Conditions and Management

Unfortunately for many women, painful periods are common. For some women, the pain may be a mild annoyance, while others may find that it disrupts their daily life entirely. If your menstrual pain is so bad that you miss school, work, or regular activities and struggle to get out of bed, it is important that you visit a doctor to determine what might be causing your pain and find the best way to address it. Here are some of the questions you may want to ask your doctor when discussing painful periods and dysmenorrhea.

Is My Menstrual Pain Abnormal?

Dysmenorrhea is the term given to painful periods, and there are two categories. Primary dysmenorrhea refers to menstrual cramps that are not caused by an underlying medical condition, and it is considered completely normal. It may begin in a woman’s teenage years and typically becomes less intense and frequent in adulthood.

In some cases, menstrual pain that is so severe that it affects your daily life could be caused by secondary dysmenorrhea, which means that the pain has an underlying medical cause that may require further diagnostic tests and treatment.

Why Is My Period So Painful?

If your menstrual cramping is caused by primary dysmenorrhea, it simply means that you have an excess of the hormones known as prostaglandins. These are the hormones that cause your uterus to contract during menstruation. When the uterus contracts too strongly, it may press against blood vessels nearby, which cuts off the oxygen supply to muscle tissue and causes pain.
As many as half of the women who get their period experience this condition.

Other women experience secondary dysmenorrhea, which is menstrual pain that may be traced to one of the following disorders.

Uterine Fibroids

One major cause of secondary dysmenorrhea is uterine fibroids. These noncancerous tumors may grow on the wall of the uterus and may lead to heavy bleeding and severe pain as well as other problems, such as an enlarged abdomen, anemia, and urinary incontinence.

Endometriosis

Endometriosis is a condition where endometrial tissue grows outside the uterus, whether it is on the outer wall of the uterus, the ovaries, or another location in the pelvic region. When this tissue sheds each month just like the lining of the uterus, it can lead to symptoms such as excessive bleeding, severe pelvic pain, and infertility.

Adenomyosis

Another disorder that may cause a secondary dysmenorrhea is adenomyosis, which is caused when the tissue that usually grows on the walls of the uterus is growing in the muscle of the uterus instead. Some symptoms include strong menstrual cramps, heavy bleeding, and passing blood clots.

How Can I Get Relief From Menstrual Pain?

Your doctor might suggest that you try one of the following approaches to alleviate your menstrual pain.

Medication

One of the top treatments for primary dysmenorrhea is anti-inflammatory medications such as ibuprofen and naproxen. These Nonsteroidal anti-inflammatory medications, reduce your body’s output of prostaglandins which helps to alleviate uterine contractions and pain.
In some cases, your doctor may prescribe hormonal contraceptives such as birth control pills, contraceptive patches or vaginal rings, or a progestin IUD. Women who take these medications for birth control typically experience less menstrual pain than those who do not, so your healthcare provider might suggest using these options even if contraception is not your goal.

Heat

When you are experiencing severe cramping, place a heating pad or a hot water bottle on your abdomen. If your menstrual pain is in your lower back, you can also use a heating pad there to get some relief. A warm bath or a hot towel might also help.

Avoiding Certain Foods

During menstruation, you may find that avoiding foods linked to bloating and water retention provides some relief by alleviating cramps and decreasing tension. These include caffeine, salty foods, fatty foods, carbonated beverages, and alcohol. Quitting smoking may also help make periods less painful.

Alternative Therapies

Many women are turning to alternative therapies for relief from menstrual cramping. Yoga is one good option, thanks to its relaxing effects. A gentle massage of the abdomen, side, and back for around 20 minutes may also help reduce your menstrual pain. It can be particularly effective if it is used in conjunction with essential oils to gain aromatherapy benefits. For example, one study found a significant reduction in pain levels and duration of cramps in a group of women who received massages for their menstrual pain using a combination of lavender, marjoram, and clary sage oil.

Talk With Raleigh Gynecology & Wellness About Dysmenorrhea

Although menstruation is a part of life, you do not have to suffer from painful periods every month. If your menstrual pain is having a negative impact on your life, reach out to the knowledgeable team at Raleigh Gynecology & Wellness. We offer specialized care to help women of all ages in Raleigh and the surrounding area manage dysmenorrhea and other disorders.

