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Dear Sir,

I am 32 and single.Since beginning, i have been experiencing severe menstrual cramps on the first day of the cycle. Of late, it has been really difficult. The menstrual cycle is regular but atleast 8- 10 days before dark tanned spots appears on my face. The marks are so prominent and dark that people actually start asking as to what is the matter? I feel extremely tired and dull atleast 8- 10 days before it begins. The first day ,i still experience cramps and by end of the day i suffer from severe migraine. Please help as this is really affecting my job and routine life. I walk around 40 mins daily.



Category: Family Physician-GP

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Category: Infertility Specialist
Dr. Aarti Vazirani is online now

Expert:  Dr. Aarti Vazirani replied 4 Days.

Thanks for your query at DoctorSpring.

Firstly you have mentioned three issues, let me talk about them one by one.

THe first is the severe cramping and pain during periods. This is called dysmennorrhoea.
It is of two types - primary, when no cause is found, and secondary, when there are conditions in the uterus such as fibroids , cysts etc which cause dysmenorrhoea. Firslty, you should have a gynecological evaluation, which will involve a thorough per speculum and per vaginum examination. A pelvic ultrasound is also a must.

If all these are negative, then the issue of pain should be dealt with individually. You should take NSAIDS or painkillers like Brufen or Naproxen or Meftal spas.These should be taken thrice a day for the length of your periods. To be fully effective, if your cycles are regular, then you can start taking them 1 - 2 days before your periods.

Secondly, the pigmentation on your skin. For this, you need to seek a dermatological opinion. There are various topical treatments / peels available to treat this. Also, taking regular Vitamin C, vitamin E will help the pain during cycles and the skin changes. Drinking lots of water during the periods helps. Avoid overeating, eating spicy, greasy food, and binge eating. Have small frequent, light, home cooked meals. Stay away from alcohol, smoking, caffeine etc. Try and keep your weight in check if you are overweight.

Regarding menstrual migraine, it is treated with a group of drugs called Triptans. Also, painkillers like Brufen and Naproxen will deal with the menstrual cramps and also cure the migraine. Avoid triggers like excessive light, sound, chocolates, wine, spicy food, emotional stress.

Another suggestion is that you can use birth control pills for 3 - 6 months. These pills noticeably reduce pain during periods, skin changes and migraine - all three.Please discuss this option also with your gynecologist.

Wish you all the best.
Please feel free to ask for further clarifications.

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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