When should you worry about painful periods?

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Menstrual cramps are normal; in fact, many people experience some kind of pain and discomfort when they menstruate — it is known as ‘dysmenorrhea‘. But, extreme and debilitating period pain is not normal. “It can indicate something is wrong with your fertility, in addition to unleashing a destructive storm inside your pelvis. If you are trying to get pregnant and have painful periods, you may want to take a step back and consider what your menstrual cycle may be trying to tell you,” warns Dr Karishma Dafle, fertility consultant, Nova IVF Fertility, Pune.

The doctor explains that natural, physiological substances called ‘prostaglandins’, which control muscle function, cell development, body temperature, and inflammation throughout the body, cause cramps. “Prostaglandins encourage the contraction of uterine muscles during menstruation to remove the uterine lining. Despite how effective they are, high doses can put the uterus into an overdrive, and cause intense contractions that may reduce the oxygen flow to the uterine muscles, resulting in excruciating cramping,” Dr Dafle explains.

When should you worry?

“You may have an underlying issue if your cramps have gotten worse over time and are now much more severe than they ever were. Consult a gynaecologist to rule out potential issues if you are unsure,” says the doctor.

What are these underlying health issues?

Chronic menstruation discomfort brought on by chronic illnesses that affect fertility aggravates with time. Circumstances that may result in reduced fertility are:

* Fibroids: Benign tumours that develop inside the uterus. They can inflict excruciating agony, raise the risk of miscarriage, and interfere with fertility.

* Endometriosis: In endometriosis, uterine tissue extends outside of the uterus and impacts other pelvic organs. It can impair the uterus’s ability to function, affecting fertility in addition to causing discomfort. Many endometriosis cases go untreated, and researchers believe up to half of all infertile women may have endometriosis.

You may have an underlying issue if your cramps have gotten worse over time. (Photo: Getty/Thinkstock)

* Adenomyosis: Adenomyosis includes the endometrium growing into the uterine muscle; it should not be confused with endometriosis, in which the lining develops outside the uterus. Extreme discomfort and frequent periods are side effects of adenomyosis. There, however, isn’t any proof that it affects fertility; but, it can raise the risk.

* Inflammatory pelvic disease: Significant menstrual discomfort is often caused by pelvic inflammatory illness, which is distinguished by the formation of scar tissue around the fallopian tubes, uterus, and ovaries. It can also create tubal obstructions, which prevent fertilisation.

“A personalised fertility treatment programme may be the key to conception. With the latest tools and technologies — from cutting-edge procedures like intracytoplasmic sperm injection (ICSI) and in-vitro fertilisation (IVF) to routines like intrauterine insemination (IUI) and natural cycle monitoring, get expert consultations and chart out plans,” the doctor advises.

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