Dear Doctor,

I recently got cramps about the time I was supposed to get my periods which did not come. Earlier on, I was suffering from anxiety and the doctor gave me a prescription and I became better. Could I be pregnant?

Iradukunda

Dear Iradukunda,

Having cramps in the stomach or legs during menstruation is a problem many women suffer from. It is called dysmenorrhoea. This may be without any cause (primary dysmenorrhoea) which occurs due to release of prostaglandins. Secondary dysmenorrhoea occurs secondary to some disease like pelvic inflammatory disease, endometriosis, uterine fibroids, etc. These conditions not only cause abdominal cramps, heavy bleeding, but also impair fertility.

If one is having abdominal cramps during every menstrual cycle with no other problem like vaginal pruritis, discharge, dyspareunia, etc., then missing periods when expected could be due to pregnancy.

Traditionally, diagnosis of pregnancy is suspected with missing of periods. But this becomes difficult if someone has irregular cycles.

Fortunately, pregnancy test kits are now available and can detect it as early as 2 to 3 weeks of conception, i.e. even before missing a period. Ultrasound examination can show a foetus implanted in the uterus, very early.

Vaginal ultrasound is more sensitive than abdominal ultrasound in detecting early pregnancy. The only drawback is some women find it very uncomfortable and prefer abdominal ultrasound.

It is advisable for you to undergo a pregnancy test for confirmation. If positive, you need to take all due precautions to keep it safe because cramps during early pregnancy are sometimes associated with miscarriage later on.

Dr Rachna Pande  is a specialist in internal medicine at Ruhengeri Hospital