Although discomfort is not unusual in the days preceding and during your period, for some women, menstrual periods are consistently painful. This type of pain may fall under the umbrella of dysmenorrhea, a term that generally refers to pain that accompanies menstruation or menstrual cramps.

Types of Dysmenorrhea

There are two types of dysmenorrhea: primary and secondary.

Primary Dysmenorrhea

Common menstrual cramps that recur each month and are not caused by other diseases is known as primary dysmenorrhea. For many women with this condition, the pain begins a day or two prior to their period; for others, it may come when the actual bleeding begins. The pain may be mild to severe and occur in your lower abdomen, thighs, or back.

The pain may last anywhere from 12 to 72 hours and might be accompanied by symptoms such as fatigue, diarrhea, nausea, and vomiting. The good news for many women with primary dysmenorrhea is that their cramps may become less painful as they get older and could stop entirely after having a baby.

Secondary Dysmenorrhea

Another type of dysmenorrhea is secondary dysmenorrhea. This occurs when a woman’s painful periods are caused by a disorder or an infection of the reproductive organs. It is not typically accompanied by fatigue, diarrhea, nausea, or vomiting, and it may begin earlier in a woman’s menstrual cycle and last longer than typical menstrual cramps.

The menstrual pain that results from secondary dysmenorrhea could be tied to one of the following reproductive organ conditions:

Adenomyosis

In this condition, the lining of the uterus grows into the muscle, causing it to grow bigger than normal and spurring abnormal bleeding and pain.

Pelvic Inflammatory Disease

PID is an infection that is caused by bacteria that begins in the uterus and may spread to other reproductive organs. It can cause pain during sex and stomach pain in addition to painful periods.

Fibroids

These are benign growths that may be found on the inside or outside of the uterus.

Endometriosis

With endometriosis, the tissue lining the uterus is situated outside of the uterus. These tissue pieces bleed during a woman’s period, leading to pain, swelling, and scarring.

Diagnosis Of Dysmenorrhea

Diagnosing dysmenorrhea can be difficult because menstrual cramps are common. However, if you are feeling pressure or aching pain in the abdomen that is severe at times and/or pain in your lower back, inner thighs, or hips, and you believe that your cramps are unusual or severe and last longer than three days, get in touch with a healthcare provider.

Your doctor will ask you to describe your menstrual cycles and your symptoms and may perform a pelvic exam to check for other issues. If your doctor suspects secondary dysmenorrhea, you may also need an ultrasound or other diagnostic tests to determine the condition behind your painful periods so that it can be treated.

How To Relieve Menstrual Cramps

Treating primary dysmenorrhea can be challenging because it is not caused by a specific medical condition. Here is a look at some of the ways you may be able to get some relief. What works for one woman will not necessarily work for another, so it may take some trial and error to find the best approach for you.

Pain Relief Medication

Many doctors recommend taking ibuprofen when your cramping starts. As a nonsteroidal anti-inflammatory drug, or NSAID, ibuprofen reduces the output of prostaglandin, which causes the uterus to contract. Naproxen is another NSAID that offers better relief for some women. If you are unable to take drugs in this category, a pain reliever like acetaminophen may also work.

Massage

Some women find that a massage of the lower back and abdomen can help relieve menstrual cramps.

Dietary Changes

If you suffer from menstrual cramps, avoiding any type of food or beverage that contains caffeine, as well as alcohol, can offer some relief.

Heat

Placing a hot water bottle or a heating pad on your abdomen or lower back can take the edge off of menstrual cramps.

Relaxation

If your menstrual cramps are particularly intense, make sure you get plenty of rest and do not overexert yourself. Structured relaxation breathing exercises may also be helpful.

Exercise

Exercise might be the last thing you feel like doing when you’re experiencing menstrual cramps. However, studies show that women who exercise regularly may experience less menstrual pain, so consider making exercise a part of your weekly routine to help prevent cramps.

Hormonal Contraceptives

Women who take hormonal contraceptive medications tend to experience less menstrual pain, so your healthcare provider might suggest that you take these drugs if other approaches do not provide relief. This could include options like a birth control pill, contraceptive patches or vaginal rings or even a progestin based intrauterine device (IUD). Your gynecologist can discuss which options may be most appropriate for you to try.

