Why does my stomach hurt when I am on my period?

Stomach pain during menstruation is usually caused by primary dysmenorrhea or secondary dysmenorrhea, which may be related to factors such as excessive secretion of prostaglandins, endometriosis, adenomyosis, pelvic inflammatory disease, and abnormal uterine development. Dysmenorrhea can be relieved by hot compresses, medication to relieve pain, and dietary adjustments.

1. Excessive secretion of prostaglandins

When the endometrium is shed during menstruation, a large amount of prostaglandins are released, causing the uterine smooth muscle to contract strongly, causing spasmodic pain in the lower abdomen. This pain usually occurs 1-2 days before menstruation and may be accompanied by nausea and headache. You can use prostaglandin synthase inhibitors such as ibuprofen sustained-release capsules, diclofenac sodium suppositories, or naproxen tablets as directed by your doctor to relieve symptoms. You can use a hot water bottle to apply heat to your abdomen every day to avoid strenuous exercise.

2. Endometriosis

Endometrial tissue ectopically grows into the ovaries, pelvic cavity and other parts of the body. During menstruation, these tissues will also bleed and stimulate peripheral nerves, leading to progressively worsening dysmenorrhea, which may be accompanied by painful sexual intercourse and painful defecation. Laparoscopy is required to confirm the diagnosis, and drugs such as dienogest tablets and goserelin sustained-release implants can be used for treatment. In severe cases, laparoscopic surgery is required to remove the lesions.

3. Adenomyosis

Endometrial glands invade the myometrium, causing the uterus to uniformly enlarge. Abnormal uterine contractions cause severe pain during menstruation. The pain often radiates to the lumbosacral region, and may be accompanied by increased menstrual flow. Ultrasound examination shows thickening of the uterine myometrium, and levonorgestrel sustained-release intrauterine system or oral mifepristone tablets can be used for treatment. Hysterectomy should be considered when conservative treatment is ineffective.

4. Pelvic inflammatory disease

Pelvic inflammatory disease caused by bacterial infection can lead to increased pelvic congestion during menstruation, persistent lower abdominal pain, and may be accompanied by fever and abnormal vaginal discharge. The diagnosis needs to be confirmed through gynecological examination and pathogen detection. Treatment requires the use of ceftriaxone sodium for injection combined with metronidazole sodium chloride injection as directed by the doctor, and pelvic physical therapy to promote the absorption of inflammation.

5.Abnormal uterine development

Congenital uterine malformations such as bicornuate uterus, septate uterus, etc. may affect the discharge of menstrual blood and cause abdominal pain during menstruation. The pain usually starts at menarche in adolescence. Ultrasound or magnetic resonance imaging can confirm the diagnosis. Mild deformities can be treated with oral short-acting contraceptive pills to regulate menstruation. Severe cases require hysteroscopic surgery to correct the shape.

During menstruation, you should pay attention to keeping your abdomen warm, avoid raw or cold foods and strenuous exercise, and drink appropriate amounts of ginger tea or hot milk to relieve discomfort. If the pain continues to worsen or is accompanied by abnormal bleeding, timely medical treatment is required to rule out organic disease. Daily recommendations include recording menstrual cycles and pain characteristics to help doctors more accurately determine the cause. Regular work and rest and moderate exercise can help improve pelvic blood circulation and reduce the occurrence of dysmenorrhea.