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"Whether it's a mild, dull ache that lasts one night or a form of torture that sidelines you for days, many of us are no stranger to menstrual cramps. In fact, more than 50 percent of women have some level of pain each month.Before you reach for the heating pad again, though, there are a couple of things to know. First, these days, there are effective remedies that help ease the agony. But more important, not all period pain is normal \u2014 sometimes it can signal a potentially serious condition. Here's a crib sheet for recognizing subtle signs that may mean you should visit your gyno for a checkup.\n\tAdvertisement - Continue Reading Below\n\t\n\nSymptom: \"The monthly pain can be pretty bad. But if I take over-the-counter meds early on, I'm fine.\"\n\nPossible Culprit: JUST PLAIN MENSTRUAL CRAMPSCramps that can be quelled by OTC painkillers are probably nothing serious. Blame them on hormonelike body chemicals called prostaglandins, which trigger uterine contractions to expel blood and uterine tissue from your body, explains Susan Brill, MD, director of adolescent medicine at Saint Peter's University Hospital, in New Brunswick, New Jersey. Prostaglandins also contract your bowels, causing diarrhea and nausea.Even though cramps like these aren't worrisome, that doesn't mean you have to suffer. Anti-inflammatory medication (such as Advil or Aleve) tames the pain by targeting prostaglandins. Pop them at the first twinge; the earlier the meds start slowing prostaglandin production, the less pain you'll feel. If these don't work, see your gyno; some will prescribe stronger painkillers. Heat also helps, so fire up that heating pad or hot-water bottle.Another solution: going on the Pill. \"Birth-control pills stop ovulation, so the uterine lining doesn't really build up and fewer prostaglandins are produced,\" says Mary Jane Minkin, MD, clinical professor of ob-gyn at Yale University School of Medicine.Symptom: \"Lately I've been gushing so much blood during my period, I'm soaking through a tampon every hour.\"Possible Culprit: FIBROIDS\"Fibroids are benign tumors within or along the uterine wall,\" says Dr. Brill. They can be as small as an apple seed or as large as a grapefruit, and several can occur at once. They typically crop up in your 30s and 40s; 40 percent of chicks have one by their mid-30s. African-American women have a higher risk. Though fibroids can cause pain, they generally trigger a feeling of moderate pressure in the pelvis at any time. And the closer they are to the lining of the uterus, the heavier your flow \u2014 it may last longer than seven days and/or you may have to change your tampon every hour or two, says Dr. Minkin. The good news is that unless the pelvic pressure is really major or having a heavy flow is a hassle, there's no need to treat them. But if the pain and blood flow are bad, your gyno can shrink them via medication or, in rare cases, recommend surgery to remove the growths.Symptom: \"I get insane pelvic pain through-out the month \u2014 even during sex.\"Possible Culprit: ENDOMETRIOSISEndometriosis is a condition without a clear cause. Tissue that normally lines the uterus migrates outside it and begins growing on other organs nearby, says Dr. Brill. It affects up to 15 percent of reproductive-age women and takes an average of 10 years to diagnose after symptoms start. It's hard to diagnose partly because so many chicks think it's just severe menstrual cramps...so they don't see their gyno for tests.Endometriosis typically brings on killer pain in the lower abdomen \u2014 and sometimes in the back and thighs \u2014 that often can't be alleviated by OTC meds. This pain can pop up any time of the month. A heavy flow can also be a sign, as can painful sex. \"It'll feel like you have cramps during intercourse because your guy's penis rubs the tissue growing outside the uterus,\" says Dr. Minkin.Any of this sound familiar? Then make an appointment with your gyno. If she diagnoses you with endometriosis, birth-control pills or other hormones can slow the growth of the renegade tissue. In severe cases, surgery may be needed to reduce the amount of tissue that's built up outside the uterus.Symptom: \"I'm doubled over with lower-ab aches, and I'm running a fever.\"Possible Culprit: PELVIC INFLAMMATORY DISEASE\n\tAdvertisement - Continue Reading Below\n\t\n\nWicked pelvic pain that persists for days, weeks, or months and may be accompanied by a fever, painful urination, and/or yellow or green discharge is a sign of pelvic inflammatory disease (PID), a serious infection of the upper reproductive tract. PID is usually the result of an untreated chlamydia or gonorrhea infection; since these STDs may not have symptoms, sometimes you don't know you're infected until the bacteria spreads. \"It's critical to treat PID quickly,\" says Dr. Brill, \"because scar tissue can form in your fallopian tubes, causing infertility.\"Make an emergency appointment with your gyno. She'll run tests and, if you do have PID, prescribe antibiotics. For all the pain PID causes, it's cleared up easily, so don't put off that doctor's visit."^^<http://www.w3.org/2001/XMLSchema#string>
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