I have period pains that are literally crippling. For about four months now I’ve been experiencing very heavy periods that are so painful I have had to take time off work. My periods are often accompanied by bad migraines. It is really getting me down and I’m worried it might be a sign of something serious. I’m 33 and am hoping to start a family soon. Please help.
Mr Richard Hutson, Consultant Gynaecologist replies:
The most common causes of severe menstrual pain in a lady of your age are fibroids, pelvic inflammation, endometriosis or adenomyosis. More serious causes, such as gynaecological malignancy, do not usually present simply with symptoms around the time of menstruation. Cancer type symptoms are more persistent.
In any case, as you are hoping to start a family soon, you should have a pelvic ultrasound scan, swabs (to exclude infection) and an up to date smear. Further management would depend on the results of these investigations but you may go on to have a laparoscopy where your pelvic and gynaecological organs would be directly inspected. At the same time, a dye would be passed to ensure that your fallopian tubes are not blocked. This procedure is done under general anaesthetic as a day case procedure.
Providing your fallopian tubes are not blocked and fibroids and endometriosis have been excluded, you are likely to be given a tablet (Tranexamic Acid) to take at the time of your period to lighten the menstrual loss. Changing your contraception may also improve your headaches. However, at 33, you should be encouraged to try for a family sooner rather than later as your fecundity (ability to conceive) is decreasing now that you have passed the age of 30.