[25F] Experiencing menstrual-related back pain, cramps, and systemic symptoms

Patient Description

A 25-year-old female presents with a history of back pain, cramps, nausea, fatigue, mood swings, lightheadedness, and heavy menstrual flow. The back pain, rated 5/10 for severity, occurs in the lower back towards the glutes and is a mix of sharp and dull sensations, exacerbated during menstruation. Cramps have been a long-standing issue for 7 years, described as extremely painful, leading to nausea, lightheadedness, dizziness, and a spread of pain throughout the body. Nausea, rated 7/10, is predominantly peri-menstrual and leads to loss of appetite and the sensation of being on the verge of vomiting. Mood swings are characterized by sudden emotional changes, and lightheadedness, rated 4/10, has been noted for a couple of years, occasionally causing the room to spin. The patient has experienced heavy periods for several years, with significant bleeding that can saturate a tampon in less than an hour. No known allergies, no current medications, and no significant past medical history were reported.

Arora's Assessment

What might be happening

Based on the information you've provided, you may be experiencing:

Dysmenorrhea: This is a medical term for painful menstruation. It can cause severe and frequent cramps, especially in the lower abdomen, and can sometimes cause back pain. The pain can start a day or two before your period and last for several days. It can be accompanied by nausea, vomiting, sweating, dizziness, headaches, and fatigue.
- Treatment typically involves over-the-counter pain relievers, such as ibuprofen or naproxen. Hormonal birth control can also help by preventing ovulation and reducing the severity of menstrual cramps.
Premenstrual syndrome (PMS): This is a group of changes that can affect you on many levels. It can happen one to two weeks before your period. Symptoms can be physical and emotional. They include mood swings, food cravings, fatigue, irritability, and depression.
- Treatment can involve lifestyle changes, such as regular exercise, a balanced diet, and getting enough sleep. Over-the-counter medications can help with symptoms such as headache, pain, and swelling. In some cases, prescription medication may be recommended by your doctor.
Menorrhagia: This is the medical term for menstrual periods with abnormally heavy or prolonged bleeding. Symptoms can include soaking through one or more sanitary pads or tampons every hour for several consecutive hours, needing to use double sanitary protection to control your menstrual flow, or passing large blood clots.
- Treatment can involve iron supplements to prevent anemia, nonsteroidal anti-inflammatory drugs (NSAIDs) to help reduce menstrual blood loss, oral contraceptives to help regulate the menstrual cycle, or other medications.

Please note that these are possible explanations for your symptoms, but other conditions could also be responsible. It's important to consult with a healthcare provider for an accurate diagnosis.

What you can do

Over-the-counter pain relievers: Non-prescription medications such as ibuprofen (Advil, Motrin IB, others) or naproxen sodium (Aleve) can help reduce menstrual pain.
Heat: Applying a heating pad, heat wrap, or hot water bottle to your abdomen can be soothing.
Regular exercise: Physical activity, including walking, can help to reduce menstrual pain.
Dietary changes: Eating a balanced diet with plenty of fruits and vegetables can help. Try to avoid caffeine, alcohol, and salty foods in the week before your period to help prevent bloating and fluid retention.
Stress management: Techniques such as yoga and meditation can help to manage stress and reduce symptoms.