On 29th August 2018, Cloudnine launched a live Tweetinar on Painful Menstruation on its Twitter handle @CloudnineCare. It was led by Dr Sumati Tadas, Obstetrician & Gynaecologist at Cloudnine Hospital, Pune. The Tweetinar touched on a range of topics related to primary and secondary dysmenorrhoea. Excerpts are included below.
Specialist Details: Dr Sumati Tadas
Specialty: Obstetrics & Gynaecology.
To Consult: The Best Gynecologist in Pune
Clinical Focus and Expertise:
Infertility evaluation, infertility treatment, high-risk pregnancy care, breast care, hysterectomy, laparoscopy, sexual health, reproductive medicine
Tweetinar Questions & Answers
1. Could you shed light on why my period is sometimes excessively heavy and painful, and other times rather scanty?
This could be due to an infection in the uterus, such as endometritis.
2. With age, I have started experiencing severe back pain and headaches along with my period. What could this be due to, and what is the remedy?
Back pain is associated with congestive dysmenorrhoea, which in turn, could be due to pelvic inflammatory disease. The condition warrants detailed investigation and treatment.
3. Why does my upper abdomen feel bloated a day before my period starts?
Bloating before menstruation occurs due to water retention triggered by a rise in progesterone. Bloating typically recedes at the onset of a period.
4. Over the years, I have noticed a vast variation in menstrual pain. Does age have anything to do with it?
Yes! Severe menstrual pain, known as primary dysmenorrhoea, usually reduces with age and childbearing.
5. My periods have become increasingly painful since my daughter's birth. What could this be due to?
In your case, it is worth probing into the possibility of endometriosis and fibroids.
6. Does menstrual pain reduce with age?
Yes! Menstrual pain usually reduces with age and childbearing.
7. What is the major difference between normal period pain and dysmenorrhoea?
Dysmenorrhoea is triggered by underlying conditions like endometriosis and fibroids.
8. Does age play a role in menstrual pain?
I am close to 35 and still get painful cramps. Primary dysmenorrhoea usually reduces with age and childbearing. Your pain may stem from an underlying condition like endometriosis. I recommend that you consult a doctor for your pain.
9. What are the main causes of painful menstruation?
Basic causes include endometritis, fibroids, endometriosis and pelvic inflammatory disease.
10. What kinds of foods are best consumed during a menstrual cycle?
You can eat anything and everything. Curd, in particular, can serve as a great pain reliever.
11. My menstrual pain is so severe that it keeps me away from my normal activities. Do you suspect any underlying problem?
You should get tested for endometritis, fibroids, endometriosis and pelvic inflammatory disease.
12. Can painful menstruation hinder pregnancy? Also, does menstrual pain reduce after childbearing?
Pain caused by pathological factors can hinder pregnancy, but only a gynaecologist can confirm the existence of these. Physiological factor-led menstrual pain does reduce after delivery.
13. Why is the first day of periods more painful than the rest?
On the first day of menstruation, the uterus, congested with blood, presses on the cervix. This pressure causes the cervix to expand, resulting in pain.
14. Is it a good idea to take a painkiller every month for cramps?
Extended use of painkillers is not advisable. If your pain keeps you from continuing with your regular routine, consult a doctor to rule out any underlying conditions.
15. What is the solution for irregular periods?
Irregular periods must be investigated for underlying hormonal imbalances. Corrective treatments can help regularise cycles.
16. My teenage daughter experiences severe cramps during the first 2 days of her menstrual cycle. What can I do to relieve her pain?
Speak to a gynaecologist for a suitable course of pain killers.
17. Does hot water fermentation help relieve menstrual cramps?
Hot water fermentation can help relieve back pain but is not a direct solution for menstrual cramps.
18. Can you recommend any particular exercises in the days leading up to menstruation, that can help relieve impending pain?
No specific exercises are required. Just continue your daily routine and you'll be fine.
19. Is it possible to have pain-free periods?
Most women experience a certain amount of discomfort during menstruation, although the severity differs from woman to woman.
20. Is dysmenorrhoea triggered by changes in lifestyle?
Dysmenorrhoea is not triggered by lifestyle changes but rather, by underlying diseases.
21. Are there any tests that should be done for painful menstruation?
There are no specific blood tests, but sonography can help identify the root cause.
22. Can you recommend any tried and tested home remedies for painful periods?
While there are several old wives' tales about menstrual pain relief, nothing is medically certified.
23. I have read that one should not drink coffee during premenstrual syndrome (PMS). Is this true? Also, what are the other food items to be avoided?
Coffee, like spicy and non-vegetarian food, elevates body temperature, and hence, can cause some discomfort during menstruation. However, you can consume it in moderation.
24. Since delivering my baby, I have started experiencing excruciating pain and excessive bleeding during the first two days of my period. Is this normal?
Acquired conditions can aggravate period pain. I recommend that you consult a doctor to rule out any underlying conditions.
25. What is the best way to deal with painful menstrual cramps?
Drink plenty of water, maintain a light diet and avoid constipation-inducing foods.
