Prolonged Menstrual Pain: Is It Concerning? Causes & Solutions
Menstrual pain (dysmenorrhea) is a common phenomenon experienced by most women during their monthly menstrual cycle. However, many women wonder: is prolonged menstrual pain concerning? This article will help you understand this issue, differentiate between normal and abnormal menstrual pain, and provide effective remedies.
How Long Should Normal Menstrual Pain Last?
Menstrual pain (dysmenorrhea) occurs due to uterine contractions that help expel the shed endometrial lining during menstruation. According to the American College of Obstetricians and Gynecologists (ACOG), approximately 80% of women experience menstrual pain at varying degrees.
According to Traditional Medicine Physician Nguyen Thi Thuy Trang, advisor to Binh Dong Pharmaceuticals: "Typically, menstrual pain lasts from 48-72 hours, possibly beginning 1-2 days before menstruation and gradually decreasing as menstrual flow diminishes. This is a normal physiological phenomenon that women shouldn't worry too much about."
The duration and intensity of menstrual pain can vary from person to person, depending on several factors such as:
- Age
- Individual constitution
- Lifestyle and nutrition
- Overall health condition
Source: According to a study published in the Journal of Reproductive Medicine and Gynecology (2023), approximately 90% of women of reproductive age experience menstrual pain, with an average duration of 2-3 days.
Warning Signs of Abnormal Menstrual Pain
Although menstrual pain is normal, there are abnormal signs that women should pay special attention to. According to the World Health Organization (WHO), the following cases are considered abnormal:
1. Abnormal Duration of Pain
Menstrual pain lasting longer than 72 hours or persisting after menstruation has ended is a warning sign that requires immediate medical attention.
2. Severe Pain Intensity
Pain that severely affects daily activities and doesn't respond to common pain medications.
3. Menstrual Pain with Other Symptoms
Traditional Medicine Physician Nguyen Thi Thuy Trang warns: "Special attention should be paid when menstrual pain is accompanied by symptoms such as fever, nausea, vomiting, painful urination, frequent urination, or abnormal foul-smelling vaginal discharge. These could be signs of gynecological conditions that require prompt treatment."
Source: According to the National Obstetrics and Gynecology Hospital (2024), menstrual pain that exceeds tolerance levels or has abnormal duration is related to pathological conditions in approximately 30% of examined cases.
Causes of Abnormally Prolonged Menstrual Pain
1. Endometriosis
Endometriosis is a condition where endometrial tissue grows outside the uterus, typically on the ovaries, fallopian tubes, uterine surface, or other organs in the pelvic region. During menstruation, these tissues also shed and bleed but cannot exit the body, causing inflammation, pain, and scar tissue formation.
Typical symptoms:
- Severe lower abdominal pain before and during menstruation
- Pain during sexual intercourse
- Pain during urination or bowel movements during menstruation
- Dark, clotted menstrual blood
Source: According to the Vietnam Society of Reproductive Endocrinology and Infertility (2023), endometriosis affects approximately 10% of women of reproductive age and is a common cause of prolonged menstrual pain.
2. Uterine Fibroids
Uterine fibroids are benign tumors that develop from the uterine muscles. They can put pressure on surrounding organs and change the shape of the uterus, leading to prolonged menstrual pain and heavy menstrual bleeding.
Common symptoms:
- Prolonged menstruation with heavy bleeding
- Feeling of fullness or pressure in the pelvic area
- Lower back pain
- Frequent urination or constipation
Traditional Medicine Physician Nguyen Thi Thuy Trang shares: "Uterine fibroids are common in women over 35 and may not cause symptoms if they are small. However, when fibroids grow larger, they can cause severe and prolonged abdominal pain during menstruation."
Source: According to Hanoi Obstetrics and Gynecology Hospital (2024), uterine fibroids are found in approximately 70% of women over 50, and about 30% of cases cause symptoms of prolonged menstrual pain.
3. Pelvic Inflammatory Disease (PID)
Pelvic inflammatory disease is an infection of the female reproductive organs, usually caused by bacteria from the vagina or cervix traveling up to the uterus, fallopian tubes, or ovaries. This condition can make menstrual pain more severe and longer than normal.
