What causes uterine pain in early pregnancy?
Uterus pain in early pregnancy is caused by uterine contractions. These contractions are due to hormonal changes and increase the risk of miscarriage. There are two types of uterine contractions: non-contractive (non-contraction) and contractionive (contraction). Non-contractive contractions occur only after fertilization takes place. Contracting contractions happen before or shortly after fertilization occurs. When these contractions occur, they cause some discomfort to the woman. This is called uterine distress. The discomfort may be mild or severe depending upon how long it lasts and whether there are other symptoms associated with it such as nausea, vomiting, fatigue, headache etc.
The pain from non-contractive contractions is not usually painful enough to interfere with normal activities like driving or working. However, if the contractions continue for too long, then the woman will experience heavy bleeding. Heavy bleeding is when there is no period at all. If there is no period, then she does not have a menstrual cycle and cannot get pregnant either.
The amount of blood lost depends on several factors including age, weight, nutrition and medical conditions. If a woman is exposed to severe stress, or has anemia (low concentration of red blood cells in the body), then she may suffer from heavy bleeding.
What are the reasons for uterine pain in early pregnancy?
There are many reasons for pain in early pregnancy including:
Hormonal changes associated with the menstrual cycle cause contractive contractions. Sometimes blood loss can be excessive during menses and it can lead to prolonged bleeding.
A slight infection in the lining of the uterus can cause contractions. This is called “pyometra”. It is more likely to occur in older women or younger women who have not had a baby yet.
A small growth like a cyst or a polyp in the lining of the uterus that suddenly enlarges can lead to severe contractions and bleeding. This is called uterine fibroid cyst or tumor.
Fibroids are non-cancerous tumors that grow in the walls of the uterus. They can cause excessive bleeding, pain, and repeated miscarriages.
What are the risk factors associated with uterine pain in early pregnancy?
There are some risk factors that may increase the chance of having contractive contractions and heavy bleeding. These include:
Older age where hormonal changes are more common.
Smoking and using chewing tobacco increases the risk of contractive contractions.
Exposure to environmental toxins such as lead and carbon disulfide.
Underlying medical conditions such as thyroid disease or diabetes.
What are the symptoms of uterine pain in early pregnancy?
There are many different symptoms that may appear if a woman suffers from contractive contractions or heavy bleeding. The most common ones include:
Pain in lower abdomen or pelvis.
A dull ache in the lower back.
Frequent urination due to stress on the urinary tract.
Tenesmus which is a constant urge to defecate.
Nausea and vomiting.
Backache and headache.
Exhaustion and fatigue.
How is uterine pain in early pregnancy diagnosed?
The doctor asks about the medical history and does a physical examination. The physical examination includes a pelvic exam. The doctor may order certain laboratory tests depending upon the findings on history and the physical examination. These may include:
Blood count to find out the exact number of red blood cells, white blood cells, and platelets.
Blood tests to rule out other causes for bleeding such as vitamin K deficiency, liver disease, leukemia, HIV, or syphilis.
Urinalysis to rule out pregnancy or urinary tract infection.
Ultrasound of the pelvis to rule out fibroids, cysts, or tumors.
How is uterine pain in early pregnancy treated?
The treatment depends upon the cause of the pain and the symptoms. It is important to treat any underlying condition first because this may resolve the symptoms and make other therapy unnecessary. In some cases, the pain is mild and will resolve on its own. The treatment for uterine pain in early pregnancy may include:
Using non-narcotics such as acetaminophen (Tylenol) to reduce pain and swelling for a few days. Warm baths or heat therapy can also be used.
Low dose of antibiotics to treat possible infection.
Use of non-steroidal anti-inflammatory drugs (NSAIDs) such as ibuprofen, naproxen, or prescription drugs such as indomethacin for pain.
Use of hormones such as Progesterone to stop contractions and bleeding. This is useful in women who have few or no other treatment options left.
Surgical removal of fibroid, cyst, or tumor if it can be done.
If the pain is due to miscarriage, then expectant management may be needed until the pregnancy has naturally passed. After a period of rest, the woman may be able to get pregnant again.
When should I call my health care provider?
If there is vaginal bleeding that soaks more than one pad per hour or if you are passing clots bigger than a plum.
If you have pain that is worse, sharp, or sudden in nature.
You have significant swelling, fever, and feeling unwell.
You have abdominal pain that does not improve with rest.
Note: If you are in labor or think you are in labor, do not hesitate to call your health care provider or go to the emergency room right away.
American Pregnancy Association : Pain During Pregnancy.
Baby Center : Common Pregnancy Complaints.
Mayo Clinic: Lower right abdominal pain (Possible causes).
Medline Plus: Abdominal Pain.
UCSF Medical Center: Abdominal Pain.
Last updated 22 March, 2018.
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