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During menstruation, the uterus contracts to shed the uterine lining, which may cause pain. In this video, Dawn Mayo, MD, an OBGYN at Metropolitan Methodist Hospital, explains how the body’s hormones may also cause bloating and alter bowel function.
Abdominal pain during the menstrual cycle can have more than one cause. In a normal menstrual cycle a chemical prostiglandin is released in higher levels. This causes contractions of the smooth muscle of the uterine wall and assists in the sloughing to the lining which then becomes the menstrual flow. The prostiglandins can also affect smooth muscle in other parts of the body, including the intestines. The contractions of the intestines are sometimes felt as painful.
Another source of abdominal pain during menses is the brain misinterpreting the source of the pain. The sensory nerves of the abdomen are not highly organized. Pain messages from the uterine cramps that occur during menses may "read" as pain in the abdomen by the brain.
Finally, an abnormal source of abdominal pain during menses may occur if endometriosis is present. Endometrial implants on the intestines grow and then bleed with menstrual flow. The presence of active bleeding in this tissue causes irritation and pain.
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