26. Is it advisable to avoid weightlifting exercises on painful period days?
Yes, it is best to avoid weight lifting exercises on painful period days.
27. Is dysmenorrhoea curable?
It is. Once the cause is identified, treatment takes about 3-6 months to show results.
28. Can a consistent yoga routine help minimise pain during menstruation?
Although yoga can influence muscle tone, it doesn't have a direct impact on the uterus. Thus, it may or may not help.
29. Do sleep and stress play a role in dictating menstrual pain?
Adequate sleep can serve to minimise menstrual pain. Stress, however, has no such bearing.
30. Do younger women experience more severe menstrual pain than women closer to menopause?
Young adolescent girls typically suffer the most menstrual pain. Among older women, those suffering from adenomyosis and fibroids may also experience severe pain.
31. I never used to have painful periods, but after having kids, I have begun experiencing premenstrual pain in my legs and back. The pain vanishes as soon as my period starts. Is this normal?
Premenstrual pain in the legs and back is perfectly normal. Physiotherapy may help alleviate this pain.
32. What is the ideal interval between the two periods?
The average menstrual interval is 21-35 days. If your cycles are any less, or any further apart, you should consult a doctor.
33. How can one reduce bloating before and during periods? Are any foods to be avoided?
Bloating is due to hormones, and not related to any specific foods. You can ease bloating by avoiding constipation-inducing foods and drinking lots of water.
34. Does endometriosis impact fertility, cause issues in conceiving or increase the chances of an ectopic pregnancy?
Yes, endometriosis can lead to fertility issues and increase the chances of an ectopic pregnancy.
35. I have heard that nuts and beans can provide relief to heavy and painful periods. Is this true?
Period pain relief isn't associated with any specific foods. Nuts and beans are healthy and rich sources of energy.
36. What are some acquired diseases that can cause severe period pain?
Acquired diseases include endometritis, fibroids, endometriosis and pelvic inflammatory disease.
37. My mother, who is in her 40s, has been experiencing painful periods for the past year. What could the reason for this be and what should we do about it?
Blood tests and sonography can help identify the exact problem. Endometriosis, fibroids and adenomyosis are some possibilities. These can be treated via surgery or medication.
38. Is it normal to have premenstrual food cravings?
Yes, premenstrual cravings are normal. Indulge yourself in moderation!
39. Is it safe to take a pain killer for unbearable cramps?
Yes, it is. However, try to find out the reason for the pain by consulting a gynaecologist. Medications are not recommended in the long run.
40. Are there any precautions to be taken to avoid painful periods?
There are no particular precautions that can overrule acquired diseases. Consult a doctor to study your pain in greater detail.
41. My grandmother used to advise me against eating cold foods like ice cream, and even washing my hair during periods, to avoid pain. Is this logical?
Perhaps these practices were pointed at reducing body heat, which is beneficial during periods.
42. Is it normal to have some pain during periods or is it always due to an underlying condition?
While bearable pain is normal, severe pain warrants a visit to the doctor.
43. I am 35 and my period length has tapered down to 3 days, vis- a- vis a flow of 5 days some years ago. Is this a product of age?
Possibly. It's perfectly normal for the length and flow to reduce with age.
44. Can you recommend a solution for painful menstruation in teenagers?
Avoid heavy exercise, don't allow body heat to rise and increase your intake of curd and cold items.
45. What is the best treatment for interstitial cystitis?
Plenty of water, antibiotics and a urinary alkaliser can work wonders.
46. What is the best painkiller for painful periods?
Meftal Spas is an effective pain reliever as it relaxes the muscles and soothes the pain. That said, if your pain is severe, you must get it investigated. Painkillers are not recommended in the long term.
47. I regularly experience cramps about 10 days prior to my expected period date. What could the reason for this be?
This is probably ovulation pain, triggered by the egg rupturing from the ovary. It is perfectly normal.
48. What is the best cure for yeast infection?
Vaginal infection can be cured with topical or oral drugs. Speak to a gynaecologist for the best course of action.
49. As a woman with the polycystic ovarian syndrome (PCOS), I experience severe pain during periods. What can I do about it?
PCOS can be effectively treated for pain and subfertility. Speak to a gynaecologist to know more.
50. How common is dysmenorrhoea?
About 30-40% of women suffer from this problem.
51. What causes primary dysmenorrhoea?
The uterus, congested with blood, presses on the cervix. This pressure causes the cervix to expand, resulting in pain.
52. At what age does primary dysmenorrhoea start?
Primary dysmenorrhoea can start at puberty, and secondary dysmenorrhoea, at any age.
53. What is secondary dysmenorrhoea?
Secondary dysmenorrhoea refers to severe period pain caused by acquired conditions.
54. What tests are performed to diagnose dysmenorrhoea?
An internal examination, sonography, and certain blood tests may be required for diagnosis.
55. What medications are used to treat dysmenorrhoea?
Medications are dependent on the cause, but pain killers are usually prescribed.
56. Do birth control pills have any effect on period pain?
Yes, birth control pills can help to relieve painful periods.
Dr Sumati Tadas,
Obstetrician & Gynaecologist,
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