Pain during menstruation


Painful menstruation - This is a group of diseases that occur in some women with the appearance of menstrual bleeding. Severe menstrual pain may be primary (without a known cause) or secondary (caused by anatomical anomalies or other diseases).

In many women, painful menstruation disappears over time, after 20 years or after pregnancy. Treatment consists of taking painkillers, excluding acetylsalicylic acid. In case of anatomical changes, surgical removal is used.

Causes of pain during menstruation

Painful menstruation can be:

  • primary (functional) - associated with the occurrence of the ovulatory cycle, without any pathological reasons. As a rule, functional dysmenorrhea is caused by excessive contraction of the uterus muscles and abnormal peeling of the uterine mucosa, caused by hormonal factors or psychological factors.
  • secondary (acquired) - associated with another disease that causes pain during menstruation. These causes include endometriosis, narrowing of the cervical canal, polyps of the uterine lining, uterine fibroids, uterine malformations and / or its abnormal position, acute inflammatory processes in the pelvis, chronic pelvic inflammation, polycystic ovary syndrome.

Primary menstruation is usually dominated by young girls who have recently begun menstruating. This is usually due to the appearance ovulatory cycle (menstrual cycles, at the beginning, can occur without ovulation).

Importance is also attributed to increased stress, the so-called sympathetic system, which regulates the activity of the body regardless of our will (for example, peristalsis). Dysmenorrhea usually decreases after the first pregnancy.

During menstruation.

Sometimes the initial painful menstruation can be associated with the incorrect position of the uterus. When the uterus is in the so-called overly bent position, that is, the angle between the uterus stem and the neck is acute, it may be difficult for the blood to flow out. The uterus, trying to clear the contents, is excessively reduced, which can cause severe pain in the lumbosacral region.

Endometriosis is a condition that determines the appearance of the mucous membrane characteristic of the uterus, outside the uterus. The ectopic mucosa contains functional similarities with the endometrium (uterine mucosa). This means that the lesions of the abnormal mucosa undergo similar changes associated with the life cycle of a woman, like the mucous membrane located in the uterine cavity.

The consequence is a collection of menstrual flow in the abdomen or in other areas (for example, lungs). This is a relatively common disease. It is estimated that 7–15% of women of childbearing age develop endometriosis.

Uterine fibroids is also a common disease of women of childbearing age. It affects about 20% of women after 35 years and up to 50% of women after 50 years. Uterine fibroids are benign tumors located in the uterus.

The cause of these tumors is not fully known. It seems that the development of fibroids is affected by hormonal imbalance in women associated with high levels of estrogen, as well as low levels of progesterone. However, this is not the rule, sometimes women who have a high level of estrogen, do not suffer from fibroids. As a rule, the size of the tumor decreases after menopause. Myomas consist of muscle fibers characteristic of the uterus. Can reach various sizes, but usually do not exceed 10 cm.

Polycystic ovary syndrome is a disease that occurs in 10-15% of women of childbearing age. These are hormonal imbalances in women, and, more precisely, an increase in the production of male sex hormones, in particular, testosterone, excessive secretion of the hormone LH (a hormone produced by the pituitary gland that stimulates the ovaries) and high levels of insulin in the blood.

As already mentioned, sometimes the painful symptoms associated with menstruation may be accompanied by acute or chronic pelvic inflammation. Applies to most women of childbearing age, sexually active.

The most common cause is inflammation of the vagina, which spreads to the uterus, fallopian tubes and ovaries. Pelvic inflammatory pathogens are primarily Chlamydia trachomatis, Neisseria gonorrhoeae and Mycoplasma genitalium.

Symptoms of painful menstruation

Painful menstruation is different, above all, the pain that is felt in the abdomen and the sacrum, it can be dull or similar to colic, often makes it difficult for everyday life. Nausea and vomiting, diarrhea and severe headaches may also occur. The pain increases on the second day of menstruation, then gradually subsides.

The painful symptoms associated with endometriosis are mainly localized around the pelvis. The pain appears mainly in the period of menstruation, but can also recur in other phases of the menstrual cycle. Sometimes pain may be accompanied by urination. Other problems include bloating, fatigue, weakness, irregular bleeding, and problems with pregnancy.

Symptoms of fibroids include: lower abdominal paincaused by pressure of an expanding tumor on the bladder or rectum, severe bleeding, monthly bleeding between menstruation, symptoms of inflammation - in the case of large fibroids, prone to partial necrosis. Small fibroids, even in large quantities, may not manifest themselves at all.

