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Abdominal cramps after periods

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I am a 35 year old woman. 157# 5'8. family history of cancer, hypertension, glaucoma, copd, depression.... I've had two natural childbirths, tubal ligation in 2003, and a roux en y gastric bypass in 2005. currently taking hctz 25mg for hypertension, Celexa 40mg fot depression/ premenstrual irritability.
Since I had my children, my periods have become heavier, I've had cramps that are excruciating, which I never had before. in the past three months, they have been so heavy I soak through a super tampon in an hour. thus lasts for two days, and the third is light. my problem lately had been AFTER my periods. headaches, extreme nausea, lower abdominal cramps and extreme fatigue. I was so ill last month I had to check into the emergency room. the doctor decided I didn't need a cat scan, but gave me iv fluids, zofran, and painkillers. seemed to be fine after that. thus month, same thing. I ended up in an urgent care center with abdominal pain so bad I was doubled over, dehydrated because I can't keep anything down, and general fatigue. can you say what is going on possibly? my Bloodwork is coming back good, no infections. however yesterday the doctor said she saw evidence of an infection even though my white count was still within normal limits. I got a shot of lincomycin, and scripts of cipro, flagyl, phenergan, and lortab.

Category: OBGYN

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Category: Infertility Specialist
Dr. Aarti Vazirani is online now

Expert:  Dr. Aarti Vazirani replied 4 Days.


Thanks for writing to us at DoctorSpring.com with your health concern.

It is unusual for you to have all these symptoms AFTER your periods. Earlier, they would have coincided with pre menstrual syndromes.

There can be the following two possibilities that I can think of -

1. The first is endometriosis. The normal lining that is present in the interior of the uterine cavity starts proliferating elsewhere too - bladder, bowel, pelvic surfaces, ovary, tubes. This causes heavy bleeding , cramps, excruciating pain, painful intercourse etc.
It is diagnosed by clinical examination, and ultrasound / laparoscopy.

2. You have a gastrointestinal issue it seems, as the symptoms are more of abdominal pain and fatigue. It could be gastroenteritis, however it would not coincide with periods, in some women, it flares up more during periods due to increased levels of prostaglandins that cause a hypersensitive bowel.

Please tell me how and where did the doctor see the evidence of infection, for which antibiotics were prescribed.

If the infective reason is the one, then you would respond to the antibiotics, and this picture would not recur.

If it does I advice the following -

1. A thorough gynaecological checkup - internal exam ( per vaginum and per speculum )
2. Pelvic and abdominal ultrasound .
3. Hormones - FSH, LH, TSH, prolactin.
4. Liver and kidney function tests.
This amount of workup would show the diagnostic way.

All the best.
Hope this helps, Please feel free to discuss further.

Dr. Aarti Vazirani
Category: Infertility Specialist
Residency: Obstetrics & Gynecolog, BJMC,Civil hospital, Ahmedabad, 2008
Post Graduate: MS (Obstetrics & Gynecology), B.J. Medical College, Ahmedabad, 2008
Medical School: MBBS, B.J. Medical College, Ahmedabad, 2004
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