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Advice for Period Pain
Period pain, also known as Dysmenorrhea, is a condition which can affect women with varying degrees, and normally occurs for a few days during each period. Period pain itself is a completely normal part of the menstrual cycle which can cause painful cramping in the lower stomach that can spread to the back and thighs.
The sensation of period pain can vary. For some women, the pain will come in intense spasms, whilst others experience a dull aching sensation instead. It can have a significant impact on a woman’s quality of life and well-being. As well as pain, women may also experience other menstrual symptoms like nausea, fatigue, bloating and headaches.
There are two types of dysmenorrhoea: primary and secondary.
Primary dysmenorrhoea is when a person experiences period pain regularly during their period. There’s no specific cause for it, and it usually starts towards the beginning of menstrual life. Primary dysmenorrhoea isn’t caused by any other medical conditions or diseases. This is a common type of period pain.
Primary dysmenorrhoea happens when the muscles in the wall of the womb contract. Mild contractions do occur in the womb usually, but they’re mild enough that most women won’t feel them. Around the time that your period starts, womb contractions get stronger to help the womb lining shed. These contractions reduce oxygen and blood supply to the womb and trigger pain sensations. At the same time, levels of chemicals called prostaglandins rise in the body which causes the womb muscles to contract more and lead to more menstrual pain.
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Secondary dysmenorrhoea is period pain that is caused by an underlying health issue, most commonly endometriosis. Other common causes of secondary dysmenorrhoea include pelvic inflammatory disease, fibroids, and cervical stenosis. This is usually seen in older women and usually starts after several years of painless periods.
With secondary dysmenorrhoea, you may also feel pain even when you’re not on your period. You usually won’t feel sick or tired, but you may have heavier and less regular periods, and an unusual discharge.
A healthcare professional can diagnose your condition by enquiring about your symptoms and how your periods affect your day-to-day life, as well as taking a detailed medical history. If you’re young and haven’t had sex before, you may just have your tummy examined. If you’re sexually active, you may require a more intimate examination of the inside of the vagina.
For further investigations, your GP may request an ultrasound scan to look at your womb from the outside, through your tummy. You may also have a transvaginal scan, that scans from the inside using a device that goes into your vagina.
Over-the-counter painkillers, like ibuprofen and paracetamol, can help to relieve mild menstrual cramps. For some women, these painkillers just aren’t enough though. Fortunately, dysmenorrhoea is pretty easy to treat, and there are plenty of different options available including prescription pain killers that are available at Pharmacinta.
The main symptom of primary dysmenorrhoea is cramping pain in your tummy (lower abdomen). The pain can also spread to your lower back and your thighs. You may feel this a few days before and/or during your period, and it usually gets better at the end of your period. As well as pain, you might have some other symptoms before or during your period, such as:
- Tiredness
- Feeling sick or being sick
- Diarrhoea
- A headache or feeling light-headed
- Bloating
- Emotional symptoms such as mood swings
The duration of pain is completely individual and may start one to two days before you begin bleeding. It will last (on average) for around three days.
If you have secondary dysmenorrhoea, besides cramping pain you might also have a feeling of heaviness in your tummy, and back pain. You may also have other secondary dysmenorrhoea symptoms, such as:
- Heavy or irregular periods
- Bleeding in-between periods
- An unusual discharge from your vagina
- Pain during sex, and you may bleed afterwards
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.
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, these contraceptive devices are made from plastic and copper. Fitting inside the womb, they can sometimes 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.
- The intrauterine device (IUD) may also make period pain worse. This is a contraceptive device that is inserted into your uterus - it is usually made of plastic or copper.
While any woman can develop dysmenorrhea, the following women may be at an increased risk for the condition:
- Women who smoke
- Women who drink alcohol during their period (alcohol tends to prolong menstrual pain)
- Women who are overweight
- Women who started their periods before the age of 11
- Women who have never been pregnant
Painkillers can make it easier to deal with period pains, and different painkillers work in different ways. Some painkillers work by changing the way your body responds to pain, while others directly block pain signals that are sent to your brain. While painkillers won’t address the underlying cause of period pain, they can provide quick and effective relief.
Over-the-counter painkillers, such as paracetamol and ibuprofen, can help you deal with mild period pain. If your period pain is really intense, prescription medications can be prescribed to manage the pain.
