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

Stomach pain during menstruation may be caused by excessive secretion of prostaglandins, abnormal uterine contractions, endometriosis, pelvic inflammatory disease, adenomyosis, etc. It can be relieved by applying hot compresses to the abdomen, taking painkillers, using hormonal drugs, surgical removal of lesions, and conditioning with traditional Chinese medicine.

1. Excessive secretion of prostaglandins

During menstruation, the endometrium releases large amounts of prostaglandins, which stimulate the uterine smooth muscle to contract strongly, causing spasmodic pain in the lower abdomen. The pain is mostly concentrated 1-2 days before menstruation, and may be accompanied by gastrointestinal reactions such as nausea and diarrhea. You can use nonsteroidal anti-inflammatory drugs such as ibuprofen sustained-release capsules and diclofenac sodium sustained-release tablets as directed by your doctor to inhibit prostaglandin synthesis, or use phloroglucinol injection to relieve smooth muscle spasm.

2. Abnormal uterine contractions

The myometrium of some women is overly sensitive to prostaglandins, causing uncoordinated uterine contraction rhythms and manifesting as persistent lower abdominal pain. Pain may radiate to the lumbosacral region, and discharge of membrane-like tissue is common in menstrual blood. It is recommended to use Nuanbaobao hot compress on the lower abdomen, or follow the doctor's advice to take Yuanhu Zhitong Dropping Pills, Ketoprofen Enteric-coated Capsules and other drugs to regulate uterine contraction.

3. Endometriosis

Endometrial tissue grows ectopically in the ovaries, pelvis, etc., and bleeding from the lesions stimulates the peritoneum during menstruation, leading to progressively aggravated dysmenorrhea. The pain usually starts one week before menstruation and may be accompanied by painful sexual intercourse and painful defecation. The diagnosis needs to be confirmed by ultrasound examination. Drugs such as dienogest tablets and goserelin sustained-release implants can be used as directed by the doctor to inhibit intimal growth. In severe cases, laparoscopic surgery is required to remove the lesions.

4. Pelvic inflammatory disease

Pelvic inflammatory disease caused by bacterial infection can lead to increased pelvic congestion during menstruation, dull pain in the lower abdomen accompanied by fever and abnormal secretions. The pain is significantly worse during menstruation and may be accompanied by frequent urination and urgency. Routine leucorrhea and ultrasound examinations are required. After diagnosis, antibiotics such as levofloxacin hydrochloride capsules and metronidazole vaginal gel can be used as directed by the doctor, and infrared physiotherapy can be used to promote the absorption of inflammation.

5. Adenomyosis

The endometrium invades the myometrium and forms diffuse lesions. During menstruation, the lesions bleed, causing the uterus to uniformly enlarge and harden, causing severe colic. The pain becomes progressively worse and may be accompanied by increased menstrual flow. Ultrasound examination shows honeycomb changes in the myometrium of the uterus. Mild cases can be controlled by drospirenone ethinylestradiol tablets, mifepristone capsules and other drugs as directed by the doctor. Severe cases require hysterectomy.

During menstrual abdominal pain, strenuous exercise and raw or cold food should be avoided, and the abdomen should be kept warm. Use a hot water bottle at about 40°C to apply hot compress to the lower abdomen for 15-20 minutes every day. Properly supplementing foods such as salmon and flax seeds that are rich in omega-3 fatty acids can help reduce inflammation. If the pain persists for more than 3 days and cannot be relieved, or is accompanied by fever, abnormal bleeding and other symptoms, you should see a gynecologist in time to check for organic diseases. You can usually improve pelvic blood circulation and reduce the probability of dysmenorrhea through yoga, pelvic floor muscle training and other methods.