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Cramping issue triggered by intense exercise
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Hello, I'm hoping to get some advice and feedback from any women who have suffered from menstrual cramping during intense exercise.

My daughter is a 15 year old high school athlete. She plays various sports including field hockey and lacrosse, in which she plays midfield and engages in long stretches of intense running similar to a triathlete's hard tempo run. She's in excellent shape and usually has great endurance. Every month or so, usually after about 5 minutes of intense running she gets a debilitating cramping sensation in her lower abdomen/pelvic area combined with nausea and has to leave the game or take a break from practice. She says the cramping also gives her the sensation of having to do a bowel movement even if she had a already had one just prior to the exercise. She then paces the sideline and after about 5-10 minutes of pacing can re-enter the game and the pain is gone. It may come up for a few days at a time but then goes away for several weeks. It has been happening for about a year or more.

Her pediatrician doesn't know what it is, but suggested that we have a sonogram. She had two sets of sonograms about 6 months apart. The first sonogram showed some ovarian cysts, and the pediatrician thought that may be the cause of the pain. He also predicted that the cysts were the type that would go away by themselves. The second sonogram showed that the cysts had gone away, but the cramping condition has continued. We thought that it was occurring mainly a few days before her period, but sometimes it happens the day she gets it or the day after. I'd say it usually occurs the week before her period to the day of. The good news is that the bouts of this pain aren't getting any more frequent and the intensity or duration of them is remaining constant, which makes her pediatrician feel it is probably not too serious. She doesn't normally have much cramping, so if she weren't exercising on a particular day she probably would not have any cramps. It's definitely triggered by the exercise and not something that would normally happen.

We haven't sent her to an OB/GYN yet, but that may be the next step.

Given that she intends to play sports in college and be a life-long athlete, we want to resolve this ASAP. So, I'm hoping some of you out there have had similar situations and can share some suggestions and advice. Feel free to send me a private message if you prefer. Many thanks.
Last edited by: barhersh: Jan 11, 16 3:38
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Re: Cramping issue triggered by intense exercise [barhersh] [ In reply to ]
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I actually just read an article about this but cannot for the life of me find it. I do, however, remember reading that one cause is likely a weak pelvic floor and/or core. There were tips and exercises to strengthen both (and yes, it included kegels). I can vouch for the fact that I experience this pain more when I have been neglecting my abs. The stronger my core the less pain. If I find the article, I will try to post it. Not saying that this is the fix for what your daughter is experiencing but working on strengthening both shouldn't hurt and its free...
Last edited by: gwaveswims: Jan 11, 16 7:01
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Re: Cramping issue triggered by intense exercise [gwaveswims] [ In reply to ]
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Has she tried Motrin? Amazing what some Motrin can do. A 15yo can take up to 800mg every 8 hrs (with food). Ovulation occurs about 14 days before the first day of the period- that causes intense cramping in some women. Sounds like hers is a bit later than that, though. An option to consider and ask OB about (that's where you need to go next if she sees Peds instead of FP) is birth control pills. Suppresses ovulation and makes cramps waaaaay better. She can even tri-cycle (no, not an athletic term!)- that's when you stay on the active pill for 8-12 weeks to skip periods. It can be a miracle. An added benefit to the pill can be clearer skin if she has acne.
Good luck!
(I'm an FP doc)
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Re: Cramping issue triggered by intense exercise [barhersh] [ In reply to ]
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Thank you very much for the ideas and suggestions. We have some good leads from the responses. Much appreciated.
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Re: Cramping issue triggered by intense exercise [gwaveswims] [ In reply to ]
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gwaveswims wrote:
I actually just read an article about this but cannot for the life of me find it. I do, however, remember reading that one cause is likely a weak pelvic floor and/or core. There were tips and exercises to strengthen both (and yes, it included kegels). I can vouch for the fact that I experience this pain more when I have been neglecting my abs. The stronger my core the less pain. If I find the article, I will try to post it. Not saying that this is the fix for what your daughter is experiencing but working on strengthening both shouldn't hurt and its free...


I think you are recalling "pelvic organ prolapse" which may be worth looking into.

I experience this type of pain quite often, and it is postulated that it is due to my polycistic ovary syndrome (PCOS), which not only causes formation of cysts on my ovaries over and over, but also causes the cysts to swell at times. This becomes extremely apparent during intense exercise when my heart rate is suddenly going up from rest - a very similar pattern to what your daughter experiences. Given that cysts have been found on her ovaries, you may want to have bloodwork done to screen for PCOS. My pain is limited now that I manage my hormone profile better, mostly through medication and diet modification.
Last edited by: JustMeHere: Jan 12, 16 13:11
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Re: Cramping issue triggered by intense exercise [JustMeHere] [ In reply to ]
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While I'm sure the underlying causes are similar, it was a Runners World article that was referencing young women with weak pelvic floors that were experiencing pain during endurance exercise without any organ prolapse. The part that caught my attention was the pubic pain that resonated down into the inner thighs (that was not the result of pubis osteitis).

And I agree the recommended exercises sounded as though they would benefit those with organ prolapse as well.
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Re: Cramping issue triggered by intense exercise [barhersh] [ In reply to ]
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I agree with several of the posters above.

I think what may be going on is that the physical activity is triggering cramps in an enlarged uterus, possibly just by the actual physical jostling of it during the exercise.

I found this article http://onlinelibrary.wiley.com/...016347509157770/epdf, the uterus grows a lot during the cycle and is largest just before the bleeding starts. This, possibly with pelvic floor weakness or ligamentous laxity that holds the uterus in place, may cause the physical jostling of the uterus to induce cramps.

Does she get cramps if she does a physical exertion that does not include any gravity on the uterus? Like swimming, rowing, or riding a bicycle?

I definitely think seeing an OB/Gyn is a good idea to make sure there is no physical problem other than "female physiology" causing this in your daughter. Best of luck!

Two wheels good. Four wheels bad.
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