For many women the arrival of their period is highly anticipated every month – and not for any good reason! Anticipating the painful cramps and negative symptoms that come alongside them too. In particular, the first few days of your period. Sound familiar? In this article, we explore what makes periods so painful, the potential causes and how to manage and alleviate the discomfort. 

 

The symptoms of painful periods

Dysmenorrhea (pronounced dis-men-o-re-ah) is the medical term used for describing particularly painful periods. And with dysmenorrhea, you are most likely to experience dysmenorrhea during the first 3 days of your period.

Dysmenorrhea is NOT the same as PMS (premenstrual syndrome)…so do keep that in mind.

Dysmenorrhea, or painful periods, are even more common than what you may think. In a study of over 21,000 women, over 71% reported having severe abdominal cramps when in their menstruation phase. Dysmenorrhea occurs in women of reproductive age, ranging from 16% to 91% prevalence, with severe pain reported by 29% of these people. Painful periods can be debilitating and in severe cases, can impact your quality of life and well-being.

 

Wondering if you have dysmenorrhea? Typically these very painful periods begin within two years of beginning your period, or as soon as your menstrual cycles have been regular. 

 

To add insult to injury, the suffering from painful periods aren’t only felt in the lower stomach area. Dysmenorrhea is felt in a few different places:

  • Lower abdomen
  • Inner thighs
  • Lower back
  • Pelvic area

These symptoms may occur along with:

  • Nausea
  • Vomiting
  • Headaches
  • Dizziness
  • Fatigue
  • Difficulty sleeping

 

There are two types of dysmenorrhea:

Primary Dysmenorrhea

When painful periods are not associated with any other medical condition.

Secondary Dysmenorrhea

When painful periods are linked to an underlying reproductive medical condition such as PCOS, endometriosis, fibroids, Crohn’s disease and adenomyosis. It is important to note that cancer in the pelvic area may also cause secondary dysmenorrhea.

 

Potential Causes of Painful Periods

Generally speaking, the cause of painful periods are thought to be:

  • Age – It is more common for women under the age of 30 to have dysmenorrhea
  • Smoking
  • A higher or lower than considered ‘healthy’ BMI
  • Long menstrual cycles
  • Not having any children or no pregnancies
  • If you started your periods at a younger age than average
  • If you have had a cesarean in the past
  • History of painful periods in your family
  • Chronic stress, or if you are going through a period of particularly high stress

However, if you have secondary dysmenorrhea, the cause of your period pain would be the medical issue that you have been diagnosed with, but there is potential that some of the above may contribute to your painful periods, too.

It is thought that the particularly painful periods occur because of an excess of prostaglandins that are located in the uterus. Prostaglandins are hormone-like chemicals that trigger muscle contractions in your uterus.

An increased number of prostaglandins in the uterus during your period will not only result a very painful period, but also symptoms such as nausea and diarrhea.

How painful periods can impact daily life

For many, the impact of painful periods extends beyond the physical discomfort:

  • Negative emotional health during your period
  • Negative psychological health during your period
  • Missing days at work, or education
  • Problems functioning as required day-to-day
  • Disruption to social activities and relationships
  • Daily routines and practises are negatively impacted
  • Lower quality of life when on your period
  • Negative impact on your well-being

 

1 in 3 women cannot complete their daily activities due to their painful periods

How to manage a painful period

Grab a pen and paper, or open the notes on your phone. You’re going to want to hear this.

To manage a very painful period, or dysmenorrhea (primary), requires you to be on top of your game. Organisation and a little preparation make all of the difference!

  1. Look into NSAIDs (Non-Steroidal Anti-Inflammatory Drugs). Think ibuprofen and aspirin, which are easy to get over-the-counter. There are better pain killers than just your typical paracetamol variants. NSAIDs are the most ideal pain relief drug for painful periods because they inhibit the production of the prostaglandins that we mentioned earlier. Less prostaglandin response = less pain.
If you haven’t already, you need to get confirmation from your GP that NSAIDs are suitable for you. There are some health conditions that prevent anti-inflammatory drugs from being taken. Please also follow the dosage guidelines.

2. Set timers for your pain relief. We know, it perhaps sounds excessive…but so are your period pains!! The typical recommendation of timing between painkillers is 4 hours (make sure you check the packaging), so set an alarm for 4 hours later after you have taken them.

Our uterus’ work hard, but we work harder!

 

3. Try heat therapy. Heat pads, hot water bottles and hot baths (we’ve even heard someone doing saunas!). Whatever method of heat that is accessible to you, try it. Research has shown that targeted heat can penetrate 1cm below the surface area of a source of heat. A hot water bottle, for example.

Targeted heat helps to ease the cramping of the active muscles during your period and reduce the tension that is caused by muscle spasms. Not only this, the heat that you apply can reduce the pain further because of the nerve compression that it provides.

 

4. Cut the caffeine. It is a well-known fact that caffeine may be a vasoconstricting effect – which means reducing blood flow; having the complete opposite effect of the above! Less blood flow during your period is likely to cause worse cramps…it’d be a good idea to change your Starbucks order to a decaf when on your period.

 

5. Prioritise your sleep. Easier said than done, we know. It isn’t so much the length of sleep that matters (although you should be getting your 7-8 hours daily regardless) but more about the quality. If you are someone who can only manage 6 hours sleep, try to make those 6 hours undisturbed to give your body the best chances of repairing and recovering. You need sleep!

 

6. Exercise. Controversial for some; we understand that for women with secondary dysmenorrhea this may not be an option, but exercise does help reduce period pains. Listen to your body and work with it – we don’t expect you to be running marathons to lessen your period pain. 

 

When should I seek medical advice?

