Urgent! Why do I have lower abdominal pain and diarrhea on the first day of my period?

Patient's question:

Detailed condition and consultation purpose: Abdominal pain on the first day of menstruation with diarrhea, especially lower back and abdominal pain

Doctor's answer:

Hello:
Considering dysmenorrhea, after identifying potential causes through medical history and general and local examinations, the following treatment measures are recommended:
(1) General Management
Conduct necessary health education to alleviate anxiety, tension, and fear, and reduce mental stress. Timely treatment of chronic systemic diseases is essential. Individuals with developmental issues or weak constitutions should correct these conditions. Begin physical exercise to enhance physical fitness. Avoid strenuous exercise and excessive fatigue during the menstrual period, prevent exposure to cold, and pay attention to menstrual hygiene.
(2) Prostaglandin Synthesis Inhibitors
To reduce prostaglandin release, take 25mg of indomethacin, 0.3g of acetylsalicylic acid, or 250mg of mefenamic acid orally 3–5 days before menstruation. Dosage: 2–4 times daily. These medications may be highly effective.
(3) Acupuncture and Moxibustion Therapy
During dysmenorrhea episodes, the primary acupuncture points are Qihai, Hegu, and Sanyinjiao. The supplementary points are Guanyuan, Zongzi, and Zusanli. First, stimulate the primary points with strong intensity, retain the needles for 10–15 minutes. If the pain persists, add supplementary points or moxibustion on Qihai and Guanyuan.
(4) Hormonal Therapy
1. Ovulation Suppression
Since dysmenorrhea primarily occurs in ovulatory cycles, oral contraceptives (Type I or II) can be tried to suppress ovulation. The dosage and usage are the same as for contraception. This may alleviate symptoms. Alternatively, take 5–10mg of medroxyprogesterone daily, 2.5–5mg of norethisterone, or 4–8mg of megestrol daily, starting on the 5th day of the menstrual period and continuing for 20–22 days for 3 cycles. This is suitable for endometriosis and older individuals.
2. Estrogen
Often used for individuals with poor uterine development.