Menstrual cramp is one of the reasons some ladies wish they were born a man. And trust me, they are mostly consistent. That’s why it can be so alarming when your cramps suddenly feel different. Maybe what was once tolerably painful is now incapacitating. Or the shabby feeling you’re used to continue even after your flow is over. Or you’re bleeding more. Whatever the shift is, the fact that something has changed is a red flag you shouldn’t ignore. If you notice any kind of change, don’t blow it off.
- Agonising cramps and heavy flow
You could have: uterine fibroids. These benign growths stem from inside or outside the muscular uterine wall. What causes them is unclear, but fibroids are super common, especially in women in their thirties and forties.
What to do: Check in with your ob-gyn and tell her your symptoms. She’ll likely run some scans, which can identify if you have a fibroid and better determine whether you should have it removed.
- Low-grade, constant pain
You could have: pelvic inflammatory disease (PID), a serious infection of the uterus, ovaries, and/or fallopian tubes. An untreated STD such as chlamydia or gonorrhoea, both of which often have no symptoms, typically causes PID.
What to do: Make an appointment with your ob-gyn pronto. While PID is not usually an emergency, your doc will want to test you to find out the exact cause and get you on antibiotics ASAP.
- Sharp pain on one side
You could have: an ovarian torsion. An ovarian torsion happens when something (like a cyst) causes your ovary to twist, choking off its own blood flow.
What to do: Hightail it to the ER. Doctors there will want to do an ultrasound and other scans. If they diagnose torsion, you’ll need emergency laparoscopic (a.k.a., minimally invasive) surgery to untwist it.
- Painful cramp that meds don’t help
You could have: endometriosis, a condition that causes uterine tissue to migrate to other organs such as the ovaries and fallopian tubes, where it adheres. Over time, the runaway tissue can develop into benign cysts. Up to 10 percent of women are thought to have endometriosis, according to the American College of Obstetrics and Gynaecologists, though it can take years to diagnose because most women assume their killer cramps are normal.
What to do: See your doctor and relay your symptoms. She’ll likely schedule you for imaging tests and give you a sense of what your options are. Because endometrial tissue is hormonally sensitive, going on oral contraceptives or other hormonal meds can cut back the pain.
- Significant cramps post-IUD
You could have: an ill-fitting copper (non-hormonal) IUD. In the first three months after your ob-gyn inserts this tiny T-shaped device into your uterus, some cramping is considered normal as your body adjusts.
What to do: If this is persistent or new after having had no problem with your IUD, it warrants a follow-up exam and probably an ultrasound to ensure good position.