Contact Raleigh Gynecology & Wellness

If you are suffering from painful periods, reach out to the friendly team of women’s health professionals at Raleigh Gynecology & Wellness. We can help you determine the cause of your menstrual pain and get it under control so you don’t have to put your life on hold when your period comes each month.

If your menstrual cycle has started to deviate from what you consider normal, you may be wondering what could be causing this sudden change. In particular, if your once-normal period begins to occur less frequently than before or your bleeding is significantly lighter than it was in the past, you may be diagnosed with oligomenorrhea.

What Is Oligomenorrhea?

Oligomenorrhea is a change in a woman’s menstrual cycle that causes it to regularly last longer than 35 days or occur fewer than nine times a year. If your menstrual cycle is occasionally irregular or you have missed a period and are not pregnant, it does not necessarily mean that something is wrong.

Throughout your lifetime, your menstrual cycle may vary. In addition, the hormones controlling your menstrual cycle may be influenced temporarily by certain factors that resolve on their own. When your period changes and does not revert to your previous “normal” after a few months, it is a good idea to see a medical professional.

What Causes Oligomenorrhea?

There are many reasons that a woman experiences infrequent or abnormally light bleeding. Some of these causes are harmless while others may signify a more serious health condition. This is why it is essential to see a doctor and discuss changes to your cycle.

Life Changes

One common cause of oligomenorrhea is a major life change. Getting pregnant, having a baby, and breastfeeding can all impact your period in some way. However, there are less significant life changes that may also affect your period, such as undergoing intense stress at work, losing lots of weight, or going on vacation.

Taking Medication

In some cases, a medication could be behind your oligomenorrhea. Hormonal birth control pills can transform your menstrual cycle dramatically, as can birth control methods such as patches, rings, IUDs, and shots. For some women, these interventions could cause periods to become more frequent and heavier, but others may find that it leads to the lighter and more infrequent periods that signify oligomenorrhea.

In fact, some women may even choose to take hormonal birth control continuously to make their periods lighter or suppress them entirely. Some other types of medications that could have an effect on your menstrual cycle include anticoagulants, such as aspirin, antipsychotic and antianxiety medications, and certain epilepsy treatments.

Age-Related Oligomenorrhea

When a young woman first starts getting her period, it may take several years before she starts following a regular pattern. In the beginning, it is not unusual for girls to experience erratic bleeding and periods that may be lighter or heavier than those of the previous month’s period. As hormones stabilize, a young woman should start to notice some consistency in her cycle length and flow.

Similarly, when a woman is entering menopause, the hormonal changes that facilitate this transition can cause periods to come later or sooner than expected in addition to variances in heaviness and duration until periods cease to occur altogether.

Physical Activity Levels And Weight

A woman who is extremely physically active might experience lighter periods. Elite athletes and those who exercise heavily can develop oligomenorrhea, and it is not unusual for some women’s periods to stop entirely as a result. This issue may resolve when activity levels are reduced.

Weight can also play a role with women who are severely underweight, malnourished, or suffering from eating disorders, such as women with anorexia nervosa or bulimia often experiencing oligomenorrhea.

However, it is not just being underweight that can cause oligomenorrhea. Some overweight or obese women may find that the increased estrogen levels caused by having a greater amount of body fat can impact their menstrual cycle. Maintaining a healthy weight is usually enough to resolve any weight-related causes of menstrual irregularities.

Health Conditions

There are several underlying health conditions that may cause oligomenorrhea. Some of these include thyroid disorders, elevated levels of prolactin in the blood, pelvic inflammatory disease, polycystic ovarian syndrome, primary ovarian insufficiency, obstruction of the uterus, Graves’ disease, uncontrolled diabetes, Prader-Willi syndrome, and anabolic steroid use.

Diagnosis Of Oligomenorrhea

When you see a doctor about irregularities in your menstrual cycle, they may ask you about your health as well as that of other women in your family. Some topics of discussion may include your symptoms, sexual history, past pregnancies and births, other health conditions and operations you have had, and the medications and supplements you currently take. It is useful to bring a log of your period so your physician can identify trends and changes. Your doctor may also conduct a physical exam and other types of tests to determine the potential cause of your oligomenorrhea.