Symptoms of polycystic ovary syndrome are associated with changes in the hormonal balance in a woman's body. In addition to painful menstruation, menstrual irregularities, hirsutism (hypertrichosis), problems with pregnancy, acne or seborrheic dermatitis, the presence of dark spots on the skin, bloating, hair loss (male type) can occur.

Diagnosis of painful menstruation

In order to properly recognize causes of painful menstruationA visit to the gynecologist is necessary. The basis of the diagnosis is a study of doctors, allowing, among other things, to identify violations of the uterus, changes concerning the uterus and appendages. A useful additional study is ultrasound, transvaginal examination.

In addition, the doctor may conduct a study of the purity of the vagina (in order to eliminate the causes of inflammatory processes), cytology, and blood tests (blood morphology, CRP and hormonal - the level of female sex hormones, such as estrogen, progesterone, LH, FSO and testosterone ).

Diagnosis of endometriosis is quite complicated. Among visualization methods, only magnetic resonance has found practical application. In some cases, biochemical analysis may be useful, including the concentration of the Ca 125 antigen.

Often, however, the final diagnosis can be made only by making a diagnostic laparoscopy (method of surgical "entry" in the abdominal cavity) and using the obtained fragments for examination under a microscope.

Diagnosis of uterine fibroids, as a rule, includes a medical examination (gynecological palpation), transvaginal ultrasound.

In the case of polycystic ovary syndrome, there are principles to identify this disease based on the following criteria:

  • Lack of or too rare ovulation.
  • Symptoms of excess male sex hormones (hypertrichosis in places characteristic of men: belly, chest, shoulders, face).
  • Detection of at least twelve enlarged follicles (ovarian thalassemia).

Pelvic inflammation may be associated with an increase in temperature, laboratory tests show an accelerated erythrocyte sedimentation rate, an increase in serum CRP levels, abnormal vaginal or cervical secretions, and incorrect results from cytology or microbiological studies (seeding from the vagina). In many cases, laparoscopy with the taking of strokes from the pelvic-abdominal cavity is necessary.

Treatment of painful menstruation

In the case of painful primary menstruation, ovulation is inhibited with contraceptives or a decrease in prostaglandin production. Secondary cases are treated with the treatment of the underlying disease. If the causes cannot be determined, then the analgesic and antispasmodic agents remain. Keep in mind that in such cases it is not possible to use acetylsalicylic acid (i.e., aspirin), which can increase bleeding.

You can also use household remedies for painful menstruation:

  • Chamomile or peppermint infusions that have an antispasmodic effect,
  • warm compresses on the stomach,
  • soft massaging of the abdomen,
  • diet without spicy, containing too many seasonings, but with a lot of fiber,
  • eating food supplements with vitamin B6, magnesium and calcium,
  • avoiding the use of strong tea and coffee,
  • alcohol rejection
  • drinking an appropriate amount of water.

Sometimes the pain is so strong, and the medications are not effective, that the doctor is forced to apply surgical treatment, which consists in breaking the uterus innervation. Sometimes even psychotherapy is required to help overcome the fear of manifestation of the disease.

In the case of endometriosis, the range of treatment and the choice of method depends on:

  • the age of the patient
  • potential breeding desire,
  • severity of illness
  • the presence of adhesions,
  • localization of foci of endometriosis,
  • reactions to pretreatment.

Pharmacological treatment consists of hormone therapy and symptomatic treatment, that is, pain relievers. The principle of action of hormonal drugs is based on slowing the activity of the ovaries and secondary atrophy (disappearance) of endometrial foci. This method is used mainly in women who, despite the prompt treatment of the disease, are progressing or are experiencing new changes.

Apply the following drugs:

  • danazol
  • progestin
  • gonadotropin analogues,
  • estrogen-progestogen preparations,
  • aromatase inhibitors,
  • selective progesterone receptor modulators.

Surgical treatment of endometriosis may include removal of isolated lesions, resection of the ovary, or, in extreme cases, removal of the ovary from the uterus. Women who want to become pregnant should use the most limited intervention, however, this behavior is associated with a large percentage of relapses.

Treatment of uterine fibroids consists in operative enucleation or removal of the uterus. The choice of the method of operation depends on the size, location and number of fibroids, the patient's age, as well as the desire to preserve fertility. The surgical procedure can be performed both in a normal mode (laparotomy) and laparoscopically.

