OB/GYN Dr. Nita Landry is here to answer women’s period-related problems. A question from The Doctors YouTube forum asks, “Why do some girls get back pain when on their period rather than cramps?”
Dr. Nita explains that during your period, your uterus is contracting to get blood out. Contractions can cut off blood flow to the uterine muscle. Any time cells are not getting a lot of oxygen it is going to result in pain. Dr. Nita explains the reason for back pain, however, is called referred pain. She explains that when the nerves of neighboring organs are close together, you can feel pain in one region even if the body feels it in another. So the front part where the uterus is can hurt but you feel it in your back. Dr. Nita recommends NSAIDs and heating pads for pain relief.
The Doctors also receive an email from Barbara. She says she is 52 years old and in perimenopause. She says “I still have regular monthly periods, but they are heavy and affecting my quality of life. What are my options (besides a hysterectomy) to help me?”
Dr. Nita has quite a few to share! She explains that heavy periods in menopause transition are fairly normal but her doctor will want to rule out any pre-cancer or cancer and may do some imaging or an endometrial biopsy to make sure there are no abnormal cells. Once this is ruled out, there are ways to control the symptoms depending on what is causing them.
Dr. Nita says oral contraceptives with either estrogen and progesterone or just progesterone can be prescribed. She says there are non-hormonal treatments like NSAIDs or something called tranexamic acid which works to decrease vaginal bleeding. If you have a polyp or fibroid, the doctor may try to remove it. Another option is an endometrial ablation which is outpatient surgery where a small device is used to destroy the inside lining of the uterus. The goal of this procedure is to have normal periods although sometimes it stops them altogether. Dr. Nita tells Barbara that the average age of menopause is 51.4 years of age so to hang in there!