The appearance of pain and stitches in the uterus is usually a reason for a gynecological consultation. Its causes are varied and range from trivial conditions related to the menstrual cycle to pathologies involving any structure of the abdominopelvic cavity.
This multifactorial origin is precisely what makes a thorough medical evaluation necessary. The doctor or gynecologist is obligated to determine if there is a surgical emergency or if another type of treatment is needed. You should also rule out the possibility of pregnancy. Are you interested in learning more?
Main causes of pain and stitches in the uterus
When evaluating possible causes of pain and stitches in the uterus, the doctor looks for other symptoms, such as bleeding or abnormal discharge in the genitals. Also ask about possible gastrointestinal or urinary symptoms. In general, the causes are usually the following conditions.
The main cause of pain and palpitations in the uterus is related to menstruation, known as “dysmenorrhea”. It affects more than half of women of childbearing age and severe cases lead to school or work absenteeism.
Menstrual colic appears cyclically at the beginning of each period and usually lasts between two and three days. Additionally, it can cause other symptoms such as the following:
- Nausea and vomit.
- General discomfort.
Pain in dysmenorrhea is described as colicky, localized in the lower abdomen, although it may radiate to the lower back or thighs. The condition is classified as primary when there is no apparent cause for the pain.
However, it is secondary when it is due to an underlying pathology. This is why it is important to ask yourself about the characteristics with which it presents itself and the relationship it has with menstruation.
Possible causes of pain
Menstruation is triggered by a series of cyclical hormonal changes. Between these, there is a decrease in the concentration of progesterone, which responds to the degeneration of the Corpus luteum.
As a result, the production of substances known as prostaglandins is stimulated, which are involved in uterine contraction and vasoconstriction. Thus, the blood supply to the endometrium decreases, which leads to ischemia and pain.
Are more medical tests needed in dysmenorrhea?
First of all, it is necessary to evaluate whether pain and throbbing in the uterus are associated with the menstrual cycle. If colic appears with the period and has occurred on previous occasions, sand performs a complete gynecological examination.
When the results are within normal limits, no further testing is needed. Pain relievers can be used for three to four days to manage the pain.
However, sometimes it is necessary to verify that the pain is not related to processes other than menstruation. For this reason, additional tests such as a complete blood count, urinalysis, and abdominal and pelvic ultrasound may be ordered.
Likewise, it is important to rule out genital malformations when the pain appears in the first menses and is too intense.
Mittelschmerz syndrome: pain and stitches in the uterus that confuse
Another common cause of pelvic pain is pain that occurs around ovulation. In medical terms it is known as periovulatory syndrome or mittelschmerz. It is described as a pain in the lower abdomen, It predominantly affects one side.
This can appear between days 7 and 24 of the menstrual cycle and its distinguishing feature is that it changes the hemiabdomen over the following months.
Causes of Mittelschmerz syndrome
There are two theories that attempt to explain the origin of periovulatory pain. The first is based on the painful distension of the surface of the ovary —where the follicle grows—, which occurs just before ovulation occurs.
The second one responds to increased secretion of prostaglandins by the action of the luteinizing hormone, which generates the contraction of the perifollicular smooth muscle fibers and, with it, the sensation of pain.
He mittelschmerz it is not a syndrome that originates in the uterus. However, due to its high frequency and misinterpretation of its location, it can be confused with other causes of pain, especially when it is intense and predominates on the right side. It is usually similar to appendicitis.
For the above, it is essential to have a thorough questioning which includes a history of similar pain on other occasions.
Pelvic inflammatory disease
Upper genital tract infection is grouped into an entity known as “pelvic inflammatory disease” (PID), which also affects nearby organs. In this pathology, abdominal pain worsens during sexual intercourse or at the end of menstruation. Similarly, it can lead to the appearance of malodorous vaginal discharge and the sensation of sudden changes in temperature.
Physical examination reveals tenderness on movement of the cervix, which is considered a finding suggestive of PID. Complementary tests such as complete blood count, C-reactive protein and erythrocyte sedimentation rate they should not delay initiation of early antibiotic treatment. On the other hand, the execution of a vaginal smear and the use of ultrasound can be very useful.
Causes of pain in the uterus due to EPI
The increase of microorganisms from the vagina is the main cause of pelvic inflammatory disease. The germs most frequently involved in a woman with an active sex life are i Neisseria gonorrhoeae and the Chlamydia trachomatis.
However, Not all infections are caused by a sexually transmitted organism. There are risk factors that increase your chances of developing PID, such as:
- Risky sexual practices. Multiple sexual partners and relationships without barrier methods.
- Presence of an intrauterine device (IUD), especially during the first few weeks after its placement.
- Previous history of pelvic inflammatory disease.
- Exploration or manipulation of the uterine cavity through the vagina, such as hysteroscopy or hysterosalpingography.
Endometriosis is another cause of pelvic pain, in this case of chronic evolution. It often appears before menstruation, increases in intensity during menstruation and gradually decreases.
It is important to investigate the characteristics of menstrual cycles, as they usually have a long duration with profuse bleeding. Sometimes, in fact, they are more frequent and appear before 28 days.
Origin of endometriosis
Endometriosis responds to the presence of endometrial tissue outside the uterine cavity. The origin of the pain and the association with the menstrual cycle respond to the hormonal changes that occur during this process.
The physical examination provides little information, but the chronicity of the clinical picture and the characteristics of menstruation can serve as a starting point for a diagnostic suspicion.
Complementary tests in endometriosis
The alteration of some tumor markers (Ca-125 and Ca-19-9) has been described in the presence of endometriosis. However, they are not specific to this entity and therefore more research is needed to determine its true usefulness.
Imaging studies may produce certain results in some cases, but are not considered ideal for diagnosing this condition. For its part, laparoscopy is the invasive technique that provides accurate information, since it allows the identification of foci of endometrial implantation outside the uterus.
However, samples for biopsy of suspicious lesions should be taken, as their histology will confirm the diagnosis. Some authors describe that ovarian hormonal suppression with improvement of symptoms can also be used as a method to diagnose it.
Consulting a gynecologist is essential
In most cases, pain and throbbing in the uterus are not a serious condition. They even tend to occur in a timely manner. Despite this, It is advisable to discuss this with your doctor or gynecologist receive timely and appropriate care, if needed.
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