Most period pain is minor and can be easily treated with over-the-counter medication. However, sometimes severe or chronic pain is a sign of an underlying condition such as endometriosis, uterine fibroids, or pelvic inflammatory disease.
The vulva is a resilient structure that has many accordion-like folds to increase elasticity. To ease menstrual pain, avoid douches and genital hygiene washes with fragranced ingredients.
Menopause
Women going through menopause often experience vaginal pain on a period. The reason is simple: estrogen levels decline. Estrogen is a natural lubricant that helps the vaginal walls stay soft and thick. When the estrogen levels decline, it may lead to vaginal atrophy and pain. Using natural methods of lubrication like a vulva ring or a water-soluble lubricant can help alleviate the pain.
Another menopausal symptom that can cause period pain is hot flashes. Hot flashes are sudden, brief increases in body temperature and occur in about 75% of women who go through menopause.
While cramping is a typical part of getting a period, it’s important to see a doctor if the pain is severe or continues for more than seven days. The doctor may be able to determine the root cause of your pain and provide you with treatments that will relieve it. If the pain isn’t relieved by over-the-counter pain medications, it could be due to a more serious issue like endometriosis or fibroids. In those cases, you’ll need to see a specialist for treatment.
Endometriosis
When menstrual pain becomes severe and cannot be relieved with over-the-counter painkillers, it is usually a sign of some physical condition. This is called secondary dysmenorrhea and requires the attention of a doctor.
Endometriosis is a medical condition in which tissues resembling the uterus lining grow outside the uterus. These cells contract and bleed during the menstrual cycle, but they cannot exit the body. The tissue often ends up forming in the pelvic area, causing pain during a period. The pain is sometimes felt in the vagina, and it may be accompanied by bowel issues such as diarrhea or constipation.
Women with this condition are at increased risk for a variety of other health problems, including cancer. It is important to see a doctor if the pain is severe, persists for long periods of time, or interferes with daily activities. A gynecologist can recommend a course of treatment that can help manage symptoms and prevent them from getting worse. They may recommend a laparoscopy or surgery to remove the errant tissue. In extreme cases, a hysterectomy may be necessary, but this should only be considered when the disease has advanced.
Fibroids
Fibroids are non-cancerous growths of muscle and tissue that develop inside the muscular wall of your uterus or womb (womb). They can be the size of a pea or even larger and may cause heavy bleeding from the uterus. They can also make it harder for you to get pregnant.
Your doctor will examine you for fibroids during a pelvic exam and a blood test or an ultrasound scan. The most common symptom of uterine fibroids is abnormal heavy menstrual bleeding, which can be accompanied by cramps and fatigue.
A doctor may recommend medications to shrink uterine fibroids. If medication doesn’t work, surgery may be required to remove the fibroid(s). Fibroids can grow into cancerous tumors, which is rare.
A doctor will discuss all of your treatment options to find the best one for you. If your uterine pain is severe and interferes with your daily life, talk to your doctor about treatments like a GnRH agonist (a drug that lowers estrogen levels and triggers a temporary “medical menopause”). It can help shrink uterine fibroids and reduce menstrual pain.
Pelvic Floor Issues
The pelvic floor is a “hammock” of muscles that supports your core and keeps your internal organs in place. In women, it holds the bladder, uterus and vagina. It can be weak or damaged due to childbirth, injury, being overweight or surgeries. Pelvic floor disorders cause urinary incontinence, bowel dysfunction and sexual problems. If your pain is not relieved by NSAIDs, see a doctor for an evaluation.
Some conditions causing pelvic pain during your period include bacterial vaginosis and yeast infections, which may be aggravated by menstrual blood. These conditions can lead to itching, burning, or foul-smelling discharge. Folliculitis is another condition that causes vulva pain during the menstrual cycle.
If you are experiencing severe cramping that does not respond to NSAIDs, this is called secondary dysmenorrhea and requires medical attention. Your healthcare provider will ask questions and perform a pelvic exam to look at your uterus, cervix and pelvic organs. They will also take a sample of your vaginal fluid for testing. Then, they will recommend treatment. This may include a pelvic floor physical therapy or a pessary to support your internal organs.
Infection
A lot of women experience pain in their vulva and pelvic area during their periods. This is a totally normal occurrence called “proctalgia fugax.”
The cervix is the neck-like part of your uterus that sticks out into your vagina. It’s the place your gyno takes a sample from for a Pap smear and it dilates during pregnancy and childbirth. It can also cause painful cramps during a period.
It’s also common for your entire pelvic area to swell up during your period, aesthetic gynecologist Dr. Moushumi Shoma Datta tells Bustle. This is because your body is full of hormones that make your vulva and rectum tissue engorged and painful.
However, if your pelvic pain is accompanied by sores in your vulva or vagina or it’s paired with abnormal vaginal discharge that resembles thrush or gonorrhoea, this is a sign you should go see a doctor ASAP. This is a symptom of Pelvic Inflammatory Disease (PID), which can be caused by sexually transmitted diseases like chlamydia and gonorrhoea, and it’s a serious medical issue that requires immediate attention.
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