Menstrual cramps teleconsult in Singapore
Period pain (dysmenorrhoea) affects up to 80% of menstruating women in Singapore, and around 10 to 20% have pain severe enough to interfere with work, school or daily life. A teleconsult is well-suited to familiar period cramps — the doctor can prescribe stronger NSAIDs than the OTC dose, issue an MC, arrange same-day delivery, and screen for secondary causes that need gynaecological review.
What is menstrual cramps?
Primary dysmenorrhoea — pain without an underlying disease — accounts for about 80% of menstrual cramps. It is driven by prostaglandins released as the uterus sheds its lining, causing strong muscle contractions. Pain typically begins a few hours before or with the start of bleeding, peaks within 24 hours and resolves within 48 to 72 hours. It usually starts in adolescence and often improves with age, after childbirth, or on hormonal contraception.
Secondary dysmenorrhoea — pain caused by an underlying condition — is less common but important to identify. The main causes are endometriosis (tissue resembling the uterine lining growing outside the uterus, affecting around 10% of women), adenomyosis (uterine lining tissue within the uterine wall), uterine fibroids, ovarian cysts, and pelvic inflammatory disease (PID). Hallmarks of secondary dysmenorrhoea include pain that starts in the 20s-30s rather than adolescence, pain extending beyond the period, deep pain with sex, infertility, very heavy bleeding, and pain that worsens over years.
What commonly causes it
- Primary dysmenorrhoea — prostaglandin-driven uterine cramping (most common, 80%)
- Endometriosis — particularly if pain extends through the cycle, deep pain with sex, or infertility
- Adenomyosis — heavy painful periods, common in women over 35
- Uterine fibroids — heavy bleeding, bulky uterus, possibly visible on ultrasound
- Ovarian cysts — sudden one-sided pelvic pain
- Pelvic inflammatory disease (PID) — pain with fever, abnormal discharge, recent unprotected sex
- Intrauterine device (IUD) — copper IUD can worsen cramps; hormonal IUDs usually help
- Pregnancy complications — ectopic pregnancy in early pregnancy with one-sided pain (always check pregnancy test first)
When teleconsult may be suitable
- Familiar period cramps similar to previous cycles
- Mild-to-moderate pain not controlled by over-the-counter ibuprofen or paracetamol
- Need for a stronger NSAID prescription (mefenamic acid, naproxen 500 mg) or an MC
- Review of hormonal contraception as a long-term solution
- Discussion of suspected endometriosis or adenomyosis and next steps
When to seek in-person care
- Possible pregnancy — always check first if any chance; ectopic pregnancy is a medical emergency
- Severe one-sided pelvic pain, fainting, or shoulder-tip pain
- Very heavy bleeding (changing pads/tampons hourly, passing large clots, dizziness on standing)
- Fever with pelvic pain and abnormal vaginal discharge — possible pelvic infection (PID)
- New severe pain unlike your usual cramps, or pain not relieved by maximum-dose NSAIDs
- Pain extending well beyond the menstrual period, or deep pain with sex
- Difficulty conceiving alongside painful periods — possible endometriosis
What to tell the doctor
- Note the first day of your last period and your usual cycle length
- Describe the pain: severity (0 to 10), location, character, when it starts and ends
- Note bleeding pattern — how many pads/tampons per day, presence of clots
- Share any pregnancy possibility, contraception in use, and previous gynaecological history
- List what you have already taken and how well it worked
What you can safely do at home
- Apply a hot pack or hot water bottle to the lower abdomen — comparable to ibuprofen for mild cramps
- Take an NSAID early — ibuprofen 400 mg or naproxen 500 mg at the first sign of cramping, with food
- Add paracetamol 1 g every 6 hours if NSAID alone is not enough
- Light exercise (yoga, brisk walking) — counter-intuitive but reduces pain
- Magnesium supplementation 250 to 500 mg/day can reduce cramp severity for some women
- Limit caffeine, alcohol and salty food in the days before your period
What the doctor will ask
- Is this pain typical for your cycle, or different from your usual pattern?
- Heavy bleeding, fever, abnormal discharge, fainting, or any pregnancy possibility?
- What pain relief have you tried and how did it work?
- Pain outside the menstrual period? Pain with sex? Difficulty conceiving?
- History of endometriosis, adenomyosis, fibroids, ovarian cysts, PID, or pelvic surgery
Frequently asked questions
Can a teleconsult treat my period cramps in Singapore?
Yes — for familiar primary dysmenorrhoea, the doctor can prescribe a stronger NSAID (mefenamic acid, naproxen), issue an MC, and arrange same-day delivery. Suspected endometriosis, adenomyosis, ovarian cyst rupture, ectopic pregnancy or pelvic infection need in-person assessment, often with ultrasound and gynaecology referral.
What is the best painkiller for menstrual cramps?
NSAIDs work better than paracetamol because they block the prostaglandins causing the cramps. Singapore options include mefenamic acid 500 mg three times daily, naproxen 500 mg twice daily, or ibuprofen 400 to 600 mg three times daily. Start the day before your period or at the first sign of pain, take with food, and continue for the first 2 to 3 days.
How do I know if I have endometriosis?
Suspect endometriosis if: pain starts in your 20s-30s rather than adolescence, pain extends beyond the period or occurs mid-cycle, deep pain during sex, difficulty conceiving, pain that worsens over years, or pain that needs increasing medication. The diagnosis requires pelvic ultrasound and sometimes laparoscopy. A teleconsult can start the workup and refer you to a gynaecologist.
Can the pill stop my period cramps?
Yes — hormonal contraception is one of the most effective long-term treatments for severe primary dysmenorrhoea. The combined pill, progestogen-only pill, hormonal IUD (Mirena) or contraceptive injection thins the uterine lining and reduces prostaglandin production, dramatically reducing cramps. Eligible patients can start the pill via teleconsult after a brief screening for contraindications.
When should I head to A&E for menstrual pain?
Go to A&E for: severe one-sided pelvic pain with fainting or shoulder-tip pain (possible ectopic pregnancy or ovarian torsion), very heavy bleeding with dizziness, fever above 38°C with abnormal discharge (possible pelvic infection), or any severe new pain not relieved by maximum-dose painkillers. Always do a pregnancy test first if there is any chance of pregnancy.