Why do I always have stomach ache during menstruation?

Persistent stomach pain during menstruation may be related to factors such as primary dysmenorrhea, endometriosis, adenomyosis, pelvic inflammatory disease, and mental stress, which can be relieved by hot compresses, drug intervention, surgical treatment, etc. Dysmenorrhea usually manifests as lower abdominal distension, backache, and in severe cases, nausea and vomiting.

1. Primary dysmenorrhea

Primary dysmenorrhea is related to the increased secretion of prostaglandins during menstruation and is a physiological pain. The main manifestation is spasmodic pain in the lower abdomen on the 1st to 2nd day of menstruation, which may be accompanied by headache and fatigue. It can be relieved by hot compress. When the pain is severe, you can use ibuprofen sustained-release capsules, acetaminophen tablets, ketoprofen enteric-coated capsules and other drugs as directed by your doctor.

2. Endometriosis

Endometriosis may cause progressively worsening menstrual cramps, which often begin 1-2 days before menstruation. The lesions are mostly located in the ovaries or pelvic cavity and may be accompanied by dyspareunia or infertility. The diagnosis needs to be combined with ultrasound examination, and drugs such as dienogest tablets and drospirenone ethinylestradiol tablets can be used for treatment. Severe cases require laparoscopic surgery.

3. Adenomyosis

Adenomyosis is more common in multiparous women. The pain continues to worsen and the uterus is uniformly enlarged and hard. Ultrasound shows thickened myometrium with uneven echo, and CA125 may be slightly elevated. Levonorgestrel sustained-release intrauterine system can be used for mild symptoms, but hysterectomy should be considered for severe symptoms.

4. Pelvic inflammatory disease

Chronic pelvic inflammatory disease may induce lower abdominal pain during menstruation, accompanied by increased leucorrhea or fever. Gynecological examination showed cervical tenderness, and ultrasound showed thickening of fallopian tubes. Antibiotics such as cefixime dispersible tablets combined with metronidazole tablets need to be used in a standardized manner, and surgical drainage is required when an abscess forms.

5. Mental factors

Chronic anxiety or stress may aggravate dysmenorrhea symptoms through neuroendocrine regulation. This type of pain is often diffuse and accompanied by sleep disorders or mood swings. It is recommended to improve the condition through regular exercise, abdominal breathing training or psychological consultation. If necessary, short-term use of estazolam tablets can be used to regulate autonomic nerve function.

Daily attention should be paid to keeping warm during menstruation and avoiding strenuous exercise and cold and raw foods. Recording the severity and duration of pain can help doctors determine the cause. If the pain affects your life or is accompanied by symptoms such as abnormal bleeding and fever, it is recommended to see a gynecologist as soon as possible to check for organic diseases. Moderate supplementation of magnesium and vitamin B1 may help relieve spasmodic pain.