There are several prescription treatments available for painful periods that are not caused by other medical conditions i.e. primary dysmenorrhea. The most effective method is by using anti-inflammatory drugs. In particular, nonsteroidal anti-inflammatory drugs (NSAIDs) such as Mefenamic Acid and Naproxen.
Mefenamic Acid is commonly used for the treatment of period pain. It belongs to a group of medicines called non-steroidal anti-inflammatory drugs (NSAIDs). These are thought to reduce period pain because they can reduce prostaglandin levels in the body, as well as providing general pain relief.
Naproxen provides long lasting relief from period pain and cramps. It relieves painful stomach cramps, backache, headache, and all the other aches and pains associated with period pain. Naproxen works by reducing the production of prostaglandins, which in turn reduce the contractions of the uterus. It works directly at the site of the pain to offer long lasting relief.
Studies have shown that Naproxen is slightly more effective than Mefenamic Acid at reducing pain. It was found to reduce work and school absences due to period pain. They have similar side effects profiles.
Hormonal Contraception
Hormonal contraceptives like the combined contraceptive pill can make your periods lighter and ease menstrual symptoms including the pain. These work as the hormones in the contraceptive prevent ovulation. It can also provide protection against unplanned pregnancy.
Fewer prostaglandins are released when you have lighter periods, which can make your menstrual cramps less painful. If you’d prefer not to take the contraceptive pill, or if it isn’t suitable for you, there are other types of hormonal contraceptives that can help with period pain such as contraceptive implants, injections and intrauterine system (IUS).
Secondary Dysmonerrhoea
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. Please see your GP for further investigations. Some women may need to be referred to a specialist or have surgery, depending on the condition that’s causing the pain.
Hot Water Bottle & Heat Patches
Using heat patches and hot water bottles are effective ways of relieving period pain for many people. 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.
TENS Machine
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.
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. Partaking in relaxing activities can help soothe the discomfort of period pain. Gentle massage of the lower abdomen can help ease period pain.
Diet
Consuming healthy foods helps to prevent water retention. The overconsumption of fatty foods (along with obesity) has also been linked to higher levels of prostaglandins (the source of period pain). Switching to healthier options that are high in omega-3 fatty acids, calcium, and vitamin D can reduce the risk of period pain. If you need help getting enough of these nutrients in your diet, you can also take supplements like fish oil tablets.
Natural Remedies
There are very few studies that suggest that herbal remedies can treat menstrual cramps effectively. Herbal teas have been used in almost every culture throughout history to treat pains and illnesses. Different teas are thought to treat period pain in different ways, such as having anti-inflammatory effects to reduce cramping or soothing effects for relaxation. Chamomile and ginger are two of the most popular herbal teas used to ease period pain.
Frequently Asked Questions
Pain associated with menstruation is called dysmenorrhea. More than half of women who menstruate have some pain for 1 to 2 days each month. Usually, the pain is mild. But for some women, the pain is so severe that it keeps them from doing their normal activities for several days a month.
Most women have some pain with their menstrual periods. For some women, severe pain comes with other symptoms, including diarrhea, nausea, vomiting, headache, and dizziness.
There are two types of dysmenorrhea: primary and secondary. Primary dysmenorrhea is the cramping pain that comes before or during a period. This pain is caused by natural chemicals called prostaglandins that are made in the lining of the uterus. Secondary dysmenorrhea is caused by a disorder in the reproductive organs. The pain tends to get worse over time and it often lasts longer than normal menstrual cramps.
Primary dysmenorrhea begins soon after a girl starts having menstrual periods. In many women with primary dysmenorrhea, periods become less painful as they get older. This type of period pain also may improve after giving birth.
Some of the conditions that can cause secondary dysmenorrhea include the following: Endometriosis, Fibroids, Adenomyosis, problems with the uterus, fallopian tubes, and other reproductive organs, Other conditions such as Crohn’s disease and urinary disorders.
Gentle exercising like swimming, walking or cycling may help to reduce the pain. A warm bath, or sleeping with a hot water bottle may also help soothe period pain. Having a back and stomach massage may be useful, and relaxation techniques like yoga or pilates can also help. Stopping smoking may help improve the pain.
