Why Zheng Qinwen fell to menstrual pain

Zheng Qinwen was that close to a shock French Open win against world number one Iga Swiatek on Monday. But midway through her game, the debutante at Roland Garros crumbled in pain, clutching her stomach.”It’s just the girl thing,” the 19-year-old said in reference to her menstrual pain.
Menstrual pain, particular the Day 2 kind, is a reality among young women. But increasingly cramping is worsening in the younger population and pain management is becoming a necessary healthcare protocol. “This may look like a recent medical condition but the fact of the matter is that the increasing awareness about menstrual health has encouraged conversation on cramping,” says Dr Ranjana Sharma, Senior Consultant, Obstetrics and Gynaecology at Indraprastha Apollo Hospitals, Delhi.
What is menstrual cramping?
It is a throbbing and restrictive pain that can manifest as a dull tightness or sharp jabs, in your lower torso, back and inner thighs. Cramps usually begin a day or two before your periods, peaking on the second day of onset. They last up to three days. “So far, the tendency was to look at genetic factors for severe cases, understanding if their mothers suffered the same way. But there are several causes that may lead to debilitating conditions. And if the pain lasts longer than three days, consult a gynaecolog,” says Dr Sharma. “Hormone-like substances or prostaglandins trigger the muscle contractions that expel the uterine wall during periods. Higher levels of prostaglandins lead to severe menstrual cramps,” she adds.Best of Express PremiumPremiumPremiumPremiumPremium
What are the causes?
According to Dr Sharma, “Endometriosis is a common cause. This condition happens when the tissue similar to the lining of the uterus grows outside it, most commonly on fallopian tubes, ovaries or pelvis. Then there is adenomyosis, which is a thickening of the uterus. It occurs when the endometrial tissue that lines your uterus grows into the muscles of your uterus. These tissues also bleed, may be not as much, but cause extreme pain. During periods, tissues surrounding the uterus may undergo changes and are responsible for several degrees of cramping.” Adenomyosis, when worse, can even lead to prolonged menstrual bleeding.
Some women have a condition called cervical stenosis, where the small opening of their cervix impedes menstrual flow, causing a painful increase of pressure within the uterus. “At other times, you must watch out for fibroids and cysts close to the bleeding spot. They range in size from as small as a seed to large masses that can enlarge and inflame the uterus. This causes pelvic pressure, lower back pain, leg pain and heavy periods. There may be a pelvic congestion of blood clots or may be even pelvic inflammation that constricts flow,” says Dr Sharma.
There’s also a small risk of an intra-uterine device (IUD) perforating your uterus during insertion or bacteria entering your uterus during insertion, causing pelvic congestion. Sometimes the device may move out of place, causing extreme discomfort.
How can you manage the pain
Severe menstrual cramps cannot be treated as such but they can be eased with the following tips, says Dr Sharma.
(1) Get regular exercise. No matter how severe your pain, do not stop physical activity. Curling up in a static position may, in fact, aggravate your pain.
(2) You can use painkillers that are safe and recommended your doctor. Do not attempt OTC drugs because they do not completely eliminate pain. You can use a heating pad on your lower abdomen for relief.
(3) Manage your stress and performance pressure when menstruating. They can trigger anxiety and pain.
(4) Take a hot bath as it soothes your lower abdomen and back.
(5) Have a proper diet, include a lot of fibres. Constipation can worsen your menstrual pain;
(6) Follow the advice of your doctor who may recommend tests to identify the trigger. If there is a hormone issue or imbalance, you might be put on oral contraceptives or related medication.
(7) Drink hot teas to relax the nerves.
“The best way to dull the pain is not to think or obsess about it too much. Focus on getting through the day rather than considering the pain as an obstacle,” adds Dr Sharma.