Some Causes and Features of Menstrual Cramps
Cause |
Common Features* |
Tests |
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Adenomyosis (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 |
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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 |
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Cervical stenosis (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 |
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Cysts and tumors in the ovaries (ovarian cancer or noncancerous ovarian growths) |
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 |
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Endometriosis (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 |
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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 |
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Intrauterine devices (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 |
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Pelvic congestion syndrome (chronic pain due to accumulation of blood in veins of the pelvis) |
Pain that is 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 |
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Vaginal bleeding or discharge |
A doctor's examination Sometimes ultrasonography of the pelvis, sonohysterography, or hysteroscopy |
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* Features include symptoms and results of the doctor's examination. Features mentioned are typical but not always present. |
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MRI = magnetic resonance imaging. |
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