Painful Periods Could Be A Sign Of Fertility Struggles + How To Tell If Something Is Off
If you're a woman reading this, chances are you've experienced menstrual pain at one time or another. The technical term for this is dysmenorrhea, and it occurs up to three days before you get your period.
There are two types of dysmenorrhea: primary and secondary. Primary dysmenorrhea is normal and very common, as it's correlated with the natural shedding of the uterine lining in preparation for the start of the next menstrual cycle.
On the other hand, secondary dysmenorrhea indicates underlying conditions that may cause trouble with fertility. If you've always had pain-free periods or moderate cramps during menstruation but have started to experience painful menstruation—it could be a symptom of secondary dysmenorrhea.
The following are some of the conditions that may result in secondary dysmenorrhea and could be an indicator of fertility challenges.
Endometriosis is the most common cause of painful menstruation and trouble conceiving. The condition comes about when the lining that typically is on the inside of the uterus begins growing on other part of the reproductive system (such as fallopian tubes and ovaries) thus destroying or weakening them, which can result in fertility challenges. If a patient has been trying to get pregnant unsuccessfully and has chronic lower back pain, nausea, and pain after sex, she may have endometriosis.
Laparoscopy is a procedure to formally determine endometriosis. It's also important to note that not all people will have pain when they have endometriosis and that not all people will struggle with conception when diagnosed.
2. Pelvic Inflammatory Disease (PID)
PID refers to a wide range of infections of the reproductive system that are typically triggered by untreated STIs (sexually transmitted infections) though it can also be as a result of unrelated non-STIs. The trickiest part of PID is that the symptoms—such as pain during sex and unusual vaginal discharge—may be mild to nonexistent. Even though PID is not normally associated with painful menstruation (it may play a part), untreated infections of STIs such as chlamydia or syphilis can cause scarring in the fallopian tubes which can negatively affect fertility.
3. Ovarian Cysts and Fibroids
Fibroids are noncancerous tumors on the uterus that affect approximately 30 percent of women ages 30 to 45. If the benign growths are inside or close to the uterine lining, they may obstruct blood flow, resulting in painful menstruation. Depending on their location and size, they may affect fertility and potentially result in pregnancy loss.
On the other hand, cysts are fluid-filled sacs that most commonly form in the ovaries resulting in painful cramps. While cysts are not cancerous and most will clear on their own, they may cause problems with fertility if they form in delicate areas such as the fallopian tubes or ovaries, particularly if the cysts are large.
Related to endometriosis, adenomyosis is a condition in which the uterine inner lining grows into the uterus wall. It can cause cramps, lower abdominal pain, and bloating during menstruation in addition to heavy bleeding. While the fundamental cause of adenomyosis is yet unknown, research indicates that several reproductive hormones such as follicle-stimulating hormone, prolactin, progesterone, and estrogen may trigger it. The abnormal quantities of these hormones coupled with the damage the condition may cause to the uterine wall can play a role in fertility.
While most instances of dysmenorrhea should not cause alarm for potential fertility problems, it is always advisable to consult an obstetric gynecologist whenever you experience unusually painful menstruation. Moreover, it is always advisable to get a pelvic checkup from time to time, to protect yourself from any reproductive health complications.
Millie Behera, M.D., is the Founder and Medical Director at Bloom Reproductive Institute, Scottsdale, Arizona. She is board certified in Obstetrics & Gynecology and Reproductive Endocrinology. Millie has published a number of research papers and international presentations in the field of in-vitro fertilization, non-invasive treatment of fibroids, fertility preservation therapies, and advanced robotic surgery. You can also follow her on Facebook.