Here, experts weigh in on the common triggers and fixes to bring relief.

By Mirel Zaman
November 25, 2019

It affects nearly one in three U.S. Women. We tend to write off pelvic pain as period related. Sometimes, it is. But not always. We've got the latest information on how to handle the top causes.

The Culprit: Uterine Fibroids

Pelvic pain with heavy or irregular bleeding can sometimes be caused by uterine fibroids, benign growths on the wall of the uterus that affect up to 70 percent of women.

Spending more than an hour a day outside may decrease the risk of fibroids by 40 percent, possibly because of the vitamin D, research shows. (More here: Science-Backed Reasons Nature Is Good for Your Health) But severe symptoms may call for procedures like a uterine artery embolization, which cuts off blood flow to the fibroids to shrink them.

The Culprit: Endometriosis

If you have cramps all month and pain during sex, you may have endometriosis, says Pari Ghodsi, M.D., an ob-gyn in Los Angeles. The condition occurs when the tissue that lines the uterus is growing outside of it. (If you're having pain after sex, read up on reasons why that might be happening.)

Milder symptoms are usually resolved with a hormonal contraceptive, but more severe endometriosis may require targeted meds. One that was recently approved: Orilissa, a prescription pill that suppresses the hormone that exacerbates symptoms.

The Culprit: Period Cramps

About 84 percent of women have cramps during their period, as the uterine muscles and blood vessels contract to shed the uterus’s lining.

Calcium and magnesium can relax the muscles, easing the pain, Dr. Ghodsi says. The study-backed dose: 600 milligrams of calcium and 300 milligrams of magnesium, which you can get from supplements or foods like yogurt, nuts, spinach, and whole grains.

Also, try taking a nonsteroidal anti-inflammatory drug like ibuprofen every four to six hours (as directed on the bottle), starting a few days before your period until the cramps stop, Dr. Ghodsi says. If symptoms persist, ask your doctor about hormonal birth control, which can relieve cramps. (Related: How Much Pelvic Pain Is Normal for Menstrual Cramps?)

The Culprit: Muscle Weakness

Sitting for hours at a time and poor posture can weaken the pelvic-floor muscles, says Erin Weber, a physical therapist at Physio Logic in Brooklyn, New York. That can cause soreness or spasms. (Here's more on the importance of having strong pelvic floor muscles.)

Spending more time moving and less time sitting can prevent pelvic pain. (And, who knew? The Surprising Pelvic Perks of Peeing in the Shower)

This exercise can also help: Sit on the edge of a chair with your feet flat against the floor, leaning slightly forward to balance on your sit bones (those two knobby bones at the bottom of your backside). “Lift” the perineum (the space between your vagina and butt) off the chair, as if you’re using it to pull a tissue from a tissue box. Repeat for one minute, twice a day. (Also try these other pelvic floor exercises everyone should do.)

Shape Magazine, November 2019
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