Painful Periods or Sex

Painful Periods or Sex

Are sharp pains in the lower abdomen. Many women have menstrual cramps just before or during their menstrual periods.

For some women, the discomfort is barely painful. For others, menstrual cramps may be severe enough to interfere with daily activities for a few days each month.

Some diseases, such as endometriosis or uterine fibroids, can cause menstrual cramps. Treating the cause is essential to reducing pain. Menstrual cramps that are not caused by another illness usually decrease with age and often improve after giving birth.

Symptoms
Symptoms of menstrual cramps include the following:

• Throbbing pain or cramps, which may be severe, in the lower abdomen
• Pain that begins 1 to 3 days before your period, peaks 24 hours after your period starts, and subsides in 2 to 3 days
• Continuous dull pain
• Pain that extends to the lower back and thighs

Some women also present:

• Nausea
• Soft stools
• Headache
• Dizziness

When to see a doctor
If menstrual cramps negatively affect your life every month, if your symptoms get progressively worse, or if you started having heavy menstrual cramps after age 25, see your doctor.

Causes
During your period, your uterus contracts to help expel its lining. Hormone-like substances (prostaglandins) involved in pain and inflammation trigger uterine muscle contractions. Higher levels of prostaglandins are related to more intense menstrual cramps.

Menstrual cramps may be caused by the following factors:

• Endometriosis. The tissue lining the uterus is implanted outside the uterus, most often in the fallopian tubes, ovaries, or tissue lining the pelvis.
• Uterine fibroids. These noncancerous growths in the wall of the uterus can cause pain.
• Adenomyosis. The tissue lining the uterus begins to grow in the muscular walls of the uterus.
  pelvic inflammatory disease. This infection of the female reproductive organs is usually caused by sexually transmitted bacteria.
  cervical stenosis. In some women, the opening of the cervix is so small that it prevents menstrual flow, causing a painful increase in pressure inside the uterus.

Risk Factors
You may be at risk for menstrual cramps if you have the following:

• You are under 30 years of age
• You started puberty early, at age 11 or younger
• Have heavy periods (menorrhagia)
• Have irregular menstrual bleeding (metrorrhagia)
• Have a family history of menstrual cramps (dysmenorrhea)
• Smoking

Complications
Menstrual cramps do not cause other medical complications but can interfere with school, work, and social activities.

However, certain illnesses related to menstrual cramps may have complications. For example, endometriosis can cause fertility problems. Pelvic inflammatory disease can injure the fallopian tubes, increasing the risk of implantation of a fertilized egg outside the uterus (ectopic pregnancy).