Treatment of Polycystic Ovary Syndrome is to relieve pain and prevent the effects of the disease in the future. In the treatment is used as hormonal drugs (for example, drugs that stimulate the appearance of ovulation), and drugs that are used in the treatment of diabetes mellitus (metformin). You also need a lifestyle change, weight loss.

Prevent painful menstruation

To prevent the onset of painful menstruation, correct lifestyle (avoiding excesses — cigarettes, strong coffee, tea, alcohol), stress management, consumption of unsaturated fatty acids (mainly fish and seafood, as well as margarine with omega-3 and ready-made drugs available at the pharmacy). Proper genital hygiene is also important.

Why does pain occur during menstruation?

The reasons for this phenomenon can be many. The initial reason, which is indicated by the majority of scientists and physicians, lies in the increased content of specific female hormones - prostaglandins. The following reasons follow:

  • short or insufficient luteal phase,
  • endometrial enzymatic dysfunction, resulting in impaired mucosal rejection from the uterus,
  • low pain threshold at which any pain during menstruation is perceived as a strong irritant.

All the reasons described are most characteristic of primary dysmenorrhea. Among the causes of secondary dysmenorrhea are:

  • anatomical pathology of the uterus, including fibroids, adenomyosis,
  • all inflammatory processes in the pelvic organs,
  • adhesions in the abdominal cavity and pelvic cavity, which occurs after surgery,
  • varicose veins deep pelvic,
  • use of intrauterine contraceptives,
  • congenital pathologies of the development of the genitals,

Pain during menstruation and its types

In various sources there are several names that characterize the pain during menstruation - this is dysmenorrhea and algomenorrhea. The difference between these two terms in the intensity of pain and the degree of its manifestation. In dysmenorrhea, painful sensations take place and are fairly tolerable. While with algomenorrhea, pain during menstruation, on the contrary, is completely intolerable, leading to temporary disability, up to loss of consciousness. Dysmenorrhea, in turn, is subdivided into primary, which is characteristic only for non-pregnant women, it is associated (mainly) with hormonal and enzymatic imbalances, and secondary dysmenorrhea. Secondary dysmenorrhea implies the presence of diseases or pathological processes occurring in the pelvic organs and is a consequence of them, is eliminated only by the complete cure of the underlying disease.

How to recognize and treat pain during menstruation?

At home, it is possible to achieve only temporary relief of pain by taking painkillers or antispasmodic drugs. It is possible to find out and eliminate the root cause only by resorting to the help of a gynecologist. Examination of the pelvic organs through the use of ultrasound methods in most cases makes it possible to identify violations and establish the correct diagnosis. If this technique is insufficient, diagnostic laparoscopic methods are possible.

The results of biochemical and clinical blood tests also inform about the state of health of the woman. Most often you have to take a blood test for basic hormones. This type of analysis is carried out on a specific day of the cycle, which falls on the 5-7 menstrual day.

Hormonal imbalance levels off relatively easily and takes a little time in the time period. By taking special medications, under the constant control of blood counts, the necessary correction is carried out, as a result of which the natural hormones inherent in this woman and the pain during menstruation, which was the cause of the hormonal disturbance, are eliminated.

Other types of therapeutic interventions depend on the underlying causes that provoked pain during menstruation. If these are pathological tumors in the uterus or other pelvic organs, they should be removed by surgery. In the case of inflammatory processes, the pain will go away after complete removal of the inflammatory focus. However, we should not exclude the possibility that a slight pain will become a constant companion of each menstrual cycle. There are diseases, such as endometriosis, that are difficult to cure. In such cases, in addition to the treatment of the underlying disease, the constant use of painkillers is necessary.

In any case, no matter what causes the pain during menstruation, it is easier and more reliable to cope with them together with the gynecologist.

Causes of Menstrual Pain

Sometimes painful periods occur due to completely innocuous causes. For example, menstrual pain may occur as a result of improperly organized lifestyle during menstruation, when patients are too physically heavy: they lift weights, play sports, and also perform work involving considerable physical activity. Hypothermia and colds, stress and significant psycho-emotional stress can increase pain during menstruation. As a rule, painful periods that have arisen for these reasons occur only once, respond well to self-administered remedies for menstrual pain and do not recur.

Diagnostic important criterion is the time of occurrence of painful menstruation. Conventionally, all menstrual pains are classified according to the moment of appearance into primary and secondary.

