Menstrual cramp or low chestbursting alien?

March 24, 2009 9:59 AM

Is this a lady-cramp or something else?

I can't believe I lack the life experience to answer this question, but here goes.

For the past 24 hours I have been experiencing a dull pain in my lower abdomen/upper pelvic area. I don't know if it is a menstrual cramp or something else. I have never had menstrual cramps before. I have had an IUD for two years and rarely have periods.

Area: you know the bit above the mons but below the belly, about between the crest of the hips? Some women are flat there, others have a fold, it's about where "pubic hair" ends and "stuff even women with a full thatch shouldn't really have/happy trail" begins, or where the top of a low-rise bikini falls.

Symptoms: A dull pain/ache, right in the center. There's no pain on the sides, it's purely central. It is worse if I am stood up or lying flat, but lessens if I sit or bend. Heat and cold don't seem to affect it. It began yesterday while I was at the gym doing aerobic work (jumping jacks, running, jump-rope, side-shuffle in a squat).

Associated info: I have an IUD (Mirena) which has all-but stopped my periods. The strings are in place and I can't feel anything out of the ordinary with my cervix.
I am having some spotting/very light flow which began about four days before the cramps. I have PCOS and associated infertility but have never had a cyst.
I am married and sexually active.

Possibly-unrelated: I got very sunburned on Sunday (the pain began Monday). On Sunday I was doing yoga and working on bellows-breath, and my instructor said I might feel worn out like I had been coughing all night (which I interpreted as pain in my sides, which is absent).

If this doesn't go away in another 24 hours I will be making a doctor's appointment, but also worry that I'm being silly.

Question:
- Is this normal menstrual cramp sort of stuff?
- If not: could it be something non-emergency (e.g. a cyst) or something dire (ectopic pregnancy, Mirena poking through uterine walls)?



Thanks, AskMe. YANMD or my "best friend" who can guide me through the mysterious mysteries of lady-hood, but I have no female friends I can bug about this.

posted by anonymous to health & fitness (18 comments total)

if i were you, i'd already be on the phone to the doc.

whatever the copay on the insurance is ... it's worth being out the cash for something "silly" than waiting 24 hrs and finding out it's something worse.
posted by sio42 at 10:03 AM on March 24

take a pregnancy test -- I know several women who've gotten pregnant despite PCOS or an IUD.

Definitely call the doc ASAP!
posted by mdiskin at 10:08 AM on March 24

Call your doctor. I'm not one.

I had similar symptoms once, the pain became acute, and it turned out to be a kidney stone.
posted by ocherdraco at 10:08 AM on March 24

It doesn't sound like period cramps to me, fwiw my horrendous cramps actually feel like a cramp, not a dull pain - I'd recommend calling your dr.
posted by meerkatty at 10:10 AM on March 24

You've described exactly the place where I get menstrual cramps (and where all the other discomfort that goes along with it seems to radiate from) but 24 hours is a really long time, and from what you said it sounds like they started after your period/spotting. Also "dull pain" doesn't really sound like period cramps. I agree with your decision to make an appointment if it doesn't get better. In the mean time, if OTC painkillers are not an option for you, try and see if a heating pad will offer some relief - they can help with all sorts of pain.
posted by frobozz at 10:11 AM on March 24

You exercise -- I imagine, then, that you can tell the difference between a muscle kind of pain and some other kind of pain. If that's the case -- does what you're experiencing feel like a muscle pain? If so, it very well may be cramps. Mine own are dullish, and only last for a day or so.

But the fact that you have an IUD has me a little spooked, and I'd consider calling a doctor just in case; or even just a nurse at your doctor's office so you can ask, "listen, this is what's happening, should I come in or should I wait a day?"

I have had pain from a more serious abdominal issue, and -- oh, you'd KNOW that kind of pain was different. TRUST me. (It started feeling either like "I either have a cramp or gas", but within only a couple hours it was "I am going to black out from the pain if I stand up" and then progressed to "I am incapable of doing anything but thrashing back and forth on a gurney and wailing").

If the pain gets any worse, just go straight to the doctor. But if it's staying dullish now, maybe just call your doctor and ask their advice about whether you should come in yet.
posted by EmpressCallipygos at 10:21 AM on March 24

I would call the doctor and ask - they'll have a much better idea about whether this is urgent. That's certainly the area in which I experience uterine pain/cramping, but I would be worried about an infection or other IUD complication, especially since this is new after two uneventful years with your IUD. I don't thinking this is an emergency at all (dull aches usually aren't), but it does warrant a call to check in with your doctor.
posted by robinpME at 10:27 AM on March 24

The IUD would spook me as well. I'd have this examined today. Those are important bits there :(
posted by DarlingBri at 10:28 AM on March 24

Nthing what others have said about calling your doc, better safe than sorry, etc. I'd like to add, however, that your description of the pain sounds EXACTLY like what my cramps are like. Mine last for about a day, starting from the first day of my period. I'd call the doc, though, just based on the fact that something's changed to cause you pain.
posted by specialagentwebb at 10:32 AM on March 24

Being a boy, I am really in no position to answer, but I must say I do like what the OP has suggested as the two scenarios in the title.