Signs to watch for:
- Continuous pelvic or lower abdominal pain
- Fever, chills
- Foul-smelling vaginal discharge with abnormal color
- Pain during sexual intercourse
- Painful or frequent urination
Source: According to the U.S. Centers for Disease Control and Prevention (CDC), approximately 1 million women in the U.S. suffer from pelvic inflammatory disease each year, with similar rates in developing countries, including Vietnam.
4. Cervical Stenosis
Cervical stenosis is a condition where the cervix is smaller than normal, making it difficult for menstrual blood to flow out. The uterus has to contract more strongly to push menstrual blood through the narrow cervix, resulting in severe and prolonged menstrual pain.
Typical symptoms:
- Severe menstrual pain that may persist after menstruation ends
- Light or irregular menstruation
- Chronic pelvic pain
Source: According to the Journal of Obstetrics and Gynecology (2022), approximately 2-5% of women have a congenitally narrow cervical structure or post-surgical cervical stenosis, causing symptoms of prolonged menstrual pain.
5. Hormonal Disorders
Hormonal disorders such as polycystic ovary syndrome (PCOS), thyroid dysfunction, or hyperprolactinemia can cause hormonal imbalances in the body, leading to menstrual disorders and prolonged menstrual pain.
Traditional Medicine Physician Nguyen Thi Thuy Trang explains: "When the endocrine system doesn't function properly, the amount of prostaglandins – substances that cause uterine contractions – may be produced more than normal, making menstrual pain more severe and prolonged. This is common in women with polycystic ovary syndrome."
Source: According to the Vietnam Endocrinology Association (2023), hormonal disorders affect approximately 20% of women of reproductive age and are an important cause of menstrual disorders and prolonged menstrual pain.
When to See a Doctor?
You should see a doctor if your menstrual pain has the following signs:
1. Menstrual Pain Lasting More Than 72 Hours
Continuous menstrual pain for more than 3 days or persistent pain after menstruation ends is a warning sign that requires medical examination.
2. Pain Intensity Beyond Tolerance
Pain that affects daily activities, prevents you from going to school or work, or doesn't respond to common pain medications.
3. Menstrual Pain with Abnormal Symptoms
Pay special attention if menstrual pain is accompanied by:
- Fever above 38°C (100.4°F)
- Abnormal color or odor of vaginal discharge
- Excessive menstrual bleeding (having to change sanitary pads every 1-2 hours)
- Pain during sexual intercourse
- Severe nausea or vomiting
- Painful or frequent urination
- Black menstrual blood with foul odor and large clots
Traditional Medicine Physician Nguyen Thi Thuy Trang emphasizes: "When menstrual pain has abnormal signs as mentioned above, women should not self-medicate with pain relievers but should see a doctor immediately for diagnosis and timely treatment. Early detection of gynecological conditions helps increase treatment effectiveness and reduce the risk of complications."
Source: According to guidelines from the Vietnam Society of Obstetrics and Gynecology (2024), women with the above warning signs should be examined within 48 hours to avoid serious complications.
Effective Methods to Relieve Menstrual Pain
1. Modern Medical Methods
a. Pain Medications
Non-steroidal anti-inflammatory drugs (NSAIDs) such as ibuprofen and naproxen can effectively relieve menstrual pain by inhibiting the production of prostaglandins – substances that cause uterine contractions.
Note: Only use pain medications as prescribed by a doctor, avoid overuse that can cause side effects such as stomach pain, gastric and duodenal ulcers.
b. Hormone Therapy
In cases of severe menstrual pain, doctors may prescribe birth control pills or other hormonal treatments to regulate hormones, reduce menstrual flow, and relieve pain.
c. Surgery
For cases due to conditions such as endometriosis or uterine fibroids, surgery may be necessary. Modern surgical methods such as minimally invasive laparoscopy help shorten recovery time.
Source: According to the American College of Obstetricians and Gynecologists (ACOG), non-steroidal anti-inflammatory drugs are effective in reducing menstrual pain in approximately 80% of cases when used correctly.
