The 6 times your period pain could be a medical emergency – from a womb puncture to pregnancy
MOST of us take period camps to be part and parcel of periods, right?
It's true that pain is part of the normal mechanism of menstruation, according to the NHS.
In fact, nine in ten women in the UK experience period pain at some point in their lives.
With that said, really bad menstrual cramps are not normal.
Severe period cramps can signal a problem and may land you in hospital.
We spoke to Dr Fran Yarlett, GP and medical director at The Lowdown, about the six serious things that your period pain could potentially be telling you.
She said: "Period pains can usually be managed with simple painkillers, such as paracetamol and ibuprofen.
"If the pain is still not controlled or you have other symptoms such as a high fever, offensive vaginal discharge or pain that can be pinpointed to a very specific area, it’s advisable to speak to a doctor. "
1. Ectopic pregnancy
An ectopic pregnancy can be a horrible event for expecting parents.
It happens when a fertilised egg implants outside the womb.
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Most of the time, this is on the fallopian tubes, but it can also happen on the ovaries, the cervix (neck to the womb) or another organ inside the pelvis.
The NHS says it affects one in every 80 to 90 pregnancies, or 11,000 pregnancies every year.
Tragically, an ectopic pregnancy means a baby cannot survive.
"The pain is typically one-sided and associated with possibly some brown spotting or bleeding with a positive pregnancy test," Dr Fran said.
"This cannot be missed as if an ectopic pregnancy causes the fallopian tube to burst, major bleeding into the pelvic area can occur."
Other symptoms can include:
- Vaginal bleeding
- Brown watery discharge
- Missed period
- Discomfort when going to the bathroom
- Pain in the tip of your shoulder
2. Toxic shock syndrome
Period pain, which is much worse than usual, could be a sign of a bacterial infection.
Toxic shock syndrome (TSS) happens when Staphylococcus enters the body and releases toxins, which can lead to sepsis - a life-threatening immune response to harmful bacteria, Dr Fran explained.
TSS requires urgent treatment as, in serious cases, it can be fatal.
"It is sometimes associated with tampon use but thankfully is very rare," she added.
Skin wounds, surgical incisions, nasal packing, scrapes, burns or other areas of injured skin can increase the risk of the condition, the NHS says.
Bacteria may grow on tampons, especially if they aren’t changed often enough.
Other symptoms include:
- A high temperature
- Muscle aches
- A raised skin rash that feels like sandpaper
- Flu-like symptoms
3. Appendicitis
Appendicitis is a painful swelling of the appendix - a small pouch connected to the large intestine.
Severe pain in your stomach or pelvis is a common sign of the medical emergency.
Appendicitis-related pain usually ends up being a lot worse than typical period pain.
Both types of pain can affect the tummy, pelvis and lower back and can come and go.
"You can get appendicitis on your period, and it’s important to think of non-gynaecological conditions even when you’re menstruating," Dr Fran added.
According to the NHS, the main difference between the two types of pain is where they develop.
Within hours of developing appendicitis, the pain travels to the lower right-hand side, where the appendix usually lies, and becomes constant and severe.
Pressing on this area, coughing, or walking may worsen the pain.
Period pain generally affects the lower abdomen, lower back and stomach.
Other appendicitis symptoms include:
- Feeling sick (nausea)
- being sick
- Loss of appetite
- Constipation or diarrhoea
- A high temperature and a flushed face
If you have abdominal pain that's gradually getting worse, contact a GP or your local out-of-hours service immediately.
4. Endometriosis
Endometriosis is a common but relatively unknown health condition associated with crippling period pains.
It affects up to one in 10 women in the UK, and can severely impact those who suffer from it.
The condition causes tissue similar to that in the womb to grow in other areas in the body.
This most commonly occurs in the pelvis, around the ovaries, in the fallopian tubes or outside the womb.
If you haven't already been diagnosed and you suffer from debilitating menstrual pains, Dr Fran suggested getting checked by your GP.
"It can affect fertility and quality of life, so if your periods are severe every month then push for tests," she said.
In some cases, severe endometriosis pain may indicate a medical emergency, such as a ruptured cyst, acccording to the NHS.
Endometriosis can cause cysts to form on the ovaries.
If a cyst ruptures, it may cause sudden pain in the lower abdomen or back, which may feel sharp or severe.
Some cysts can become infected. If these rupture, it can trigger sepsis.
5. Coil perforation
The copper coil is an effective, hormone-free contraceptive used by millions of women in the UK.
In rare cases, the coil, otherwise known as an IUD (intrauterine device), can cause perforation.
This is when the coil punctures the wall of the womb.
According to the NHS, this can cause mild lower abdominal pain.
Dr Fran said in some cases, an operation may be required to remove the coil from the womb.
But normally, a doctor or nurse can take it out.
"If you’ve had a coil fitted in the last three months and have severe pain or strange bleeding, or can feel something resembling a matchstick during sex, ask your clinician for an ultrasound to check the position of the coil to make sure you’re protected," she added.
Other signs include:
- Severe pelvic pain after insertion (worse than period cramps)
- Pain or heavy bleeding after insertion continues for over a few weeks
- Sudden changes in periods
- Pain during sex
- Not being able to feel the threads
6. Cancer
In the early stages, womb and ovarian cancer can feel like period cramps.
According to New York Presbyterian, this happens when the tumour presses on the nearby organs, including the bladder and rectum.
And this can result in pain in the pelvic area, abdomen, or back which can feel like period pain.
"Abnormal bleeding between periods or after sex, especially if you have PCOS (polycystic ovary syndrome) or any family history of gynaecological cancer should be discussed with your clinician to check for any other worrying signs," Dr Fran added.
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Other common signs of gynecologic cancers include:
- Feeling full too quickly or having difficulty eating
- More frequent or urgent need to urinate
What is period pain?
Period pain can occur for many reasons.
Period pain can happen when the muscular wall of the womb tightens (contracts), the NHS says.
Mild contractions pass through your womb regularly but are usually so mild that most women can't feel them.
During your period, the womb wall starts to contract more vigorously, which can often be painful. It does this to encourage the womb lining to shed away, which becomes your monthly period.
According to Dr Fran, when the wall of the womb contracts, it compresses the blood vessels lining your womb.
She said: "This cuts off the blood and oxygen supply to your womb, which can cause cramps.
"The tissues in your womb then release chemicals called prostaglandins which makes you womb contract more and can also trigger pain."
If you have severe period pain, go and see your GP. You may be suffering from endometriosis of PCOS which could make your periods worse.