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Menstrual Cramps / SMG / Women

Painful Menstrual Cramps: Fibroids or Worse?

Painful Menstrual Cramps: Fibroids or Worse?

Painful Menstrual Cramps: Fibroids or Worse?

Menstrual cramps can be a pain, but when do these symptoms indicate a sign of trouble?According to a survey conducted by research company YouGov, as many as 87 percent of women in Singapore have experienced painful menstrual cramps, with 77 percent saying that it has affected their ability to work.

As common as menstrual cramps are, there may be times when they are symptoms of a more serious health problem. Here are four ways to tell if you should see a doctor about your cramps and the possible causes behind them.

You Can’t Go About Your Day

Menstrual cramps, also known as dysmenorrhea, are prompted by the production of prostaglandins — chemicals that trigger muscle contractions in your womb to expel the lining during menstruation. For most women, the discomfort is merely annoying. But if your cramps are so severe that they interfere with your daily activities, then it may be time to consult an obstetrician-gynaecologist (OB-GYN) at a women’s health clinic.

“If you tell me that your quality of life is affected, that you have to take a day off from work or school or are unable to perform to your normal level, then something is not quite right,” says A/Prof Fong Yoke Fai, Obstetrician-Gynaecologist at Astra Laparoscopic & Robotic Centre for Women and Fertility.

Painkillers Offer No Relief

Most women who struggle with menstrual cramps often turn to over-the-counter medication for pain relief. If common pain killers do not help, book a consultation with an OB-GYN to get to the root of the problem. Remember that you should always seek your doctor’s advice before taking any types of pain relief medication.

Your Cramps Last More than Three Days

While it is normal for your menstruation to last anywhere from 3 and 7 days, it is unusual to experience severe cramps throughout the entire period. Menstrual cramps typically begin on the day of or the day just before the bleeding starts, but they should not continue until the end of your menstruation.

You’re Worried About Your Symptoms

Still unsure if your menstrual cramps are normal? While cramps and aches in your lower abdomen may be par for the course, diarrhoea and nausea are not. Consult a gynaecologist about your symptoms if you experience any of the following:
• Menstrual pain continues for longer than usual or more than 2-3 days
• Sudden and severe pain
• Excessive bleeding or blood clots, which requires more than one pad or tampon within an hour
• Cold sweat, curling up in bed to “control” the pain
• Fainting spells
• Diarrhoea or urge to defecate especially during menses
• Nausea

What Could Be Wrong?

There are a few medical conditions that could explain your severe menstrual cramps — the most common being endometriosis and fibroids.

Endometriosis is a medical condition where cells from the womb lining grow on other parts of the body, including the fallopian tubes, ovaries or pelvic lining, while fibroids are non-cancerous growths in the womb. Once your condition has been diagnosed, the OB-GYN will likely recommend treatment based on a number of factors, like your age and fertility plans.

“If a young patient has endometriosis, we may give her hormonal pills that help to suppress the ovarian function and release of prostaglandin. But this may not be a suitable treatment for those planning to have a family,” says A/Prof Fong, adding that surgery is another possible solution and a common treatment option for women with fibroids.


A/Prof Fong Yoke Fai is the medical director of Astra Laparoscopic & Robotic Centre for Women and Fertility, located at Paragon Medical, #16-07/08. He is highly recognised in the management of menstrual-related problems, such as endometriosis and fibroids.

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