Primary menstrual pains appear very early - during the establishment of the first menstruation (menarche) or no later than one and a half years later. При обследовании девушек с первичными менструальными болями патологических отклонений со стороны половых органов не выявляется, но зато всегда диагностируется большое количество так называемых «системных» симптомов, связанных с функциональными нарушениями в работе других (неполовой) систем организма – нервной, эндокринной, психоэмоциональной и так далее.

The most common causes of primary menstrual pain are:

- Endocrine disruptions that lead to hormonal dysfunction and distort the proper secretion of prostaglandins.

- Mechanical obstacles for the timely evacuation of the contents of the uterine cavity during menstrual bleeding. These include, first of all, congenital malformations of the genitalia: the incorrect position of the uterus or its abnormal structure, partial or complete fusion (atresia) of the cervical cavity.

- Constitutional features, namely sexual infantilism, because of which the musculature of the uterus remains in an underdeveloped state and is not able to properly empty the uterus during menstruation.

- Psycho-emotional. Pronounced stress, prolonged emotional distress and depression can change the correct functioning of the brain, including the centers of menstrual cycle regulation. Also, stress can change the perception of pain by changing its threshold.

Sometimes the source of primary menstrual pain remains unexplained. If during examination of a patient with primary menstrual pain, no organic or functional pathology is detected, menstrual pain is considered an individual norm and correlated with a low pain threshold.

Thus, primary menstrual pain, according to the cause of appearance, can be classified into psychogenic (excessive lability of the nervous system and / or astheno-vegetative syndrome), spasmogenic (impaired ability of the myometrium to contract correctly) and essential (individual variant of the norm).

Menstrual pains of secondary origin appear on the background of gynecological diseases, which are their cause. Painful periods may accompany infectious and inflammatory diseases of the genital area, myoma and uterine polyps, endometriosis, adhesions and other illnesses associated with organic changes in the organs of the pelvic cavity. Sometimes secondary menstrual pains are triggered by the endometrial spiral.

Symptoms and signs of menstrual pain

Primary menstrual pains declare themselves from the first menstruation or appear in the first one and a half years after their onset. More often they appear in girls and women of asthenic physique, who have a small body weight and a labile psyche.

Painful menstruation of secondary origin occurs in women 30-40 years old with gynecological pathology, with a history of childbirth, abortion, prolonged infertility, chronic infectious diseases and surgical interventions.

Among the complaints of patients, pain is more often mentioned. Usually, the pain appears 12 hours before the start of the next menstruation and gradually increases to the beginning of the menstrual bleeding, but its duration is not always the same. As a rule, primary menstrual pains are most pronounced in the first 2 - 42 hours of menstrual bleeding, and then become insignificant or disappear altogether. The intensity of the pain is also not the same. The pain can be dull, arching, oppressive, and it can acquire brighter features - it becomes cramping, sharp, radiating to adjacent zones and organs.

It is customary to single out several degrees of pain syndrome:

- The first, the easiest, degree is characterized by minor painful sensations without accompanying negative systemic symptoms. Usually there are slight pulling, aching or pressing weak feelings for a short time, equal to the period of heavy menstrual bleeding. The patient feels well and continues to lead an active life without taking pills for menstrual pain, but over time the pain syndrome can worsen.

- The second, moderate, severity of menstrual pain is characterized by a brighter clinic. Pains are repeated every menstruation and are accompanied by other, systemic, pathological symptoms, and in the case of secondary pains, the patient shows signs of the underlying disease. This severity of pain during menstruation can no longer be ignored, as it worsens health and does not allow to lead a normal life. The patient always has to take painkillers with menstrual pain of the second degree. An important diagnostic criterion to differentiate this degree of pain from others is the rapid relief of menstrual pain with drugs.

- The third degree of menstrual pain can be called very severe. Pelvic pain is so strong that it makes it impossible for the patient to get out of bed. Systemic symptoms are more intense. No self-administered remedies for menstrual pain of the third degree do not alleviate the patient's condition.

Not always the cause of menstrual pain is obvious, often for its search requires a large list of diagnostic measures. They are held until the origins of the pain are detected.

The survey begins with the examination of complaints, general and gynecological examination. More often, patients with menstrual pains are young (up to 30 years old), have a specific constitution, emotional lability and a “worn out” look.

In adolescents, primary complaints of menstrual pain with menstrual disorders in combination with premenstrual syndrome lead among complaints.

Systemic disorders accompanying menstrual pains of any origin are conditionally classified into:

- Vegetative: migraine headaches, heart rhythm disturbances, heart pain, alternating chills and excessive sweating, dysfunction of the digestive tract, vomiting, swelling of the face and extremities, weight gain before menstruation, fluctuations in blood pressure, fainting, and many others.

