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Feeling cramps in lower abdomen and breast tenderness. Trying to conceive. Any suggestions?

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Practicing since : 2008
Answered : 689 Questions
26 years old female, from last three weeks i am feeling cramps in my lower abdomen , and breast tenderness and pain, in starting i thought that its my PMS and i am going to have periods but now its three weeks and no periods so far. i ve a irregular periods history and from last 3-4 cycle i was getting very little spotting for 1-2 days each months around my time , the last spotting i got was on 4th sept.
i want to have a baby and v are trying for last 4-5 months . but not succeeded yet. please guide me about this sudden cramps which comes and go. and i have very upset moods. feeling depressed all the time
Posted Sun, 4 Nov 2012 in Getting Pregnant
Answered by Dr. Asra Ishtiaq Ahmed 1 hour later
Hello there,
Thanks for writing to us.

As you have been 3 weeks overdue I suggest you to rule out pregnancy first by doing a urine test with the widely available home kits.

Since you have irregular periods with decreased flow during periods, I want to know if you are overweight, have too many pimples or hair over your body.

These symptoms are present in a condition called Polycystic Ovarian Syndrome (PCOS) wherein due to hormonal imbalance periods become irregular.

To rule out this you need to get certain blood tests (Serum LH, FSH, Prolactin and testosterone) along with an ultrasound abdomen to see for multiple small cysts in ovary.

Your gynaecologist will do the required evaluation. Besides thyroid disorders also lead to irregular periods so they also need to be considered as a possibility.

Change in environment, stress, anxiety, excess weight gain or loss, can all result in irregular periods. All these can also affect your fertility.
Depression, mood changes are all due to the anxiety of not having regular periods. But there is no use being anxious because it would in turn affect your cycles more. Cramps and pain are because you dint have your periods. Antispasmodics (buscopan, meftal spas) are good choice to relieve them.

Husband seminogram (semen analysis) is one more thing which should be normal before you consider yourself to be the cause of infertility. But let me tell you infertility is considered only when you are not able to conceive for one year despite using no contraception and having regular contact.

To regularize periods, Oral contraceptive pills are a good choice. They also help in reducing the premenstrual syndrome of nausea vomiting, breast tenderness, cramps. But since you want to conceive, you should not use them.

You can use progesterone tablets in the last ten days of your cycle to regularize periods and it won’t affect your fertility. But before all this you should go to a gynaecologist for a physical and XXXXXXX examination. Also step wise tests would be done according to your evaluation.

Meanwhile you can keep taking Folic acid tablet once daily. It is a vitamin and will help avoid birth defects and have favourable outcome with no side effects. These are most effective if used 3 months prior to conception. So you can start with them.

Take care.
Above answer was peer-reviewed by
Follow-up: Feeling cramps in lower abdomen and breast tenderness. Trying to conceive. Any suggestions? 48 hours later
hello mam, i went to a local doctor in USG it shows that i am pregnant. i am happy.but abt pcos i had a USG in XXXXXXX this year shows that its multiple small follicles in my left ovary. i had no acne. but i had little hair below my navel. and i had always a irregular cycle. but as i read much about PCOS i started losing weight and eliminated high carb and sugar from my diet , i lost abt 6 kg in this three months.
So now as i am pregnant i want to know if i had pcos what precautions i should take to sustain my pregnancy well. i am very excited yet anxious. plz help
Answered by Dr. Asra Ishtiaq Ahmed 4 hours later

