Know Your Pain: Period Pain – Symptoms, Causes and Treatments
By Alpro Pharmacy
September 5, 2022
Oh my! It’s that time of the month again! You know, that time when you feel like someone is punching you hard in the stomach repeatedly and you just want to lie in bed all day. Yeah, that time – Aunt Flo comes for a visit! For some women, menstrual days are an agony that goes far beyond bleeding. A painful condition that disturbs their daily activities.
Photo adopted from: https://www.bebeautiful.in/all-things-lifestyle/health-and-wellness/5-ways-to-relieve-period-cramps
What Pain Are We Talking About?
Period or menstrual pain (also known as dysmenorrhoea) is pain in the lower abdomen most women experience just before or during their menstrual periods. The severity of period pain varies between women – from a mild annoyance to severe pain. It affects up to 80% of women at some stage in their lifetime. But for 1 in every 10 women the pain is severe enough to interfere with their quality of life.
Period pain usually manifests as throbbing or cramping pain in the lower abdomen, but it may also be a dull, constant ache. Sometimes, it may radiate to the lower back and thighs. Pain typically commences 1 to 3 days prior to menstruation, peaks 24 hours after the onset of menstruation and subsides after 2 to 3 days. Other symptoms that may occur include:
- Nausea and vomiting
Period pain due to the body’s natural menstrual process is known as primary dysmenorrhea. It occurs when hormone-like substances called prostaglandins are released from the lining of the uterus (womb) and cause contraction of the muscles in the uterus to shed the thickened lining. This contraction may also reduce blood flow to the uterus, exacerbating the pain. Pain usually begins 1 to 2 years after the first period starts and is likely to improve with age and after childbirth.
Period pain can also be the result of the use of intrauterine devices and certain reproductive disorders, such as endometriosis, uterine fibroids or adenomyosis. This type of period pain is known as secondary dysmenorrhoea which usually causes a change in the intensity and duration of a normal pattern of period pain. For example, a woman never experienced period pain or had mild period pain but suddenly experiences an increased pain intensity or longer duration of pain that continues after the period ends.
Several factors have been proven to increase the risk of period pain, including:
- Being under the age of 30
- First menstruation before the age of 11
- Irregular periods
- Heavy menstrual flow
- Being overweight
- Depression or anxiety
- Nulliparous (have never given birth)
- Smoking and alcohol consumption
- Family history
Coping With Period Pain
Period pain that is caused by underlying medical conditions will need to be diagnosed and treated accordingly.
For cases of period pain that are mild enough to manage at home, the following suggestions may help reduce the severity of the pain:
- Over-the-counter (OTC) pain-relieving medications: Non-steroidal anti-inflammatory drugs (NSAIDs) such as mefenamic acid, ibuprofen or naproxen, taken at the first sign of menstruation or pain and continued for 2 to 3 days as directed may relieve menstrual pain and lighten the flow of blood. For those who cannot take NSAIDs due to medical conditions such as asthma, allergy, stomach ulcers or kidney problems, paracetamol is an alternative painkiller. Always speak with your doctor or pharmacist first before starting medications.
Photo adopted from: https://www.forbes.com/health/family/birth-control-pills-types-side-effects/
- Hormonal birth control pills: A good option to reduce menstrual flow, shorten menstrual duration and reduce menstrual pain if OTC medicine does not provide relief. Talk to your doctor about trying the birth control pill, patch, injection or ring.
- Heat therapy: Place a heat pad/pack or hot water bottle (wrapped with cloth) on the abdomen or take a warm bath may improve blood flow and reduce pain.
- Gentle massage: Light circular massage around lower abdomen
- Regular exercise such as jogging, walking, cycling, yoga or pilates
Photo adopted from: https://www.wikihow.com/Deal-With-Cramps-when-You%27re-Not-Home
- Quit smoking: Smoking is thought to increase the risk of period pain by reducing oxygen supply to the uterus
- Dietary modification: Increase intake of food rich in omega-3 fatty acids (salmon, mackerel, chia seeds), fibre (fruits and vegetables), protein (eggs, legumes) and calcium (nuts, low-fat dairy products, tofu). Limit intake of alcohol, caffeine and sugary food.
- Supplements: Vitamin E (200IU daily), vitamin D (1000IU daily), magnesium (300mg-600mg daily) have been shown to relieve menstrual cramp by reducing prostaglandin levels. In addition, chasteberry may be effective in period pain relief by restoring hormonal balance in the body.
- Alternative therapies: Transcutaneous electrical nerve stimulation (TENS), acupuncture
When To See A Doctor?
You should talk to your healthcare provider about painful periods if you experience any of the following:
- Start to get period pain when you previously had none
- Pain becomes more severe that it affects daily activities
- Pain lasts longer than it used to
- Pain during sex
- Pain between periods
- Periods become heavier than usual or irregular
- No or minimal relief from painkillers
Your healthcare provider will likely review your medical history, perform pelvic examinations and some tests such as ultrasound or CT scan to confirm or rule out underlying medical conditions.
Although menstruation is an important part of women’s health, severe period pain need not be. You don’t have to put up with it as menstrual pain can usually be treated effectively.
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Dealing with Period Pain?
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Managing pain well involves multidisciplinary care, it is not only about medication.
- Cornforth, T. (2021, July 23). Chasteberry Is a Centuries Old Remedy for Menstrual Problems. Verywell Health. https://www.verywellhealth.com/what-is-chasteberry-2721967
- Fletcher, J. (2021, November 26). What to eat on your period to relieve symptoms. Medical News Today. https://www.medicalnewstoday.com/articles/what-to-eat-on-your-period#foods-to-avoid
- Mayo Clinic. (2022, April 30). Menstrual cramps. https://www.mayoclinic.org/diseases-conditions/menstrual-cramps/symptoms-causes/syc-20374938
- Pinkerton, J. V. (2022, August 22). Dysmenorrhea. MSD Manual Professional Edition. https://www.msdmanuals.com/professional/gynecology-and-obstetrics/menstrual-abnormalities/dysmenorrhea#v1062484
- The Royal Women’s Hospital. Exercise, diet & periods. https://www.thewomens.org.au/health-information/periods/healthy-periods/exercise-diet-periods
- Tyagi, T. (2021). 5 ways to alleviate painful period cramps. [Photograph]. https://www.bebeautiful.in/all-things-lifestyle/health-and-wellness/5-ways-to-relieve-period-cramps
- WikiHow. (2021). How to Deal With Cramps when You’re Not Home. [Photograph]. https://www.wikihow.com/Deal-With-Cramps-when-You%27re-Not-Home