- Psychoemotional: shortness of breath or choking, “lumpy in the throat”, frequent unmotivated mood changes, poor sleep, apathy, anxiety and loss of appetite.

Secondary menstrual pains are always combined with the symptoms of the gynecological malady that caused them. The most common causes of painful menstruation of secondary origin are:

- Endometriosis. This complex hormone-dependent pathology provokes pain for several (5-7) days before the start of menstruation. As a rule, in addition to pain, there are also dark spotting. Pain in endometriosis continues after the end of menstrual bleeding. Often they subside only by the middle of the cycle.

- Uterine fibroids. Formed in the thickness of the uterine wall myomatous nodes violate the contractility of the myometrium, causing cramping menstrual cramps.

- Inflammatory diseases and their main complication is adhesions. Adhesions alter the position and mobility of the pelvic organs. During adhesions, the pain syndrome is not limited only to the period of menstruation, the pain is constant, and during menstrual bleeding only intensifies.

When examining the patient's complaints, it is important to find out which medications for menstrual pain she takes and how effective they are.

Laboratory diagnosis is most important for secondary menstrual pain. If they are caused by an infectious process, the results of a study of the microbial composition of the discharge of the vagina and the cervical canal (smear, culture, etc.) help determine the "culprit" of inflammation.

Also in the framework of laboratory studies determined the level of major hormones (LH, FSH, estrogens, progesterone and others).

Ultrasound scan of the pelvic cavity are all patients with menstrual pain. It allows you to determine the state of the uterus and appendages, to detect pathological formations (cyst, myoma, polyp, foci of endometriosis and others) and to study the condition of the endometrium.

To diagnose the cause of primary menstrual pains, the help of related specialists is often required: endocrinologists, neuropathologists, therapists and others.

If the pain during menstruation does not change, they are considered compensated, and if they progress from cycle to cycle, they become more pronounced and prolonged, they speak about decompensated menstrual pain.

It should be emphasized again that if the menstrual pain was limited to only one menstruation, and the subsequent menstrual periods were normal, the situation is physiological and does not require detailed examination and treatment.

Menstrual pain treatment

Secondary menstrual pains are never treated in isolation from the underlying disease, because painful periods pass only after adequate treatment of the disease that caused them. Any anesthetic for menstrual pain is integrated into the therapeutic scheme, and the main therapeutic measures are directed to their cause.

It is not easy to treat primary menstrual pain, as they have no organic basis, but are associated with systemic disorders. Therapeutic tactics depend on the severity of menstrual pain. The first, mild, degree without concomitant serious systemic failures can be cured without the participation of drugs. Mild menstrual pains go away on their own after a change in lifestyle, nutrition and reduction of the load on the nervous system. To prevent the development of autonomic and metabolic disorders, it is sometimes recommended to take antioxidants, in particular vitamin E.

Since excessive prostaglandin synthesis plays a significant role in the development of pain syndrome, it is necessary to eliminate it in order to relieve the seizures of menstrual pain. The group of non-steroidal anti-inflammatory drugs successfully copes with this task: Aspirin, Nimesulide, Diclofenac, Ibuprofen and the like. They can be used in different dosage forms - candles or tablets.

Medicinal candles for menstrual pain are very popular in patients because of ease of use and fast healing effect. In their composition may be antibacterial, antispasmodic and anti-inflammatory components that enhance the analgesic effect.

When choosing a method of treating menstrual pain, the state of the body's hormonal function is always taken into account. Hormonal dysfunction is often diagnosed in patients with menstrual pain; hormonal drugs are used to eliminate it. Hormonal pills for menstrual pain are selected based on the level of estrogen.

Self-treatment of this state is unacceptable. Selected at random pills or suppositories for menstrual pain may temporarily eliminate the pain, but are unable to eliminate their cause.

Physiological pain before menstruation

Mild pain before menstruation is the physiological norm. During ovulation, the egg leaves the cavity of the fallopian tubes, awaiting fertilization. If this does not happen, then the sex cell must be removed from the body along with the uterine mucosa, which increased during the period of ovulation. Because of the separation of endometrial cells, the vessels and nerve endings are damaged, so painful sensations arise.

With primary dysmenorrhea - the pathology of the menstrual cycle, due to which a woman experiences very strong pain and weakness every month - the bleeding may not be very active. In this case, increased discomfort is already a deviation from the norm.