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. Paracetamol would be the suitable alternative for those patients who are not allowed to take ibuprofen and aspirin. If over-the-counter pain-relief is proving ineffective, your GP can prescribe you a stronger painkiller, such as Naproxen. Combined oral contraceptive 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. If the combined contraceptive pill proves to be unsuitable, contraceptive implants or injections may be a good alternative.
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. It is also recommended to speak with your GP should the normal patterns of your periods change significantly. 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.
Experiencing period pain when you are not on your period can be a little alarming, but pelvic pain is actually very common. Nevertheless, severe or mild cramps at other times in your cycle than your period could be a sign of an underlying medical condition, so it’s always best to keep an eye on your symptoms and speak to your GP if they persist.
Many underlying conditions and changes in the body can result in period-like pain and other similar symptoms, such as: Ovulation, Pelvic inflammatory disease (PID), Endometriosis, Stress, Ovarian cysts, Pregnancy
If your period is several days late but you have cramps, this may be related to one of the above reasons. However, even regular periods can go off track sometimes, and it may just be a one-off month in which your period comes later than expected. If you think there’s any chance that you might be pregnant, take a test as soon as possible.
To relieve the cramping, try the following remedies: Place a hot water bottle, warm compress or heated pad over your lower stomach to relieve muscle tension. Try Feminax Express, Ibuprofen or Paracetamol for pain relief. Avoid crouching and bending over, and make time to lie outstretched to relax the muscles. If you feel up to it, try gentle exercises such as walking or swimming.
Premenstrual syndrome (PMS) symptoms can include cramps, and other symptoms, but they usually come before a period. Treatment for PMS can include hormonal contraception, as well as mild antidepressants and painkillers for cramping.
You shouldn’t take mefenamic acid while you are breastfeeding. While there aren’t many studies into the effect of mefenamic acid on breastmilk, the medicine could potentially make your breastmilk unsafe for your baby to drink. Other NSAIDs, such as ibuprofen, are recommended because they are proven to be safe.
Yes, it’s totally fine to take your contraceptive pill while taking mefenamic acid.
Drinking alcohol while taking mefenamic acid can cause the drugs to interact, which can irritate your stomach and cause side effects. In some cases, it can cause bleeding in your stomach and/or intestines.
An ultrasound exam may be done when pain is not relieved with medications. In some cases, an ob-gyn may recommend a laparoscopy. This is a procedure that lets an ob-gyn view the organs in the pelvis. With laparoscopy, a small incision (cut) is made near the belly button. A thin, lighted camera—a laparoscope—is inserted into the abdomen.
NSAIDs work best if taken at the first sign of your period or pain. You usually take them for only 1 or 2 days. Women with bleeding disorders, asthma, aspirin allergy, liver damage, stomach disorders, or ulcers should not take NSAIDs.
Birth control methods that contain estrogen and progestin, such as the pill, the patch, and the vaginal ring, can be used to treat painful periods. Birth control methods that contain progestin only, such as the birth control implant and the injection, also may reduce period pain.
Yes, the hormonal intrauterine device (IUD) also can be used to treat painful periods. For many women with an IUD, menstrual bleeding gets lighter the longer the IUD is in place. In some cases, bleeding stops for women with an IUD.
Acupuncture, acupressure, and nerve stimulation therapies may be useful for treating painful periods. Physical therapy that eases trigger points also may help with pain.
Some types of physical therapy teach mental techniques for coping with pain. These types include relaxation exercises and biofeedback.
Vitamin B1 or magnesium supplements may be helpful, but not enough research has been done to recommend them as effective treatments for period pain.
If your symptoms or a laparoscopy point to endometriosis as the cause of your period pain, your ob-gyn may recommend you try a birth control method: the pill, the implant, the injection, or the hormonal IUD.
If other treatments do not relieve pain, surgery may be recommended. The type of surgery depends on the cause of your pain: Fibroids can sometimes be removed with surgery. Endometriosis tissue can be removed with surgery. Hysterectomy also may be recommended for other conditions when they cause severe pain. This surgery usually is a last resort.
The best tablets for period pain will differ from person to person. Some people will find taking paracetamol or ibuprofen is effective at providing relief. Others may need to speak to their GP to get stronger painkillers like naproxen and mefenamic acid.
