Why does my stomach hurt before menstruation?

Stomach pain before menstruation may be a symptom of premenstrual syndrome, which is usually related to changes in hormone levels, increased prostaglandin secretion, mental stress and other factors.

1. Changes in hormone levels

Fluctuations in estrogen and progesterone levels during the menstrual cycle may cause the uterine muscles to contract, causing a dull pain or bloating sensation in the lower abdomen. This situation is a physiological reaction and can be relieved by applying hot compresses to the abdomen and drinking appropriate amounts of ginger tea. If the pain significantly affects your life, you can use ibuprofen sustained-release capsules, naproxen tablets, ketoprofen enteric-coated capsules and other drugs as directed by your doctor.

2. Increased secretion of prostaglandins

Excessive secretion of prostaglandins from the endometrium will increase the intensity of uterine contractions and may cause cramping pain. This kind of pain usually occurs 1-2 days before menstruation. It is recommended to avoid raw and cold food, and use prostaglandin inhibitors such as diclofenac sodium suppositories or celecoxib capsules if necessary.

3. Mental stress factors

Emotions such as anxiety and tension may aggravate pain through neuroendocrine pathways. Maintaining a regular schedule and doing light exercise such as yoga can help relieve symptoms. When symptoms are severe, you may consider using proprietary Chinese medicines such as Xiaoyao Pills or Bupleurum Shugan Powder.

4. Endometriosis

Ectopic endometrial tissue becomes congested and swollen before menstruation, which may cause progressively worsening pain, often accompanied by dyspareunia or infertility. Diagnosis needs to be confirmed by ultrasound examination, and drugs such as dienogest tablets or leuprolide acetate microspheres for injection can be selected for treatment.

5. Pelvic inflammatory disease

Chronic pelvic inflammatory disease may worsen during the premenstrual period and manifest as persistent dull pain in the lower abdomen accompanied by abnormal leucorrhea. After diagnosis, antibiotics such as doxycycline hydrochloride tablets and metronidazole vaginal gel need to be used in a standardized manner, and pelvic floor physical therapy must be coordinated when necessary.

It is recommended to record the time, degree and accompanying symptoms of pain, and avoid strenuous exercise and overexertion before menstruation. Keep your abdomen warm and add foods rich in omega-3 fatty acids, such as salmon and flax seeds, to your diet. If the pain continues to worsen or fever, abnormal bleeding, etc. occur, you should seek medical examination in time to rule out the possibility of organic diseases. Daily abdominal breathing can be practiced to help relax the pelvic floor muscles. If necessary, medical intervention can be carried out under the guidance of a doctor.