Typically, pain during menstruation begins at 2-3 days, the peak of pain falls on 3-4 days. If during ovulation the egg cell was fertilized, then the menstruation does not occur, the pain does not appear.

Why hurts before the monthly right side

Normal pain before and during menstruation should be only in the lower abdomen and lower back, in other cases it is necessary to think about the causes of discomfort. Some girls complain of moderate or severe pain in the right side, for which there are several reasons.

The reason that the right side is hurting below can be diseases of the genital organs, because the reproductive system is located not only in the lower abdomen, but also higher, approximately to the navel. During menstruation, there is a slight inflammation, so the pain caused by the existing pathologies increases.

Ectopic pregnancy

Pregnancy is the process of carrying a child developing from a fertilized egg. You can learn about its occurrence with the help of a cheap and simple test that reacts to a specific hormone. Often girls are limited to this without undergoing an ultrasound examination. But it is precisely the latter analysis that will help establish whether the fetus has taken the correct position.

The ovum can consolidate not only in the uterus, but also the fallopian tubes or ovaries, then an ectopic pregnancy occurs.

With the pathological development of pregnancy, a woman after 2-3 months begins to experience pain in the right or left side, they have aching, pulling or cutting nature, discomfort is possible in the lower abdomen and back. It arises due to the fact that the fetus begins to stretch the thin fallopian tubes or ovaries.

It is impossible to carry the child during an ectopic pregnancy, because the uterine tube or ovary will be broken, the fetus will die, and the mother’s life will also be at risk. If a pregnant woman has pain in her side, it is necessary to consult a gynecologist and do an ultrasound to exclude the pathological location of the fetus.

Right Ovarian Inflammation

The ovaries are paired organs of the female reproductive system, which are essential for her health and the ability to have a baby. They secrete hormones, eggs, regulate the menstrual cycle, are responsible for the development of secondary sexual characteristics.

The body carefully “monitors” the health of the ovaries, sending blood enriched with oxygen and immune cells, but sometimes it is impossible to avoid diseases of these organs. Various right-sided inflammatory processes can cause the right side to hurt before menstruation.

Oophoritis and adnexitis

Oophoritis and adnexitis are inflammatory processes that affect the ovaries and appendages, and their cause is the addition of a bacterial (staphylococcus, streptococcus, Escherichia coli) or viral infection. Often, pathogens cause inflammation due to prolonged exposure to low temperatures, low immunity, or drastic weight loss.

When oophoritis or adnexitis, side pains are aching or cutting, they intensify before the beginning of menstruation. The inflammatory process in the ovaries is accompanied by increased bleeding during menstruation, fever up to 38-39 degrees, weakness and nausea.

Cyst and polycystic

About a week and a half before the onset of menstruation, when a woman begins to ovulate, there may be constant aching pain in her side, and the cause will be a cyst or polycystic ovary. The cyst is formed due to the fact that the follicle does not fully open inside the ovary, the egg cell does not come out of it, and there the inflammatory process begins with the accumulation of pus or the appearance of compaction. Polycystic - multiple formation of cysts in the ovary.

The cause of the appearance of cysts can be such states:

  • developmental pathologies of the reproductive system,
  • low or high content of FSH - a hormone that stimulates the formation and release of an egg from the follicles,
  • reduced or increased body weight.

The pains in the cytosis are aching in nature; they occur because hormones begin to influence the ovary so that it releases the egg during ovulation. The discomfort may not be strong, but permanent, therefore unpleasant.


Apoplexy - an emergency condition, accompanied by a violation of the integrity or rupture of the ovary. It occurs because of such reasons:

  • physical injuries
  • development of infection
  • ectopic pregnancy
  • varicose veins of the ovary,
  • prolonged inflammation of the ovary and appendages.

When right-sided apoplexy pain in the side will be strong cutting, constant, sometimes because of discomfort, the woman flexes the body and can not bend it. This condition is accompanied by a very high temperature, loss of consciousness, and if a woman is not delivered to the hospital in time, death is possible due to blood loss.


Endometriosis is a pathological increase in the thickness of the uterine mucous membrane. With this disease, menstruation is more abundant, lasts longer (about 9-11 days), pain during menstruation is strong, can give in the right or left side, the ovarian region.

Ill side by endometriosis can dramatically, the sensations will be aching and not brightly expressed. Sometimes pains are accompanied by weakness, a decrease in pressure.

