Why Am I Experiencing Severe Period Cramps?
Disclaimer: As with any online advice, this article is not meant to replace a consultation with a professional doctor, and if you are concerned about your period pains, then my advice would always be to make an appointment with a physician as soon as you can.
This article also contains a graphic image depicting the surgical reduction of adhesions associated with ovarian cysts. Please proceed with caution.
For many years, I suffered from the most terrible period pains. Every month, I needed to take four days off work simply to curl up in a corner and wait for the pains to subside. It seemed that conventional painkillers, such as paracetamol, didn't make a lot of difference, and, in any case, they tended to make me feel sick in addition to being really hard to swallow.
Numerous times, I went to various doctors and explained the suffering I was going through only to be told to go home and take—yes, you guessed it—a paracetamol! I suspect that since most of them were men, they merely took it as simply another female dealing with a few cramps each month and making too big a deal out of it.
It took over ten years for the real reason behind my agonising period pains to come to light. This was when I first went to a doctor to find out why I was failing to get pregnant with my first husband, who already had children of his own from a former marriage.
At this time, I was about 26 and had been going through this pain since the age of 16, when my periods had first started.
The fertility specialist performed an internal ultrasound and informed me that I had a three-inch ovarian cyst on my right ovary. I also had distinct signs of endometriosis. After taking various blood tests, he also determined that I wasn't ovulating. He arranged for me to have the cyst—and as much of the endometriosis as possible—removed in the hopes of improving my chances of conceiving.
I looked into exactly what endometriosis is and discovered it is when uterine tissue grows outside of the uterus for reasons doctors can't explain. This tissue follows the same cycle as the tissue in the uterus, so each month, it builds up a fleshy blood-filled lining before breaking down at the end of the cycle. The problem with endometriosis is that outside of the uterus, there is nowhere for the blood and tissue to escape, hence the agonising cramps during the menstruation.
The ovarian cyst could also potentially be dangerous if it grows too large and bursts, so it was important that this was removed as soon as possible. Benign cysts form naturally on the ovaries each month and usually burst to release an egg, but, in certain cases, they fail to burst and simply keep on growing larger and larger, adding to the severity of the period pains each month.
There are various kinds of cysts that can form on the ovaries:
- Follicular Cysts: These cysts form when the sac doesn't break open to release the egg. Then, the sac keeps growing. This type of cyst most often goes away in one to three months.
- Corpus Luteum Cysts: These cysts form if the sac doesn't dissolve. Instead, the sac seals off after the egg is released. Then, fluid builds up inside. Most of these cysts go away after a few weeks. They can grow to almost four inches. They may bleed or twist the ovary and cause pain. They are rarely cancerous. Some drugs used to induce ovulation, such as Clomid® or Serophene®, can increase the risk of cyst formation.
- Endometriomas: These cysts form in women who have endometriosis. This problem occurs when tissue that looks and acts like the lining of the uterus grows outside the uterus. The tissue may attach to the ovary and form a growth. These cysts can be painful during sex and during your period.
- Cystadenomas: These cysts form from cells on the outer surface of the ovary. They are often filled with a watery fluid or thick, sticky gel. They can become large and cause pain.
- Dermoid Cysts: These cysts contain many types of cells. They may be filled with hair, teeth, and other tissues that become part of the cyst. They can become large and cause pain.
- Polycystic Ovaries: These cysts are caused when eggs mature within the sacs but are not released. The cycle then repeats. The sacs continue to grow and many cysts form.
To say I felt angry was an understatement. I had gone through years of suffering that could have largely been avoided by reducing my endometriosis or by, at least, being placed on prescription strength painkillers. Who knows how long the cyst had been there? What I did know was I had been, and still was, experiencing all the classic symptoms of both problems. Yet, it wasn't until I needed fertility treatment that a doctor even suggested these possibilities.
The classic symptoms of both these conditions are listed below.
Pressure, swelling, or abdominal pain
Pain during menstruation
Chronic pelvic pain
Dull ache in lower back and thighs
Lower back pain
Pain during sex
Pain during sex
Weight gain during period
Heavy and/or irregular periods
Nausea or vomiting
Diarrhoea or constipation
Anxiety and depression
I did stay in hospital for a week and had both the cyst and some of the endometriosis removed, but it left me with a four-inch scar across my bikini line.
Some years later—after my first husband sadly died before we could further pursue fertility treatment—I was again told I had an ovarian cyst by a fertility specialist, only this time, it was on my left ovary. He could also see signs of endometriosis on the ultrasound, so he scheduled for removal of the cyst and run a dye test to see if my fallopian tubes were blocked.
By now, the technique was far simpler and could be done as a keyhole surgery in one day. Hoping against hope that this time my problems would be solved, I went in for the operation.
I had to wait seven weeks for my follow-up appointment during which time I had no idea what the findings had been or what had been done.
In the follow-up, the specialist didn't waste any time in telling me it was not good news. Apparently, I had now developed severe adhesions within my whole reproductive system, and, in certain places, my other organs had even fused with my reproductive organs. He explained that these adhesions could have been caused by the endometriosis itself or by an infection following the previous surgery. Unfortunately, they had been unable to find my ovaries through all of the scar tissue, so they could not tell if the dye passed successfully through the fallopian tubes or not. I don't even know if they found the cyst to remove it as I was too stunned by what he said next to think to ask the question.
He now felt it was extremely unlikely I could ever get pregnant without in vitro fertilization (IVF), which is something my current husband Richard and I simply couldn't, and still can't, afford—not a good position to be in when you are already about to turn 39 years old.
Thankfully, I no longer get the severe period pains, mainly because a portion of the endometriosis was removed when I had the first operation. In addition, I can now obtain mefenamic acid tablets (500 mg), prescribed by my doctor. These tablets are specifically geared towards period pains and prevent the production of chemical irritants that cause much of the pain and inflammation in the body.
I urge anyone reading this who suffers from severe period pains to insist their doctor look into the possibility of either endometriosis or ovarian cysts. Even though after removal, these problems can sometimes return, the suffering will largely be reduced, and what is left can be helped with pain medication.
Most ovarian cysts are not life-threatening, but there are some potential dangers in the event one ruptures, so don't delay getting any suspiciously severe pain investigated thoroughly.
In the event you are experiencing severe pains in your pelvis, abdomen, or sometimes even in your shoulder and neck, there may also be a risk of an ectopic pregnancy, which is life-threatening and should never be ignored.
If any of the above applies to you, I urge you to contact your doctor immediately.