But yes, "when in doubt, see a doctor" seems to be a good response.
posted by ricochet biscuit at 10:34 AM on March 24

IUD's can move around a little bit, sometimes this just causes increased cramping, sometimes it perforates the uterus. If you've had the IUD for a while but this sensation is new, and especially because you have the kind of IUD that reduces cramping, I'd call the gyn. Now.
posted by 8dot3 at 10:43 AM on March 24

Sometimes when I have a urinary tract infection I feel some cramping in that area. As above, time to see a doc.
posted by ms.v. at 10:45 AM on March 24

Does it hurt when you stand up from a sitting position, or move around while you're lying down? How about when you sneeze or cough? Does it feel like a cramp, or like something is tearing?

Not to alarm you but this very pain (and I would answer "yes" and "tearing" to my questions) was the first symptom I had of pregnancy.
posted by sutel at 10:45 AM on March 24

I am NOT a doctor, but it might be that the exercise caused the IUD to tear the wall of your uterus. Please get it checked out.

Also, seconded, IUDs aren't foolproof, my mom got pregnant off of one (no it didnt result in me).
posted by CTORourke at 12:33 PM on March 24

IANAD, but do your symptoms correspond with an ovarian cyst? I had one a few years back following a few days of cramping bad enough to make me need to lie down.

I wrote off the cramps as an especially rough leadup to ladytime, until it ruptured and I was reduced to rolling on the ground in the fetal position while my co-workers called an ambulance.

In my situation:
-I was not on birth control of any kind at the time, but hardly ever had menstrual cramping (in retrospect, that was the first sign).
-The cramps I had before the rupture felt centralized, but when poked by doctors it turned out that the right ovary area was more tender than the left.
-The cramps would also begin a few minutes after I'd eaten something, which the doctors said probably activated lower intestine areas, which in turn pressed on the cyst and caused the cramps.
-The pain of the rupture itself was hyperventilation-inducing bad but (embarrassingly) short, lasting about 1 hour. I was pretty much ok by the time I reached the hospital.

The upshot is that these things are generally benign, essentially a pimple on the ovary, but the rupturing introduces fluids into areas they're not supposed to be and that's what hurt so badly. I had an ultrasound and stayed overnight at the hospital for observation to make sure the ovary didn't twist to relieve pressure (which would thus require surgery).

I was told that ovarian cysts are common in women of childbearing age and that, unfortunately, like a pimple, there's not much you can do other than to wait for it to rupture. Hormone birth control can prevent it, but as far as I'm aware, the Mirena does not stop ovulation, so an ovarian cyst is still within the realm of possibility. At any rate, I'd definitely go in to your OB and let them determine what's going on.
posted by Queen of Spreadable Fats at 1:58 PM on March 24

Ever since about a year after I got my IUD (ParaGard [copper], not Mirena), I get a dull ache at ovulation. However, it's on the left side in the general ovarian area, not front & center. If your IUD is still fairly new to you, it may have shifted - a tiny shift, perhaps, but in a small area? Can feel like hell.

Call your doc.
posted by catlet at 2:53 PM on March 24

Lean back in a chair & relax your belly (think Homer Simpson). Then gently punch yourself repeatedly directly below the ribcage, on your solar plexus. Punch only about as hard as you'd knock on an open office door to catch your boss' attention when she happens to have her back to the doorway- in other words, not hard at all.
That uncomfortable, loose feeling is what lady-cramps feel like to me; very much like being repeatedly and gently punched by a small, weak, bored child. They don't quite *hurt*, but it feels annoying and unstoppable and uncomfortable, right in the spot you described. Usually a heating pad, bath, hot water bottle, or exercise makes it feel much better within minutes. I don't share any of your other details besides XX chromosomes, so that's all I can contribute. Hope you feel better!
posted by pseudostrabismus at 4:32 PM on March 24

If it's not any of the above, it's possible you have a trigger point activated by your workout that is referring pain to the area. If your doc can't find anything else wrong and the pain persists or returns after workouts, try a massage therapist who specializes in trigger point therapy or a chiropractor who does Active Release Therapy. I have had success with these treatments for myofascial pain.
posted by xenophile at 10:08 PM on March 24