Period Pain

Period pain is very common and is experienced by many women as a normal part of the menstrual cycle, which normally occurs for a few days during each period. It is usually felt as cramping in the lower abdomen, which may spread into the back and thighs. Taking regular pain killers, using heat compresses and trying to relax can help to ease pain and discomfort.

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Advice for Period Pain

What is Period Pain and what causes it?

Period pain – also called primary dysmenorrhoea – will affect most women at some point during their lives. As the name suggests, period pain is basically a pain suffered by women during their monthly period. It usually presents as a discomforting cramping sensation in the lower muscles of the stomach, which can sometimes spread to the lower back and thighs.

The sensation of period pain can vary; for some, the pain will come in intense spasms, whilst others experience a dull aching sensation instead. Period pain usually occurs at the same time as menstruation, and will normally last between 48-72 hours.

Period pain is caused by muscular contractions of the womb’s wall. During menstruation, these contractions become more intense, in order to encourage the wall to shed its lining. These stronger contractions cause the wall of the womb to press against the surrounding blood vessels, briefly cutting off the womb’s blood supply. Without blood, the womb becomes temporarily deprived of oxygen, which causes the affected tissues to release a pain triggering chemical. This, in turn, causes the body to produce another chemical called prostaglandins. Prostaglandins will cause the muscles in the womb to contract further, which will increase the intensity of the period pain even more.

In rare instances, period pain can be caused by an underlying medical condition. This kind of period pain is called secondary dysmenorrhoea. Some of the conditions that can cause secondary dysmenorrhoea include:

  • Endometriosis: Where the cells that line the womb begin to develop elsewhere in the body, usually the ovaries and fallopian tubes. As these cells start to shed, they can cause intense pain.
  • Pelvic inflammatory disease: A bacterial infection that affects the womb, causing it to become inflamed and irritated.
  • Intrauterine devices: Also known as IUDs, is a contraceptive device made from plastic and copper. It fits inside the womb and is sometimes known to cause period pain.
  • Fibroids: is a condition caused by non-cancerous growths inside the womb. These benign tumours can make periods heavier and more painful.

Some women experience more period pain than others. The reason for this is still not entirely clear. However, it is suspected to be due to a build-up of prostaglandins, where some women appear to suffer a larger build-up than others. The higher the concentration of prostaglandins, the stronger the pain-inducing contractions will be.

What are the symptoms of Period Pain?

Period pain is a very common infliction. It is thought to affect up to 90% of menstruating women. The majority of cases will present as:

  • Painful muscle cramps in the lower stomach
  • Painful muscle cramps in the lower back and thighs

Period pain can be experienced as intense spasms, whilst for others, the pain will be more constant and dull. Other associated symptoms of period pain can include:

  • Feeling nauseous
  • Vomiting
  • Backache
  • Bloating
  • Diarrhoea
  • Headache or migraine
  • Emotional symptoms, such as mood swings

If you are suffering from secondary dysmenorrhoea, you may also experience the following symptoms:

  • Irregular periods
  • Thick and unpleasant smelling vaginal discharge
  • Bleeding in between periods
  • Pain during sexual intercourse

Secondary dysmenorrhoea is more likely to develop as you get older. The majority of women affected are aged between 30-45 years old.

How is Period Pain diagnosed?

If your period patterns change significantly, it is advised to discuss your symptoms with your doctor.

To make an informed diagnosis, your doctor will ask about your symptoms and review your medical history. They will likely inquire as to how period pain is affecting your daily life. The next step is usually an examination of the abdomen. If unsatisfied, your doctor may arrange for a vaginal exam, where lubricated, gloved fingers are inserted into the vagina to check for abnormalities.

In some cases, a vaginal swab may be taken to rule out any sexually transmitted infections (STIs). If your doctor is still unable to make a diagnosis then further testing may be required. This could involve a pelvic ultrasound exam (using sound waves to produce an image of inside the abdomen), or a referral to a gynaecologist. If during any of the physical examination processes you experience any pain, it is important to relay this to your examiner.

How is Period Pain treated?

If suffering from secondary dysmenorrhoea, it will be important to identify the condition causing your symptoms before a suitable line of treatment can be discussed. However, if you suffer from primary dysmenorrhoea, there are several over-the counter, prescription painkillers available to you.

Non-Steroidal Anti-Inflammatory Drugs (NSAIDs), such as ibuprofen, naproxen or mefenamic acid have proven effective at relieving period pain. NSAIDs inhibit the production of prostaglandins, which is a chemical that causes the muscles in the womb to contract more severely during bouts of period pain. If NSAIDs are unsuitable, your doctor may recommend paracetamol instead.

A non-medicinal option for relieving period pain is transcutaneous electrical nerve stimulation (TENS). A TENS machine uses electrodes, which are placed on the skin at the site of pain. Electrical impulses are delivered through the electrodes, which is believed to interrupt the pain signals being sent to the brain.

