Period Pain

What is period pain?

Pain during menstruation is incredibly common. In varying degrees, it affects or has affected the vast majority of women.

The medical term for pain that accompanies menstruation is dysmenorrhea. This can be split into two distinct types - primary (caused by your period) and secondary (pain exacerbated by a condition during your period). You may experience menstrual cramps without any bleeding or pain with bleeding.

Although pain during your period is normal, you should not disregard it. If you find your period pain is extreme or having an impact on your life, speak to your doctor. You may require medication, or it may indicate another more serious underlying condition.

What causes period pain?

During the first stage of your menstrual cycle, called the follicular phase, your ovaries will begin to produce eggs and the lining of your uterus will start to thicken. The lining will continue to thicken until the latter stages of your cycle - this is to create an environment for a fertilized egg to embed in.

If you do not get pregnant, your body will need to expel this lining. Hormone-like chemicals called prostaglandins cause the muscles in the uterine wall to contract, to help push out the wall as period blood. Unfortunately, for many women, these contractions can be very painful. In general, women who experience higher levels of pain have a higher concentration of prostaglandins.

Contributing factors

Certain conditions and the use of certain devices may make period pain worse.

Secondary dysmenorrhea is defined as menstrual pain exaggerated by any of the following conditions (and others):

• endometriosis - where cells that normally make up the uterine lining grow elsewhere
• pelvic inflammatory disease (PID) - an infection of the upper-gential tract, particularly the uterus, ovaries and fallopian tubes
• fibroids - non-cancerous growths that develop in the uterus
• adenomyosis - where the endometrial lining of the uterus forms with the muscles

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.

Symptoms of the above conditions and bad reactions to the IUD (other than increased period pain) include irregular periods, unusual discharge, pain during sex and pain outside of menstruation. If you think you may have a contributing condition, you should see your GP or a gynecologist as soon as possible - these conditions can have long-lasting complications.

What other symptoms are associated with period pain?

Pain during menstruation is different for every woman. It most often presents as cramps, which will feel as though they are originating in the lower abdomen - you may also experience a throbbing or spasming pain. Again, 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.

Other symptoms, indirectly caused by the presence of pain or the increase in prostaglandins include:

• nausea
• vomiting
• diarrhoea
• gastrointestinal pain

You may find the intensity of symptoms is most apparent when your flow is heaviest.

If any of these become too intense or cause you any distress, you should seek medical assistance. You should also seek medical help if any of the following apply to you:

• you have a fever during menstruation
• you have very heavy bleeding
• pain increases with age
• you have pain outside of menstruation
• your period impacts daily life

How can I reduce period pain without medication?

Not all period pain is intense enough to require medication, and not all people want to take medication (for various reasons).

You may find some alleviation of pain by experimenting with the following home remedies and lifestyle changes:

• apply heat - heat therapy works by relaxing uterine muscles - the ones that are cramping and causing you pain. Try placing a hot water bottle or heat pad on your lower abdomen.
• exercise - when you exercise, your brain releases endorphins. These are feel-good hormones that reduce pain. Regular exercise also reduces bloating, which can exacerbate pain.
• diet - along with exercise, 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).
• stay hydrated - dehydration causes muscle cramps, including uterine cramps.
• orgasm - this is another way to release pain-fighting endorphins. Whether with a partner or alone, you may find this an effective method of momentarily alleviating period pain.
• massage - by focussing on the abdominal area, you can alleviate uterine muscle contractions. Acupuncture can also be applied for the same results - consult a professional for this service.

What treatments are available?

There are many different ways of treating period pain, however, it has been shown that the most effective method is by using anti-inflammatory drugs. In particular, nonsteroidal anti-inflammatory drugs (NSAIDs). These include ibuprofen, naproxen and mefenamic acid.

Inflammation occurs as your body breaks down endometrial cells (womb lining). Unfortunately, pain accompanies inflammation - taking an anti-inflammatory can be an effective way to manage this. You can get medication like ibuprofen over-the-counter without a prescription. However, more powerful NSAIDs require a prescription from your doctor.

Another means of treating period pain is to use hormonal contraception (if you’re not currently). Along with providing protection against unplanned pregnancy, hormonal contraceptives can ease menstrual symptoms including pain and heavy flows. These work as the hormones in the contraceptive prevent ovulation. You should speak to your doctor about how to use contraceptives to manage your period.

Can I buy these online?

HealthExpress currently sells the NSAID Mefenamic Acid online. As this is a prescription painkiller, you must first complete a consultation form where you will be asked to answer some short medical questions. You should complete these accurately.

Our doctors will review the completed consultation to make a decision whether or not the treatment can be prescribed. If they approve, it will be sent from our pharmacy with next-day delivery. If they do not approve, you will not be charged. Assuming there are no issues, the entire process, from order to delivery can take under 24 hours.