Talk To The Friendly Team at Raleigh Gynecology & Wellness

At Raleigh Gynecology and Wellness, our team of highly trained doctors, nurses, and administrative staff are devoted to helping women manage and treat health issues ranging from menstrual disorders and urinary problems to sexual health concerns and fertility issues. Get in touch today to find out more about our gynecological care and treatment offerings.

Menstruation can be a challenging time of the month for many women. Between the symptoms of premenstrual syndrome and the bleeding itself, some women may wish that their periods could come less often. However, having infrequent menstrual periods could signify a menstrual disorder that needs to be diagnosed and treated by a doctor.

What Is Oligomenorrhea?

When a woman of childbearing age experiences infrequent menstrual periods, she may have oligomenorrhea. Periods typically occur every 21 to 35 days, and some variation within this range is considered normal. Therefore, a woman who often falls outside the high end of this range may be diagnosed with oligomenorrhea.

Women who go longer than 35 days without a period and are not taking birth control medication should see their doctor, as should women who experience sudden changes to their cycle. Women with oligomenorrhea may also experience periods that are lighter than usual.

Oligomenorrhea can make it more difficult for a woman to become pregnant, so uncovering its cause is particularly important if you are trying to start a family.

How Is Oligomenorrhea Diagnosed?

Oligomenorrhea is a term used to describe infrequent menstruation, and it is typically diagnosed following a review of a woman’s menstrual history. Your doctor might ask questions about your health as well as the reproductive health of other women in your family, such as your mother, sisters, or aunts. Your doctor will discuss your symptoms with you and may ask about your sexual history and any pregnancies or births you have had, along with any medications you take, and surgeries you have undergone.

As a medical diagnosis, it refers to a normal menstrual cycle changing and lasting for more than 35 days or experiencing fewer than nine periods in the span of a year.

After being diagnosed with oligomenorrhea, it is important to determine its cause, some of which are considered relatively harmless. The hormones influencing the menstrual cycle can be affected temporarily by different factors, and periods could return to normal after a short time. However, in some cases, it could require medical treatment. Depending on the suspected cause, a physical exam, ultrasound imaging, or blood tests may be used to learn more about it.

The Causes of Oligomenorrhea

Below are some of the main causes of oligomenorrhea.

Pregnancy

One of the more common causes of a delayed menstrual cycle is pregnancy. If you suspect that this could be the cause of your period’s delay, you should take a pregnancy test to rule out this possibility.

Hormonal Birth Control

Oligomenorrhea is one of the known side effects of hormonal birth control pills. Around three to six months after you start taking birth control pills, you may begin to notice increasingly lighter periods. Some women report that their periods stop entirely. Thus, it is important to discuss this with your doctor if you have any concerns.

Age

In adolescent girls who are just beginning to get their period, it is not uncommon for their cycle to be irregular at first, and this may include periods that are spaced out longer than a typical mature woman would experience. In addition, oligomenorrhea may be seen in perimenopausal women because of fluctuations to hormone levels that occur during this phase of life.

Body Chemistry

Oligomenorrhea is common in women who have high levels of the protein prolactin in their blood as well as those who take certain types of medications known to decrease menstruation, such as antiepileptics and antipsychotics.

High Activity Levels

Young women who participate in heavy exercise and intense sports, such as marathon runners, may develop oligomenorrhea.

Eating Disorders

Women who have eating disorders, like bulimia or anorexia nervosa, may experience infrequent menstruation. Malnourishment is another common cause of oligomenorrhea.

Health Conditions

A light flow or a missed menstrual cycle could indicate that a woman has polycystic ovary syndrome, or PCOS. It may also occur in women who have thyroid problems or diabetes.

How Is Oligomenorrhea Treated?

It is important to keep in mind that just one missed cycle or light flow is not usually a problem. Moreover, oligomenorrhea is not considered serious on its own. It may be possible to adjust your menstrual period with help from hormonal birth control or progestin.

However, in cases where oligomenorrhea is caused by an underlying problem, treating that problem can restore menstrual regularity. For example, women whose oligomenorrhea is caused by an eating disorder may find that their periods return to normal once they have treated that disorder, while women whose problem is caused by excessive workouts might consider reducing their exercise regimen.

Get In Touch With Raleigh Gynecology & Wellness

If you have any concerns about your cycle or reproductive health, reach out to the compassionate team of experienced women’s health professionals at Raleigh Gynecology & Wellness. We offer specialized care for women of all ages for everything from menstrual disorders to fertility issues.