Uterine myoma

Uterine fibroids - a benign neoplasm in the muscle tissue of the uterus, which appears due to hormonal disruptions or the use of local contraceptives, such as spirals. Due to the fact that the tumor begins to "push apart" muscle cells, the nerve endings actively send signals about pain. It can be pulling or cutting, give down the abdomen, in the side or mammary glands.
Stronger than the lower abdomen, chest and right side hurt before menstruation, because then the endometrium of the uterus is compacted, and myoma creates even greater pressure inside the muscle tissue.
Stronger than the lower abdomen, chest and right side hurt before menstruation, because then the endometrium of the uterus is compacted, and myoma creates even greater pressure inside the muscle tissue.


Аппендикс – небольшой отросток, который у человека считается рудиментом. It was needed in the early stages of evolution, when animals ate predominantly grass, and this small organ contained good bacteria that helped digest cellulose.

Sometimes the appendix can inflame due to the proliferation of bacteria in it or mechanical damage to the process, in which case an emergency condition develops - appendicitis. The appearance of the inflammatory process may coincide with the onset of menstruation, so the woman risks taking appendicitis for normal menstrual pain.

If a strong cutting pain appeared in the right side, due to which it is impossible to unbend the body, such a state is accompanied by nausea and high temperature, you should immediately go to the hospital, because the rupture of the appendix will be fatal to humans.


The right side also contains the liver and gall bladder, and the inflammation of the latter, cholecystitis, can also be confused with menstrual pains.

Cholecystitis develops due to an excess of bile in the gallbladder or against the formation of stones that do not allow it to go out. Inflammation develops rather slowly, at first it is accompanied by aching pains in the right side, which can be confused with menstrual. Over time, the inflammatory process increases, the temperature rises, the person cannot eat, and the pains are already cutting.

Diverticulitis and increased gas formation

Diverticulitis or inflammation of the intestines, as well as increased gas formation can cause side pain before menstruation. During the premenstrual period, the abdominal cavity, the breasts and legs swell, and fluid accumulates in their tissues. With abdominal swelling in a girl suffering from diverticulitis or flatulence, squeezing of the intestines with accumulated fluid causes worsening of the symptoms of these diseases, stitching or aching pains that can be given to the right side or down of the abdomen.

Intrauterine contraception

Sometimes the question of why pains appear in the right or left side of the body before menstruation is given by women who have an intrauterine device. This device contains hormones, which it gradually releases into the uterus, preventing pregnancy.

After physical injuries, during active sexual intercourse, or if the intrauterine contraceptive device is not properly installed, the helix can budge and travel through the uterus, fallopian tubes, and even the ovaries. This causes a woman to severe pain in the side where the spiral went. At the same time, in addition to discomfort, there is a fever and inflammation in the pelvic area, there is pain during sexual intercourse.

Abortion and diagnostic curettage

During an abortion or diagnostic curettage, the doctor may affect not only the uterine mucosa, but also the underlying smooth muscle tissue. If the wounds are deep, then scar tissue develops in their place, which will be inelastic and susceptible to inflammation; therefore, before menstruation, cutting or aching pains in the lower abdomen may spread to the lower back or side. In this case, the discharge during menstruation will be more abundant than normal.

Medical examination

The first thing that needs to be done for pain in the side is to contact a gynecologist, who will take anamnesis and professional examination. If this doctor can not find the causes of discomfort, then you need to visit a therapist and a surgeon who will palpate the abdominal cavity to find the causes of pain, if they are not associated with diseases of the reproductive system.


Since there are a lot of reasons for pain in the side before menstruation, it is difficult to describe all preventive measures, so the main ones will be:

  • regular visits to the gynecologist (once every 6 months),
  • annual examination by a surgeon, therapist, neuropathologist,
  • support of normal microflora in the intestines to avoid flatulence and diverticulitis,
  • avoid abdominal injuries
  • Installing the intrauterine device only in a good hospital.

Pain in the side before or during menstruation is not the physiological norm, so they can not be ignored or try to cope with them independently. You must visit a gynecologist, a surgeon and a general practitioner to find the cause of this abnormality and get the right treatment.

Tubal pregnancy and its consequences

The location of the ovum outside the uterus is not uncommon and dangerous. The first sign that can tell about it is pain. Its localization on the right side is evidence that the fertilized egg was fixed in the corresponding fallopian tube. The pain, provoked by the problem, is cramping, gives to the groin area, rectum, external genital organs. A characteristic feature - menstruation during ectopic pregnancy almost always comes after the calendar period. So if there is a delay, before the monthly pains on the right (as well as during critical days), the help of a surgeon is needed. There are additional signs that indicate ectopic pregnancy:

  • pale skin
  • dizziness,
  • heart palpitations
  • low blood pressure.