We think women are nothing short of incredible for functioning throughout a period of time each month when their own body is shedding the lining of a vital organ! …but as you know all too well, periods are uncomfortable and painful. We expect some discomfort during periods, but when is the right time to reach out to a Doctor?

We recommend you speak to your GP if you are experiencing:

  • Severe pain – If the pain during your period is so severe that it interferes with your daily activities, you need to speak to someone before your next period. Debilitating periods are NOT normal! 
  • Continued pain throughout your period – We have established that dysmenorrhea is when your period pain is particularly bad during the first 2-3 days, but if your pain does not decrease after this time period, even with taking over-the-counter pain medications, you need to consult a professional. 
  • Disruptive symptoms – We expect a little discomfort with our periods, but symptoms such as excessive bleeding, dizziness, nausea/vomiting and fainting spells are red flags. Get that appointment booked! 
  • New symptoms – If you notice any new and concerning symptoms with your period or your menstrual cycle, you need to consult your GP. The earlier you this can get examined, the better.  
  • Over-the-counter medications and lifestyle changes aren’t working – If you have tried everything (download our comprehensive guide to managing period pain here) and nothing is working, it is time to see a Doctor.  
  • Painful periods alongside irregular menstrual cycles – This combo typically indicates there is something else going on that needs investigating. In some cases, an underlying health condition.  
  • History of pelvic conditions – If you have a history (or in your family history) of pelvic conditions such as endometriosis, pelvic inflammatory disease (PID), or fibroids, and experience worsening pain, we recommend you speak to your GP and get a consultation with a specialist. 

What is normal for one person, may not be normal for another. If you are having doubts or know that something isn’t quite ‘right’, it is always better to speak to your GP and get professional medical investigation and advice to rule out any underlying health issues. 

 

Before you go

Before you go, we need you to know that the pain you experience whilst on your period should not be disruptive to your life, or excruciating. If we had to guess, the likelihood is that you’ve found yourself on this page because your periods are just not manageable. 

This is your sign. Make an appointment with your GP and start the process of what is potentially causing such painful periods, and your options for pain management.

 

FAQs

Why are my periods so painful?
The reason your periods are very painful is likely because of primary or secondary dysmennorhea. There are also some lifestyle choices that you may be making, which will negatively impact how your body deals with your periods.
What causes severe period pains?
The cause of severe period pains could be an underlying condition that is impacting your reproductive health (endometrisosis, polcystic ovarian syndrome, adenomyosis, fibroids etc). Sometimes psychological difficulties can impact how we experience our periods, and lifestyle choices like eating a lot of processed foods, smoking and drinking alcohol.
How can I relieve period pain naturally?
Try completely cutting out, or lower your caffeine consumption when on your period and use heat therapy as a natural pain relief measure.
Is it normal to have extremely painful periods?
No! If you are having extremely painful periods, where they are disrupting your daily life, we strongly recommend you make an appointment with your GP to investigate what the root cause of them are.
When should I see a doctor about painful periods?
There are a number of reasons when you should visit your Doctor about painful periods: The pain is so severe to the point where it impacts your day-to-day life, or well-being There is new symptom/s to your painful periods Over-the-counter pain killers and lifestyle changes have not reduced the pain you experience If you suspect your period pain may be related to a health condition or disease. If you have any history (yourself or the females in your family) of medical conditions that impact periods, especially.
Are there specific foods that can help alleviate period pain?
There is no solid evidence that any specific foods will help to alleviate period pain. However, caffeine and dairy may exasperate your period pain.
Can exercise help reduce period pain?
Yes! Exercise does help to reduce menstrual cramps and contribute to the management of painful periods. We recommend you do exercise that you enjoy and this is manageable for you whilst on your period and with your symptoms.
What are the most effective over-the-counter medications for period pain?
NSAIDs (Non-Sterordial Anti-Inflammatory Drugs) such as ibroprufen and asprin are the best for managing period pain. You need to speak to your GP to confirm that NSAIDs are suitable for you.

References
Chan, W. Y., & Hill, J. C. (1978). Determination of menstrual prostaglandin levels in non-dysmenorrheic and dysmenorrheic subjects. Prostaglandins, 15(2), 365-375. Chauhan, M., & Kala, J. (2012). Relation between dysmenorrhea and body mass index in adolescents with rural versus urban variation. The journal of obstetrics and gynecology of India, 62, 442-445. Ferries-Rowe E, Corey E, Archer JS. Primary Dysmenorrhea: Diagnosis and Therapy. Obstet Gynecol. 2020 Nov;136(5):1047-1058. doi: 10.1097/AOG.0000000000004096. PMID: 33030880. Iacovides, S., Avidon, I., & Baker, F. C. (2015). What we know about primary dysmenorrhea today: a critical review. Human reproduction update, 21(6), 762-778. Jo J, Lee SH. Heat therapy for primary dysmenorrhea: A systematic review and meta-analysis of its effects on pain relief and quality of life. Sci Rep. 2018 Nov 2;8(1):16252. doi: 10.1038/s41598-018-34303-z. PMID: 30389956; PMCID: PMC6214933. Kho, K. A., & Shields, J. K. (2020). Diagnosis and management of primary dysmenorrhea. Jama, 323(3), 268-269. Schoep ME, Nieboer TE, van der Zanden M, Braat DDM, Nap AW. The impact of menstrual symptoms on everyday life: a survey among 42,879 women. Am J Obstet Gynecol. 2019 Jun;220(6):569.e1-569.e7. doi: 10.1016/j.ajog.2019.02.048. Epub 2019 Mar 15. PMID: 30885768. https://www.acog.org/womens-health/faqs/dysmenorrhea-painful-periods#:~:text=Certain%20pain%20relievers%20target%20prostaglandins,be%20bought%20over%20the%20counter

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