A pelvic exam by your gynecologist should be a part of every adult woman’s annual wellness regimen. During a pelvic exam, your doctor evaluates the health of your reproductive organs. Depending on your age, your doctor will provide recommendations on good hygiene, contraception and family planning options, and treat any abnormality that the pelvic exam reveals.

When Do Pelvic Exams Begin?

Once a young woman reaches puberty, she should have her first “well-woman” or “wellness” visit with her doctor or gynecologist. This first wellness visit normally occurs between the ages of 13 to 15. During that visit, you may simply have a regular physical exam where your height, weight, blood pressure, respiration, and other basic vital signs will be evaluated by your doctor. You may discuss your menstrual period, sexual activity, contraception and hygiene, and get some vaccines.

At some point after you become sexually active, your wellness visit will include a pelvic exam. By the time you reach the age of 21, an annual pelvic exam should be part of your healthcare routine.

What Happens During A Pelvic Exam?

The purpose of a pelvic exam is to examine the health condition of your external and internal reproductive organs. The doctor uses special tools designed to examine your internal reproductive organs, consisting of your vulva, vaginal canal, cervix, ovaries, fallopian tubes, and uterus.

If you think you may have any reproductive health issue or an STD or any kind of pelvic infection, it’s a good idea to inform your doctor when your appointment or examination begins. If a special test or exam is needed, the doctor may be able to perform it during your appointment, or you may need to schedule a follow-up visit to have it done.

When you arrive at your doctor’s office, you will be escorted to a private examining room. You will undress and put on a paper or cloth hospital-style gown that opens in the front. When your doctor and nurse return, they will position you so that you are safely lying down on the examining table.

After you lay down, you put your feet into the footrests, called “stirrups,” at the end of the table. Then, you slide yourself down to the edge of the table so that your knees spread out wide.

Once you are properly positioned, the examination begins.

1. The External Exam

This exam starts with a visual examination of your vulva and the opening of your vagina. The doctor is able to detect any cysts, abnormal discharge, genital warts, irritation, or other abnormalities.

2. The Speculum Exam

During this exam,your doctor gently slides a special tool called a speculum into your vagina. The speculum separates the walls of your vagina to hold it open during the examination. You may feel mild discomfort, but it shouldn’t hurt.

Your doctor then inserts a tiny spatula or brush into your vagina and swabs your cervix. This process takes some cells from your cervix that are sent to a lab for a Pap test. The purpose of the Pap test is to determine whether your cervix has any precancerous or cancerous cells.

If you are sexually active, your doctor may also take another small sample from your cervix to test for STDs or other pelvic infection.

3. The Bimanual Exam

After the speculum is removed, your doctor performs a manual examination of your pelvic region. It is the best way for your doctor to check the size and shape of your uterus. Using gloved and lubricated fingers on one hand, your doctor feels the inside of your vagina while using the other hand to gently press on your lower abdomen.

If you experience unusual tenderness or pain during this part of the exam, it may be a sign that you have an infection or an issue with enlarged ovaries, fallopian tubes, ovarian cysts, or even tumors.

4. The Rectovaginal Exam

The final part of the pelvic exam may include a rectal exam. Your doctor inserts a gloved finger into your rectum and, in some cases, another gloved finger into your vagina. This procedure enables the doctor to check the health of the muscles between your vagina and your anus. It also enables your doctor to feel for tumors on the ovaries,behind your uterus, on the walls of your vagina, or in your rectum.

How Often Should You Have A Pelvic Exam?

If you are a healthy, adult woman, you should have a pelvic exam every year. However, you may need to have one more frequently if there are any abnormalities in your pelvic area, such as any one or more of the following conditions:

• History of abnormal Pap test results.
• History of sexual health problems.
• Family history of certain kinds of cancer.
• STD or infection.
• Sex partner with an STD or infection.

Schedule Your Wellness Exam With Raleigh Gynecology & Wellness

Keeping up with your pelvic examinations is important to your overall health. It can even save your life by detecting pelvic infections, tumors or other problems before they become life-threatening. Contact the women’s health experts at Raleigh Gynecology and Wellness for more information and to schedule your appointment.