Using heat patches and hot water bottles are for many an effective method for relieving period pain. These are usually applied to the abdomen or the lower back. It is important not to apply heat directly to the skin, as it may damage it. Hot water bottles should only be used through clothes, and heat patches should only be applied as instructed by the manufacturer.

How do I prevent Period Pain?

Period pain isn’t always possible to prevent. However, there are some self-help techniques and lifestyle changes that can help reduce the symptoms from developing. These include:

  • Exercise – aim to achieve 150 minutes + of moderate-intensity exercise each week. Any type of aerobic exercise will cause the body to pump more blood; which will result in the release of endorphins to counteract the prostaglandins. This will help ease the painful cramps.
  • Stop smoking
  • Reduce alcohol consumption – current guidelines recommend not exceeding 2-3 units of alcohol per day, with at least two alcohol-free days per week.
  • Improve your sleep and relax more often

Period Pain FAQs

  • Period pain is also known as dysmenorrhoea. It is a normal part of a woman’s menstrual cycle. The condition is usually felt as painful muscle cramps in the lower abdomen, which can also spread to the back and thighs.
  • Uterine contractions cause most of the pain associated with dysmenorrhoea. As the womb contracts, the blood flow to the womb becomes temporarily restricted. This brief lack of blood supply will deprive the womb of oxygen, which in turn causes the release of pain- triggering chemicals.
  • The main symptoms of period pain are as follows:
    • Aching pain in the abdomen – this pain can present as a dull ache or as a more intense spasm. The pain experienced during period pain can range from mild to severe. The pain can spread to the lower back and inner thighs.
    If the period pain is more severe in nature, other associated symptoms can include:
    • Vomiting
    • An upset stomach
    • Loose stools
    • Headaches
  • Period pain normally begins at the onset of menstruation and generally doesn’t last for more than 2-3 days. The pain is usually at its worst when your bleeding is heaviest.
  • For the majority of sufferers, period pain can be successfully treated at home using over-the-counter painkillers, such as Ibuprofen and Aspirin. However, Ibuprofen and Aspirin should be avoided if you suffer from stomach or kidney problems, or if you have asthma. In these circumstances, Paracetamol would be the suitable alternative. If over-the-counter pain-relief is proving ineffective, your GP can prescribe you a stronger painkiller, such as Naproxen.
    Your doctor may suggest using the combined oral contraceptive pill. These pills can relieve period pain because they reduce the thickness of the womb’s lining. A thinner lining means the womb’s muscles do not have to contract as much in order to shed away your monthly period. The combined contraceptive pill also has the added benefit of reducing the amount of prostaglandins released by the body. Prostaglandins are pain-triggering chemicals.
    If the combined contraceptive pill proves to be unsuitable, contraceptive implants or injections may be a good alternative.
  • There are several self-help techniques that can help relieve the symptoms of period pain. These include:
    • Exercise – exercising during a painful period can help reduce the discomfort. Exercise causes the release of endorphins, which help counter the pain triggering effect of prostaglandins.
    • Stop smoking – smoking is believed to increase the risk of suffering from period pain.
    • Heat therapy – applying a heat pad or hot water bottle can help reduce period pain. Always ensure hot water bottles are wrapped in a protective layer.
    • Massage – gentle massage of the lower abdomen can help ease period pain.
    • Relaxation – partaking in relaxing activities can help soothe the discomfort of period pain.
    • Transcutaneous Electrical Nerve Stimulation (TENS) – a compact battery powered device that delivers mild electrical currents to the abdomen, which can help relieve pain.
  • Sadly, period pain can’t always be prevented. Adopting a healthy lifestyle and practising self-help relaxation techniques is the best method for reducing the occurrences and severity of period pain.
  • Period pain is perfectly normal. In fact, most women suffer some level of discomfort or pain during menstruation. However, if the cramping becomes severe, or if it is associated with nausea, diarrhoea, or headaches, then it is recommended to see your GP or gynaecologist.
    It is also recommended to speak with your GP should the normal patterns of your periods change significantly. For example, if you periods start to become irregular or heavier than what you are used to. In these circumstances, your doctor will likely run a few tests to check for possible underlying conditions that may be causing the irregular, painful periods. Possible underlying conditions include:
    • Endometriosis
    • Pelvic inflammatory disease
    • Fibroids
    • Adenomyosis
  • Period pain that’s caused by your natural monthly menstruation won’t affect your fertility. However, if the pain is being caused by an underlying condition, such as endometriosis, then there is a chance fertility may be affected.
  • A family history of dysmenorrhoea can increase your risk. However, it can’t always be generalised, meaning there is a chance you won’t suffer the same levels of discomfort. You can actively reduce your risk by following a healthy diet, regular exercise, and practising stress-relieving techniques.

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