Congratulations and Thanks for writing back.
As you mentioned you have confirmed your pregnancy on ultrasound so i hope it shows pregnancy in the uterine cavity and not elsewhere. This is important in every female who is pregnant to know the site of pregnancy.
First of all you should stop being anxious as its not good for your health.
PCOS has main problem of infertility (inability to conceive). Now you have conceived so you should not worry. In PCOS due to hormonal imbalances and obesity, there is a higher risk for miscarriage and complications such as gestational diabetes mellitus ( diabetes during pregnancy) and hypertensive disorders (raised blood pressure) during pregnancy. These are common in patients of PCOS. So I suggest you keep a record of your BP. Also get your blood sugar levels estimated in fasting and post prandial state ( 2hours after breakfast ) estimated. Screening of gestational diabetes is done using a test called GLUCOSE SCREENING TEST so I suggest you should take this test early even if your fasting levels are normal. Your gynecologist would explain you the procedure of taking the test. If they are normal, you need not worry.
PCOS also increases the risk of miscarriage. High insulin contributes to increased blood clotting where the uterine lining and the placenta XXXXXXX This clotting can lead to a placental insufficiency. Placental insufficiency occurs when the placenta fails to supply the necessary nutrients and remove toxic waste to and from the fetus. This insufficiency can lead to miscarriage.
It Is good to know that you lost weight prior to conceiving. As reduction in weight itself reduces insulin resistance and hormonal disbalance. But do not make any attempts to lose further weight in pregnancy. All you need to do is maintain a healthy diet. Avoid oily foods and refined carbohydrates like chocolates, chips and junk items. Take good amount of fluids and fruits.
Avoid intercourse, heavy work and stress.
Take good rest and healthy diet.
I hope you have started your folic acid tablets. If not then do start taking one tablet daily.
Regularly Visit your gynecologist for antenatal check ups.
I reiterate that you should keep a check on your BP, blood sugar and weight gain.
All the best.
take care
Above answer was peer-reviewed by
Follow-up: Feeling cramps in lower abdomen and breast tenderness. Trying to conceive. Any suggestions? 2 days later
thanks a lot doctor, yes the pregnancy is in uterine cavity, it shows gestational sac size 1.35 cm. yolk normal.
doctor prescribed me some tablets 'endogest 200 and sinate-od) ,for next 15 days , pregnancy is 5wk 4 days.
but doctor i am not feeling any nausea or vomiting or morning sickness,...i m worried is it normal??? i just feel fatigue and sleepyness but not anything else. my Hb is 14.6, and tsh etc are normal.
Answered by Dr. Asra Ishtiaq Ahmed 52 minutes later

If your Last menses was on 4th september, then by dates you are 6weeks 3days and by ultrasound you are 5 weeks 4 days which is acceptable. Your ultrasound shows a good report at the moment. Cardiac activity (baby heart beat) is not mentioned in the report so I presume its not seen yet. Cardiac activity is usually visible around 6 weeks so you can get a repeat ultrasound after 2 weeks to see for it.
Nausea and vomiting of pregnancy are related to high hcG levles in blood. This hormone peaks in blood around 10 weeks. Nausea of pregnancy usually starts around 6 weeks so you can still wait for it. Not all women have problems of nausea in pregnancy so as far as your ultrasound is normal , you need not worry. Its not a rule that all symptoms of early pregnancy appear in a female.
Fatigue and increased sleepiness are definitely early symptoms of pregnancy and you need not worry about them. Breast tenderness and darkening of areola is also seen in early pregnancy.

Your Hb report is perfect and very nice to hear that your TSH is normal.

Endogest is a progesterone hormone tablet. Progesterone is a hormone which supports pregnancy and keeps the uterus relaxed. The effectiveness of this tablet to prevent miscarriage is yet to be proved completely. But there is no harm in taking this in early pregnancy so if you have started you can continue with them.

Sinate Od contains doxylamine and is used to relive nausea vomiting of pregnancy. This can also be the reason that you are not having complaints of nausea. Mild nausea can be well taken care of by these medicines. They are generally advised early in pregnancy when nausea becomes problematic.
Its safe and you can continue with these too.
I hope you are taking Folic acid tablets also which are a must in every pregnancy in the first 3 months.
Wishing you all the best.
Take care.
Above answer was peer-reviewed by
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