Ectopic pregnancy as a cause of abdominal pain

Incorrectly installed IUD

The intrauterine device is a foreign body. Problems due to its use may also arise when properly administered. But if the device has shifted, it will appear more likely in the period of menstruation. Contribute to the pain of a special sensitivity of the uterus and increased contractions of its smooth muscles.

Torsion legs ovarian cysts

Ovarian cysts usually form at a young age. If the formation has a leg, probably its wrapping around its axis. This causes pain in the abdomen on the side where the gonad is located. A complication can occur in any period, but with menstruation, intra-abdominal pressure increases, which favors the appearance of pathology. Its distinguishing features are:

  • sharp pain, unbearable, capable of causing loss of consciousness,
  • nausea may develop, vomiting appears,
  • the temperature rises
  • pressure drops, and pulse quickens,
  • some women have impaired stool and urination,
  • a cold sweat appears.

Inflammation of the appendages

If with monthly pains in the right lower abdomen, the development of inflammation in the appendages cannot be excluded. Critical days are also an additional incentive for exacerbating or first appearing a problem. Pain affects the sacrum, the inner thighs, lower back, and sometimes the rectum. Sometimes it is first found in both appendages. But then it will be felt on the right, if the inflammation is stronger in this part of the system.

Its distinguishing features are:

  • there is more mucus in the menstrual flow, there may be pus,
  • there is a breakdown, drowsiness,
  • no appetite
  • irritability increases.

The pain syndrome itself, although quite strong, but in comparison with what happens in the previously mentioned pathologies, does not have such intensity.

Inflammation of the appendages as a cause of pain in the abdomen on the right

Ovarian cyst

A complaint that after menstruation an ovary on the right side hurts can be caused by the formation of an endometrial cyst on the organ. At the beginning of the cycle, its cells develop in the same way as the tissues of the mucous membrane of the uterus, that is, they thicken. Their abnormal location on the ovary causes pain. After all, healthy tissues of an organ are compressed, their blood supply and functions are disturbed.

Threatened miscarriage

In the initial stage of pregnancy, recurrent abdominal pain is not uncommon. Normally, without bloody discharge, they are evidence of the preparation of the organism for the subsequent bearing. Weak aching pain is from stretching the uterus, increasing its blood supply.

Another thing, when the syndrome is pronounced, is found on the background of menstrual-like secretions. This is the threat of abortion.

Localization of myoma node in the corresponding part of the uterus can also cause pain during menstruation in the right side of the abdomen. As a rule, this tumor is sensitive to estrogen. On critical days, their level falls, but immediately after the end of the period begins to increase. Contractions of the uterus, trying to get rid of the old inner lining, disturb myoma, nearby nerve roots. The tumor itself interferes with the movements of the organ. Hence, complaints that during and after menstruation the lower abdomen on the right side hurts, the amount of discharge during menstruation increases, it can end with a long-term detectable daubs.

Diseases of the digestive tract as the cause of pain

Sick on the right can not only because of problems in the reproductive system. For the period of menstruation is characterized by a decrease in immunity, many signs that change the work and other organs, in particular the digestive. And because the syndrome may indicate the following diseases:

  • Appendicitis. Errors in nutrition can provoke inflammation of the appendix. After all, some girls with monthly appetite wakes up, they eat a lot of spicy food, sweet, which causes bowel failure. The consequence of this may be an inflammation of the appendix. There is a sharp pain, first in the center of the abdomen, then it goes to the right side. Other symptoms include single vomiting, diarrhea, fever. The pain becomes quieter when lying on the right side.
  • Diverticulitis. And this intestinal pathology can worsen on the background of menstruation due to errors in the diet. Diverticulum - a protrusion on the wall of the organ in which its contents can stagnate, causing inflammation. If during menstruation it hurts on the right, there are problems with the stool (constipation, then diarrhea), increased sensation when tapping on the stomach, it is possible that this is the same problem.
  • Crohn's disease. Malnutrition with lots of sweet, salty, and spicy foods, which is common for some on critical days, causes increased gas formation. It affects the inflamed intestines badly. On the background of menstruation, there is pain in the abdomen on the right, similar to appendicular colic, diarrhea.

We recommend reading an article about mid-cycle abdominal pain. From it you will learn about the nature of pain and their duration, normal and pathological causes of pain, ways to alleviate the condition and the need to consult a doctor.