My stomach hurts but I don’t have my period.

Stomach pain but no menstruation may be related to pregnancy, endocrine disorders, polycystic ovary syndrome, ovarian cysts, intrauterine adhesions and other factors. It is recommended to seek medical examination promptly and provide targeted treatment after the cause is determined.

1. Pregnancy

When women of childbearing age experience menopause accompanied by dull pain in the lower abdomen, they need to give priority to ruling out the possibility of pregnancy. Slight abdominal pain may occur when the fertilized egg implants, which can be confirmed by a pregnancy test paper or blood HCG test. If abdominal pain persists after pregnancy is diagnosed, you need to be alert to the risk of ectopic pregnancy and it is recommended to seek medical advice from a gynecologist as soon as possible.

2. Endocrine disorders

Long-term stress, excessive dieting, or obesity may lead to hypothalamic-pituitary-ovarian axis dysfunction, manifested as delayed menstruation and abdominal bloating. It can be evaluated through six sex hormone tests. You need to maintain a regular daily routine. If necessary, follow the doctor's instructions and use progesterone capsules, dydrogesterone tablets and other drugs to adjust the cycle.

3. Polycystic ovary syndrome

The disease is often accompanied by symptoms of oligomenorrhea, acne and hirsutism, and polycystic ovarian changes can be seen on ultrasound. Patients may experience periodic lower abdominal distension and need to improve insulin resistance through lifestyle intervention. Doctors may recommend taking drugs such as ethinyl estradiol cyproterone tablets and letrozole tablets.

4. Ovarian cysts

Pathological cysts can cause acute abdominal pain when torsion or rupture, and physiological cysts may cause menstrual disorders. Ultrasound examination can clarify the nature of the cyst. Larger cysts require laparoscopic surgery. Smaller cysts can be observed or treated with Chinese patent medicines such as Guizhi Fuling Capsules and Hongjin Xiaojie Capsules.

5. Uterine adhesions

Patients with a history of uterine cavity operations such as induced abortion may experience obstruction in the discharge of menstrual blood, manifesting as amenorrhea accompanied by periodic abdominal pain. Hysteroscopy is the gold standard for diagnosis. Mild adhesions can be treated by hysteroscopic separation. An intrauterine device needs to be placed after surgery to prevent re-adhesives.

It is necessary to record changes in the menstrual cycle on a daily basis to avoid overexertion and cold stimulation. If abdominal pain lasts for more than 3 days or is accompanied by fever or vomiting, you must seek medical attention immediately. It is recommended to perform gynecological ultrasound and cervical cancer screening every year. Women over 40 years old need to pay extra attention to changes in hormone levels during perimenopause. Maintaining moderate exercise can help improve pelvic blood circulation, but strenuous exercise during menstruation should be avoided.