Cramping outside of your menstrual period may be normal during ovulation or early pregnancy. However, it can also be a sign of diseases such as endometriosis, fibroids or pelvic inflammatory disease, especially if it happens frequently every month.
This type of pain is characterized by pain in the abdomen, mild discomfort or even cramps strong enough to interfere with daily activities for a few days each month.
Read too: Menstrual cramps: what it is, symptoms, causes and treatment
Therefore, it is important to consult a gynecologist if cramping outside of the menstrual period occurs every month or worsens in intensity, to identify the cause and begin the most appropriate treatment.
Main causes
The main causes of colic outside the menstrual period are:
1. Ovulation
Ovulation can cause cramps outside of the menstrual period because when the egg is released from the ovary, which usually occurs 14 days after menstruation, some fluid that protects the egg and blood are also released, which can cause irritation in the abdominal cavity, leading to appearance of colic.
This type of cramping improves soon after the egg is released or as soon as the body absorbs the fluid or blood.
What to do: colic caused by ovulation usually improves within 24 hours and does not require any treatment. However, if the cramping is severe, you can take an anti-inflammatory such as Ponstan, use a hot water bottle on your stomach or take a hot bath to help ease the discomfort. In some cases, where a woman has very painful ovulation, she should consult a gynecologist who may recommend treatment with contraceptive pills.
2. Endometriosis
Endometriosis consists of the implantation of tissue from the endometrium, which is the inner layer of the uterus, in other organs of the woman’s body, such as ovaries, bladder and intestine, causing inflammation, abdominal pain and intense colic, which usually occurs during menstruation, but can also occur outside of the menstrual period.
Additionally, the abdominal pain and cramping caused by endometriosis can be very intense and can often be confused with other illnesses, such as irritable bowel syndrome, pelvic inflammatory disease, or a urinary tract infection.
What to do: a gynecologist should be consulted to evaluate the characteristics of pain and menstrual flow and for physical and imaging exams to be carried out, such as a transvaginal ultrasound or, in some cases, a videolaparoscopy to confirm endometriosis. Endometriosis treatment is usually done with contraceptives and/or surgery. Learn more about treatment for endometriosis.
3. Premenstrual tension
Premenstrual tension, or PMS, is a set of symptoms that some women may experience before menstruation, such as pain in the lower abdomen, swelling and pain in the breasts, for example. Check out the symptoms of PMS.
What to do: To relieve abdominal pain from PMS, you can use analgesic medications such as paracetamol. ibuprofen or buscopan, for example. If the symptoms are intense and occur in more than 2 consecutive cycles, it is recommended that a gynecologist be consulted for an evaluation.
4. Mioma
Myoma, also called uterine fibroma or leiomyoma, is a benign tumor that forms in the muscle of the uterus and generally does not cause symptoms, but depending on the size, location and quantity of the fibroid, the woman may experience abdominal pain or cramping. and bleeding outside the menstrual period.
What to do: a gynecologist should be consulted so that the diagnosis can be made through a physical examination and imaging, such as a transvaginal ultrasound, and the most appropriate treatment can be initiated, which can range from medical monitoring to the use of hormones or the use of a progesterone IUD. Find out more about fibroid treatment.
5. Pelvic inflammatory disease
Pelvic inflammatory disease, also known as PID, is an inflammation that originates in the vagina and can affect the cervix, uterus, tubes and ovaries, and can lead to the appearance of some symptoms, such as vaginal discharge, bleeding and cramps outside the menstrual period.
This inflammation can be caused mainly by an infection transmitted through unprotected sexual intercourse with a partner infected with gonorrhea or chlamydia, but it can also occur through infection during normal birth, or after an endometrial biopsy, for example. Learn about other causes of pelvic inflammatory disease.
What to do: In the presence of signs and symptoms of PID, it is recommended to consult a gynecologist who may recommend treatment with antibiotics orally or by injection into the muscle, to treat the bacterial infection that caused the pelvic inflammatory disease. In addition, intimate contact should be avoided during treatment to give the tissues time to heal. Learn more about treating pelvic inflammatory disease.
6. Pregnancy
Cramps outside the menstrual period can also be indicative of pregnancy and occur due to the implantation of the embryo and the growth of the uterus. Generally, this cramping is mild and temporary and does not cause other symptoms or discomfort. However, if the colic is frequent, painful and does not stop even when you rest or occurs in more advanced stages of pregnancy, it may be indicative of a tubal pregnancy or placental abruption, for example, and it is important to consult your doctor.
What to do: An HCG test should be taken if menstruation is late and pregnancy is suspected. If confirmed, you must have a prenatal consultation and begin follow-up with the obstetrician-gynecologist, which must be carried out throughout the pregnancy. Find out how prenatal care is done.
7. Adenomiose
Adenomyosis is a disease that occurs due to a thickening of the wall of the uterus, forming small nodules that may have no symptoms in the initial phase, but can cause bleeding or cramps outside the menstrual period in more advanced phases.
What to do: You should consult a gynecologist who should recommend treatment with anti-inflammatories or hormones and, in more advanced cases where symptoms cannot be controlled with medication, the doctor may recommend surgery to remove the uterus. Learn more about the treatment of adenomyosis.
8. Estenose cervical
Cervical stenosis is the narrowing of the cervix caused by uterine malformation, vaginal infection, the presence of a cyst or cancer in the cervix or by surgical procedures such as cauterization, for example. These conditions may have no symptoms and be discovered during routine gynecological exams, or they may cause menstrual changes such as heavy bleeding during menstruation or no menstruation and cramping outside the menstrual period.
What to do: You should have a routine appointment, at least once a year, with a gynecologist to do a Pap smear and assess the health of the uterus. The treatment of this disease must be indicated by the gynecologist according to its cause, and can be done with dilation of the cervix, in the simplest cases, or chemotherapy in the case of cervical cancer, for example.
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