Table: Some Causes and Features of Menstrual Cramps

Some Causes and Features of Menstrual Cramps

Cause	Common Features*	Tests
Adenomyosis Adenomyosis In adenomyosis, tissue from glands in the lining of the uterus (endometrium) grows into the muscular wall of the uterus. The uterus becomes enlarged, sometimes doubling or tripling in size.... read more (growth of tissue that normally lines the uterus—called endometrial tissue—into the wall of the uterus)	Heavy, painful periods, vaginal bleeding between periods, pain in the lowest part of the torso (pelvis), and a feeling of pressure on the bladder and rectum Sometimes pain during sexual intercourse	Ultrasonography or MRI of the pelvis In women with abnormal vaginal bleeding, sometimes a biopsy to rule out other causes of bleeding
Birth defects of the reproductive tract	Sometimes abnormalities found during the pelvic examination, such as genitals that feel or look abnormal or a lump in the pelvis	A doctor's examination Sometimes hysterosalpingography (x-rays taken after a contrast agent is injected into the uterus and fallopian tubes), sonohysterography (ultrasonography after fluid is infused into the uterus), or MRI
Cervical stenosis Cervical Stenosis Cervical stenosis is narrowing of the passageway through the cervix (the lower part of the uterus). Cervical stenosis often causes no symptoms. Rarely, the uterus fills with blood or pus. The... read more (narrowing of the passageway through the cervix)	Irregular or no menstrual periods, vaginal bleeding between periods, infertility, and abdominal pain that occurs in cycles Possibly bulging of the vagina or uterus	A doctor's examination Sometimes ultrasonography of the pelvis
Cysts and tumors in the ovaries ( ovarian cancer Ovarian Cancer, Fallopian Tube Cancer, and Peritoneal Cancer Ovarian cancer is cancer of the ovaries. It is related to fallopian tube cancer, which develops in the tubes that lead from the ovaries to the uterus, and peritoneal cancer, which is cancer... read more or noncancerous ovarian growths Noncancerous Ovarian Growths Noncancerous (benign) ovarian growths include cysts (mainly functional cysts) and tumors. Most noncancerous cysts and tumors do not cause any symptoms, but some cause pain or a feeling of heaviness... read more )	Often no other symptoms Sometimes abnormal vaginal bleeding If cancer is advanced, sometimes indigestion, bloating, and backache	Transvaginal ultrasonography (using a handheld device inserted into the vagina) If cancer is suspected, blood tests to measure substances produced by certain tumors
Endometriosis Endometriosis In endometriosis, patches of endometrial tissue—normally occurring only in the lining of the uterus (endometrium)—appear outside the uterus. Why endometrial tissue appears outside the uterus... read more (patches of endometrial tissue that are abnormally located outside the uterus)	Sharp or crampy pain that occurs before and during the first days of menstrual periods Infertility Often pain during sexual intercourse, bowel movements, or urination	A doctor's examination Sometimes laparoscopy (insertion of a viewing tube through a small incision just below the navel) Sometimes ultrasonography of the pelvis or MRI
Fibroids Fibroids A fibroid is a noncancerous tumor composed of muscle and fibrous tissue. It is located in the uterus. Fibroids can cause pain, abnormal vaginal bleeding, constipation, repeated miscarriages... read more	Often no other symptoms With large fibroids, sometimes pain, pressure, abnormal vaginal bleeding, or a feeling of heaviness in the pelvic area	Ultrasonography Sometimes sonohysterography or hysteroscopy (use of a thin viewing tube to see the interior of the uterus) If results are unclear, MRI
Intrauterine devices Intrauterine Devices (IUDs) Intrauterine devices (IUDs) are small, flexible, T-shaped plastic devices that are inserted into the uterus. An IUD is left in place for 3, 5, 7, or 10 years, depending on the type, or until... read more (IUDs) that release copper or, less often, a progestin (a synthetic form of the female hormone progesterone)	Pain and vaginal bleeding that often subside several months after insertion of the IUD	A doctor's examination Usually ultrasonography of the pelvis to determine whether the IUD is correctly placed in the uterus
Pelvic congestion syndrome Pelvic Congestion Syndrome Pelvic congestion syndrome is long-lasting (chronic) pain in the lowest part of the torso (pelvis) caused by accumulation of blood in veins of the pelvis, which have widened (dilated) and become... read more (chronic pain due to accumulation of blood in veins of the pelvis)	Pain that is Typically dull and aching but sometimes sharp or throbbing Worse at the end of the day and relieved by lying down Worse during or after sexual intercourse Often low back pain, aches in the legs, and abnormal vaginal bleeding Occasionally a clear or watery discharge from the vagina Sometimes fatigue, mood swings, headaches, and bloating	A doctor’s examination Ultrasonography or specialized imaging techniques Sometimes laparoscopy
Polyps in the cervix Polyps of the Cervix Cervical polyps are common fingerlike growths of tissue that protrude into the passageway through the cervix. Polyps are almost always benign (noncancerous). Cervical polyps may be caused by... read more	Vaginal bleeding or discharge	A doctor's examination Sometimes ultrasonography of the pelvis, sonohysterography, or hysteroscopy
* Features include symptoms and results of the doctor's examination. Features mentioned are typical but not always present.
MRI = magnetic resonance imaging.