Gyno.com

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Painful Periods - WebHealth

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Painful periods can be due to a narrowing of the cervical canal. During the menstrual period the spasms of the smooth muscle cells of the uterus result in dilating of the cervix. However, some women have so much pelvic pain with a narrowed cervical canal that a dilatation and curretage has to be performed by the specialist to widen the canal and relief the woman of the painful menstrual cramps. Other conditions such as uterus polyps, cervix polyps, endometriosis, adenomyosis and a retroverted uterus can also lead to painful periods. Anti-inflammatory drugs administered a few days before the expected menstrual period often help. With endometriosis the lining of the uterus, called endometrium, grows through the fallopian tube and can form cysts on the ovaries. Endometriosis symptoms present as lower abdominal pain, pelvic pain, heavy periods, irregular periods and infertility. The physician may feel a pelvic mass on pelvic examination. Often there is dysmenorrhea and painful sex, called dyspareunia. With bladder endometriosis and colon endometriosis pain during urination can be severe and there may be rectal bleeding during menstruation. Ovarian endometriosis presents with socalled endometriomas, which are also called chocolate cysts due to the fact that it bleeds into them and the old blood turns dark brown. Endometriosis between the bowel loops can cause bowel obstruction producing acute abdominal pain. Major surgery is often required due to adhesions and scarring that kinks and obstructs the bowels. Endometriosis treatment can only be instituted after a careful diagnostic work-up including pelvic ultrasound case studies, voiding cystourethrogram, barium enema and in couples who still want to conceive a baby, infertility studies. Infertility problems are particularly common in stage 4 endometriosis. Medical treatment with the continuous birth control pill is used for stage 1 and 2 endometriosis, also danazol (danocrine, cyclomen) and synarel. More severe cases, stage 3 and 4 of endometriosis, are treated with abdominal hysterectomy and ovariectomy followed by hormone replacement therapy. If some endometriosis lesions had to be left behind, progestin is added to the estrogen replacement therapy to prevent endometrial cancer (= uterine cancer) development.

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