MENSTRUATION PAINS CAN KILL?

MENSTRUATION PAINS CAN KILL?
[ACUTE AND CHRONIC PELVIC PAINS]

I came to the office one morning to meet our female receptionist weeping on her desk with her hand guarding her pelvic region, before I could ask her any question, she had shouted out loud in pains and ran towards the toilet, she didn’t make it to the toilet before she threw up, then started crying and continue guarding her lower abdomen.
As a medical personnel, many things ran through my mind, like ruptured appendicitis or ectopic pregnancy, then I myself almost panicked when those life threatening thoughts crossed my mind, because that is serious thoughts, I persuaded her to take some pain killers and quickly go to a physician, she went , and after some days was relieved, but the next month the same thing happened and so on.

In this article we are not going to look at menstruation pains alone, but all forms of acute and chronic pelvic pains, the types, causes, diagnostic tests and treatment options.

Many women have pain in their pelvic region at some point in their lives. Finding the cause of pelvic pain can be a long process, often there is more than one reason for the pain and its exact source can be hard to detect.
Pelvic pain is a common symptom in women of all ages, in some cases no specific cause canbe found, but being reassured that there is no serious underlying problem can be helpful.
Pelvic pain can be described as acute or chronic .
Acute pain relates to pain that is of recent onset and maybe severe . In young women there are many possible causes for this.
Long standing or chronic pelvic pain may have different causative factors to acute pain, although there may be some degree of overlap.


TYPES OF PELVIC PAIN

Pelvic pain can vary in how it is felt, and when it occurs. It can come and go for brief times or it can be constant. Sometimes pelvic pain can reoccur on a regular cycle or schedule, it also may occur only at certain times, before or after eating, while you urinate, during sex or during menstrual period.
Some women feel pain almost everyday. This may mean that a problem has gotten worse. Overtime it may become more deficult to cope with the pain. When this occurs, a woman may feel pain, at some times more than others, even though the problem has not gotten worse.
Pelvic pain can disrupt a woman’s work, movements, sexual relations, sleeps, or family duties. Not knowing what the cause of the pain can make it even more stressful when pain has been present for a long time, it can affect a woman’s mental and physical health.
Pelvic pain that lasts for more than 6 months and does not improve with treatment is called chronic pelvic pain.
The type and nature of pelvic pain, whether it comes and goes or is constant, is sharp or dull, is in one place or a broad area, this will help your physician detect the cause of the problem.

TYPES OF PAIN AND POSSIBLE CAUSE

[a] Localised Pain --- Maybe due to an inflammation.
[b] Colicky Pain --- May be caused by spasm in a soft organ, such as the intestine, ureter or appendix.
[c] Sudden Onset Of Pain --- May be caused by a temporary deficiency of blood supply due to an obstruction in the circulation of blood.
[d] Slowly Developing Pain --- May be due to inflammation of the appendix or an intestinal obstruction.
[e] Pain Involving The Entire Abdomen --- May suggest an accumulation of blood , pus, or intestinal contents.
[f] Pain Aggravated By Movement Or During Examination --- May be as a result of irritation in the lining of the abdominal cavity.


CAUSES OF PAIN

[1] Adhesions [Scar tissues] from previous healing after pelvic infections or pelvic surgeries, eg Ceasarian sections, appendicitis, etc
[2] Pelvic Inflammatory Disease [PID]
[3] Ovarian cysts [Twisted or Ruptured]
[4] Ectopic Pregnancy
[5] Urinary Tract Infection
[6] Appendicitis
[7] Dysmenorrhoea --- is a medical condition characterized by severe uterine pain during menstruation. While most women experience minor pain during menstruation, dysmenorrhea is diagnosed when the pain is so severe as to limit normal activities, or require medication.
[8] Ovulation pains
[9] Endmetriosis and Adenomyosis
[8] Fibroids
[9] Gastrointestinal problems like diverticulitis, irritable bowel syndrome, inflammatory bowel disease, constipation or cancer
[10] Miscarriage or threatened miscarriage
[11] Ruptured fallopian tube
[12] Endometrial polyps
[13] Cancer of the reproductive tracts
[14] Dysfuctional Uterine Bleeding [DUB]
[15] Pelvic Congestion Syndrome --- This causes chronic pelvic pain and often associated with the presence of ovarian and pelvic varicose vein. Pelvic congestion syndrome is similar to varicose veins in the legs.


DIAGNOSTIC TESTS

[1] Ultrasound Scan Test---An Ultrasound Scan is a method of obtaining images of almost any part of the body. A Pelvic Ultrasound Scan aims to visualise the organs of the pelvis, including the uterus, ovaries, fallopian tubes and bladder. Trans-Vaginal (TV) Scan is performed with an empty bladder, usually following a trans-abdominal scan. It uses a thin probe inserted into the vagina. This allows more detailed information to be obtained by having the probe closer to the pelvic organs.
[2] Blood Tests
[3] Pregnancy Tests
[4] Urinalysis and Culture Tests
[5] Culture Cells from the cervix [HVS --- High Vaginal Swab Tests]
[6] Computerised Tomography [CT]
[7] Magnetic Resonance Imaging [MRI]
[8] Laparoscopy
[9] X-Ray
[10] Cystoscopy
[11] Colonoscopy
[12] Sigmoidoscopy
[13] Intravenous Pyelography [IVP]
[14] Barium Enema.



TREATMENT

Specific treatments for pelvic pain will be determined by your physician based on
[a] Your overall health and medical history
[b] Extent of condition
[c] Causes of condition
[d] Your tolerance to specific medications, procedures or therapies
[e] Your opinion or preference.

Treatments may include

[a] Antibiotic medications
[b] Anti inflammatory and/or pain medications
[c] Relaxation exercises
[d] Oral contraceptives [ovulation inhibitors]
[e] Surgery
[f] Physical therapy.



Regards
Dr. Victor Efughi
Consultant Clinical Specialist Sonographer


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