2. Traditional Medicine Methods
Traditional Medicine Physician Nguyen Thi Thuy Trang, with over 30 years of experience in traditional medicine, shares some effective methods to relieve menstrual pain:
a. Acupuncture
Acupuncture stimulates important acupoints such as San Yin Jiao (SP6), Tai Chong (LV3), Xue Hai (SP10), and Guan Yuan (CV4) to regulate qi and blood, reduce uterine contractions, and effectively relieve pain.
b. Traditional Medicine Formulas
"In traditional medicine, menstrual pain is often due to blood stasis, cold dampness, or qi stagnation. Formulas such as Tao Hong Si Wu Tang, Wen Jing Tang, and Tian Jin Tiao Jing Tang help promote blood circulation, remove stasis, and normalize meridians, thereby helping menstrual blood flow smoothly and effectively reducing pain," explains Traditional Medicine Physician Nguyen Thi Thuy Trang.
Some commonly used herbs:
- Angelica sinensis (Dong Quai): nourishes blood, promotes blood circulation
- Red Peony Root: promotes blood circulation, relieves pain
- Motherwort: promotes blood circulation, regulates menstruation
- Mugwort: warms the meridians, dispels cold
Source: According to a study published in the Journal of East-West Medicine (2023), acupuncture therapy is effective in reducing menstrual pain by approximately 60-70% in study subjects after 3 months of treatment.
3. Lifestyle Changes
a. Regular Exercise
Gentle exercises such as yoga, walking, and swimming help improve blood circulation, reduce uterine contractions, and alleviate pain.
Traditional Medicine Physician Nguyen Thi Thuy Trang recommends: "Regular exercise 3-4 times/week, 30 minutes each time. However, during heavy menstrual days, women should avoid heavy exercises and replace them with gentle movements such as walking or gentle yoga."
b. Proper Nutrition
- Increase omega-3 rich foods: salmon, flaxseeds, chia seeds
- Add magnesium-rich foods: pumpkin seeds, dark leafy greens, bananas
- Drink enough water: 2-2.5 liters of water daily
- Limit caffeinated drinks and alcohol: caffeine can increase uterine contractions
c. Relaxation Techniques
- Meditation, yoga, and deep breathing exercises help reduce stress, thereby reducing pain
- Gentle massage of the lower abdomen with warm oil (ginger oil, lavender oil)
- Applying warm compresses to the lower abdomen or lower back
Source: According to a Harvard University study (2022), regular exercise can reduce the intensity of menstrual pain by up to 50% after 6 months of maintenance.
Expert Advice
Traditional Medicine Physician Nguyen Thi Thuy Trang, advisor to Binh Dong Pharmaceuticals, with over 30 years of experience in traditional medicine and women's health, shares:
"Menstrual pain is a normal physiological phenomenon in women of reproductive age. However, if the pain is abnormally prolonged or severe in intensity, women should seek medical attention immediately to detect potential underlying conditions early. Combining modern medicine and traditional medicine in treating menstrual pain not only effectively relieves pain but also improves long-term reproductive health.
Additionally, women should maintain a healthy lifestyle, balanced diet, regular exercise, and effective stress management. Especially during menstruation, adequate rest is recommended, avoiding cold foods, spicy foods, and alcoholic and caffeinated beverages."
Conclusion
Prolonged menstrual pain may be a warning sign of underlying gynecological conditions such as endometriosis, uterine fibroids, or pelvic inflammatory disease. However, not all cases of prolonged menstrual pain are serious. Women should understand their bodies, distinguishing between normal and abnormal menstrual pain.
When there are abnormal signs such as pain lasting more than 72 hours, severe pain beyond tolerance, or accompanied by symptoms such as fever, abnormal discharge, or painful urination, women should seek medical attention immediately for diagnosis and timely treatment. Early detection and proper treatment not only effectively relieve pain but also protect long-term reproductive health.
Final advice: Listen to your body! Don't ignore abnormal signs and don't hesitate to seek medical help when necessary.
Reference
Tam Anh: https://tamanhhospital.vn/dau-bung-kinh-keo-dai-bao-lau/
Vimec: https://www.vinmec.com/vie/bai-viet/dau-bung-truoc-va-trong-ky-kinh-keo-dai-trong-bao-lau-vi
Dược Bình Đông: https://www.binhdong.vn/cam-nang-suc-khoe/cach-giam-dau-bung-kinh-cho-phu-nu/
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