All About Periods

6 Possible Worrying Reasons Behind Your Severe Menstrual Cramps


Previously, we talked about 5 Warning Signs That Your Menstrual Cramps Are Not Normal. Now, we’ll discuss in detail what implications those warning signs could indicate.


  • Endometriosis

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A common cause for severe period pain – Endometriosis is a gynaecological condition where the tissue forming the lining of the uterus (the endometrium) starts to grow outside the uterus. This means that the endometrium has been displaced to other structures throughout the pelvis, including ovaries, fallopian tubes, bladder, or in even more severe cases, the liver, lungs or even the brain.

The first telltale sign of endometriosis is acute abdominal pains, often coinciding with your period. Other symptoms include pain after sex, painful bowel movements, nausea, and chronic lower-back pain. However, it does not affect every woman in the same way – some may experience pain, some may not. In spite of these, the fact that endometriosis could lead to severe health implications such as infertility remain.

Even if most doctors dismiss your menstrual cramps as simply ‘normal’ or simply tell you not to over-dramatise your pains, if you feel like your menstrual cramps are not normal to the point you experience fainting spells – Insist on a diagnostic laparoscopy to confirm whether or not you suffer from endometriosis.

Mild treatments include anti-inflammatory agents, painkillers or heat pads. Hormone treatments may also be suggested, starting with birth control pills. However, surgery might be necessary in severe cases. Women with severe chronic pain or infertility may end up needing to undergo hysterectomy.

Find out more on All You Need To Know About Endometriosis.



  • Adenomyosis


Adenomyosis is like endometriosis, except instead of the tissue lining (endometrium) growing outside of the uterus, it is embedded deep WITHIN the uterine muscle (myometrium). This condition can happen throughout the whole uterus, or in one particular spot.

With bleeding happening inside the muscle, this could result in lower abdominal pain, cramps, bloating and heavy bleeding before or during a woman’s period. Another possible symptom is painful sexual intercourse which can hurt up till 1-2 days after.

Adenomyosis can be detected with a pelvic exam. Treatment, depending on the symptoms’ severity, can include painkillers, anti-inflammatory drugs (NSAIDs), and a heating pad to soothe cramps. Surgery is reserved for the most difficult cases.



  • Uterine Fibroids & Ovarian CystsImage result for Uterine Fibroids & Ovarian Cysts


Fibroids are benign tumours on the walls of the uterus, and as many as 3 out of 4 women suffer from this. However, most of them do not suffer from symptoms. Fibroids’ size can range from microscopic to being large enough to disrupt the natural shape of the uterus.

Abnormal uterine bleeding is the most common symptom of fibroids. If the tumours are close to the uterine lining, or get in the way of blood flow to the lining, they can spark painful periods, prolonged periods, and spotting. Depending on their size and locations, fibroids could lead to other implications.

Although fibroids are mostly non-threatening, but they can impact fertility and potentially cause miscarriages. They can be diagnosed by a pelvic examination and ultrasound.

Treatments for fibroids can include anything from low-dose contraceptive pills to surgeries such as a hysterectomy or myomectomy (removal of the fibroid-affected part of the uterus).

Cysts, on the other hand, are fluid-filled sacs whose occurrence can happen anywhere in the body. Most commonly found in the ovaries should they appear in the reproductive system, this can spark pain anytime – not just during menstruation – and include other symptoms such as pain during sexual intercourse, weight gain, nausea and breast tenderness.

Routine pelvic exams are able to spot ovarian cysts, and further tests (eg. Ultrasounds, blood & hormone tests etc) will be conducted to determine treatment. The good news? Most cysts aren’t cancerous and will usually subside on their own.


  • Copper IUDImage result for copper iud


Yes, heavier and painful periods could be a possible side effect of the copper IUD!

Copper IUD is a reliable long-term birth control that prevents sperms from fertilising an egg. Its other birth control functions include altering the lining of the womb and transport of the egg along the fallopian tube.

Unfortunately, some women may realise that their periods become heavier and more painful. These can usually be eased with regular painkillers like ibuprofen or paracetamol. The increased period pain triggered by the IUD should also subside within a few months as the body becomes accustomed to it.

However, if the pain persists, you can always have the IUD removed!


  • Pelvic Inflammatory Disease (PID)Image result for pelvic inflammatory disease (pid)


PID refers to an infection of a woman’s reproductive organs mostly caused by untreated STDs (sexually-transmitted diseases). These infections can cause inflammation, scarring, painful menstrual cramps and infertility. Symptoms can be mild, and women don’t know they suffer from PID – even though the infection can get serious if left untreated for too long. In addition, 1 in 8 women with PID eventually face difficulties with impregnation.

Here’s the tricky part: There aren’t any specific diagnostic test for PID. Period pains aren’t usually associated with the infections, although it can sometimes play a part in them. Thankfully, physical exams are able to help diagnose a PID, although this would not be the first on the list on a doctor’s list of possible diagnoses as they run through your symptoms.

Treatment usually includes antibiotics, though surgery might be needed in more developed cases.


  • Uterine Defects
    Image result for uterine defects


While still in her mother’s uterus, a female fetus’  uterus develops from two structures known as Müllerian ducts. In some cases, the uterus does not form correctly, which can cause infertility, period pain, and painful intercourse.

For women with structural anomalies, menstrual cramps could stem from blockages and membranes dividing the uterus and vagina.


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While all these may seem scary, always seek out your gynaecologist before jumping into any conclusions about your diagnosis! I hope everything goes well for you and we’ll see you again soon!
Find out more about all you need to know about menstrual cramps and its causes, preventions, reliefs and more here!



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