Use of an IUD may significantly worsen the spasmodic type of cramping, and the device may need to be removed if symptoms are too severe.
Bladder infections can cause symptoms of dull, aching pain in the lower abdominal region. Frequent bladder infections near or during menstrual periods can be a problem for some women.
Vaginal yeast infections can occur during menstrual periods because of changes in the vaginal pH.
Childlessness is a risk factor for spasmodic cramping; congestive symptoms may actually be worse in women who have had several pregnancies.
Lack of exercise and poor posture increases the tendencies toward both types of cramps, since blood circulation and oxygenation is decreased.
Stress can worsen cramps by causing women to tense their pelvic and low back muscles unconsciously.
The result of underlying health problems that can cause uterine and low back pain, secondary dysmenorrhea occurs most frequently in older women, typically in their forties and early fifties. Often, periods will suddenly become painful after years of pain-free menstruation. Secondary dysmenorrhea is much less common than the primary types. Some common causes of secondary dysmenorrhea include the following conditions.
Fibroid Tumors of the Uterus. Fibroid tumors occur when the muscular tissue of the uterus grows excessively. Fibroids can grow very large in some women, enlarging the uterus to sizes seen in pregnancy. If they grow large enough to impinge on the bowel and bladder, or if their growth outstrips their blood supply, they can worsen menstrual cramps. These growths occur most often in women during their reproductive years.
Fibroid tumors are stimulated by estrogen. They may expand in size with the use of estrogen dominated birth control pills, during pregnancy, or in women who secrete high levels of estrogen naturally. Besides causing menstrual cramps, large fibroids can put pressure on the bladder or bowels, causing urinary frequency or bowel changes. Fibroids can also cause excessive menstrual bleeding and pelvic discomfort to the point of necessitating a hysterectomy. In fact, fibroids are one of the most common reasons for the 650,000 hysterectomies performed each year in the United States. Usually such tumors shrink after menopause because of the decrease in estrogen.
Pelvic Inflammatory Disease (PID). This refers to an infection of a woman's uterus, fallopian tubes, or ovaries. This serious infec-tion must be diagnosed and treated immediately in order to pre-vent scarring of the reproductive organs and infertility. Symptoms of PID include fever, chills, back pain, a puslike vaginal discharge, pain during or after sexual intercourse, and spotting. When chronic, a low-grade smoldering infection can also cause lower abdominal cramps during menstruation. If untreated, the chronic menstrual pain can necessitate a hysterectomy.
Endometriosis. In this condition, pieces of the uterine lining, or endometrium, implant and grow outside the uterus in other parts of the pelvic cavity. Implants can be found on any pelvic structure, including the fallopian tubes, ovaries, and outer wall of the uterus. They can even become embedded in the intestinal and bladder walls. These tissues, like the normal lining of the uterus, are responsive to hormonal changes and can bleed with the onset of the menstrual period. Although the bleeding from the uterine lining can leave the body vaginally through menstruation, bleeding from endometrial implants in the pelvis is retained by the body and can cause scarring and inflammation over time. Pain is the most common symptom that arises from this structural damage. Women with endometriosis suffer from pain during menstruation as well as during sexual intercourse.