painful menstruation, which is mostly considered to be caused by cold in the uterus. Furthermore, stagnation of qi and blood stasis can also lead to dysmenorrhea, typically presenting with blood clots during menstruation, where pain relief follows the discharge of blood clots, suggesting a high possibility of being caused by stagnation of qi and blood stasis.