Facts about painful periods

Feb 16, 2020 Dr Zulfikar Bux, Features / Columnists

By Dr Zulfikar Bux
Assistant Professor of Emergency Medicine

Many women experience menstrual pains just before and during their menstrual periods. Statistics show that as many as 90% of adolescent females and above 50% of menstruating women worldwide report suffering from menstrual pains, with 10–20% of them describing their hurt as severe and distressing.
For some women, the discomfort is merely annoying. For others, menstrual pains can be severe enough to interfere with everyday activities for a few days every month. These pains may be because of underlying medical conditions and should not be ignored.
Today we will explain menstrual pain, with the hope that it can shed some light on this annoying condition.

WHY ARE MY PERIODS SO PAINFUL?

During your period, your body makes chemicals called “prostaglandins.” These chemicals cause the uterus to contract or tighten. It’s the same kind of contraction that happens during labour and childbirth. Contractions during a period are normal. But, they can be painful. The medical name for painful periods is “dysmenorrhea.”

ARE THERE MEDICAL CONDITIONS THAT CAN BE CAUSING MY PAINFUL PERIOD?

Yes. The following conditions may be the cause of your painful period:
– Endometriosis. In this painful condition, the tissue that lines your uterus becomes implanted outside your uterus, most commonly on your fallopian tubes, ovaries or the tissue lining your pelvis.
– Uterine fibroids. These noncancerous growths in the wall of the uterus may be the cause of pain.
– Adenomyosis. In this condition, the tissue that lines your uterus begins to grow into the muscular walls of the uterus.
– Pelvic inflammatory disease (PID). This infection of the female reproductive organs is usually caused by sexually transmitted bacteria.
– Cervical stenosis. In some women, the opening of the cervix may be so small that it impedes menstrual flow, causing a painful increase of pressure within the uterus.

WHAT DO PAINFUL PERIODS FEEL LIKE?
Women with painful periods have cramping in the lower belly. The cramps can be mild or bad. You might also have pain in your back or thighs. Pain often starts with your period or right before your period.
Some women also have:
– Nausea
– Diarrhea
– Extreme tiredness
– Headache
– Bloating (a feeling of fullness in the belly)

SHOULD I SEE A DOCTOR?

See your doctor if:
– The pain is getting worse
– Pain medicine isn’t helping
– You also have pain well before or well after your period
– The pain is preventing you from performing daily activities.

ARE THERE TESTS I SHOULD HAVE?

Your doctor will decide which tests you should have based on your age, other symptoms, and individual situation.
Most women need only a physical exam. In the exam, your doctor will check the size and shape of your vagina, cervix, uterus, and ovaries. If the exam isn’t normal or pain medicine doesn’t help, your doctor might do other tests. These include:
– Pelvic ultrasound – This test uses sound waves to make a picture of your uterus, ovaries, and vagina to see if they look normal.
– Tests for infections that you catch during sex
– Laparoscopy – This is a type of surgery. The doctor will put you to sleep and make a small cut just below your belly button. Then, he or she will use a thin tool with a camera on it to see inside your belly.

HOW ARE PAINFUL PERIODS TREATED?

That depends on what is causing your painful periods. The most common treatments are:
– Pain medicines
– Birth control pills or other types of birth control that involve hormones
– Surgery may be an option if a medical condition is the cause of your painful period.

ARE THERE LIFESTYLE ADJUSTMENTS THAT CAN HELP?

Doing the following may help to minimize you period pains:
– Exercise. Studies have found that physical activity may ease the pain of menstrual cramps.
– Heat. Soaking in a hot bath or using a heating pad, hot water bottle or heat patch on your lower abdomen may ease menstrual cramps. Applying heat may be just as effective as over-the-counter pain medication for relieving menstrual cramps.
– Dietary supplements. A number of studies have indicated that vitamin E, omega-3 fatty acids, vitamin B-1 (thiamine), vitamin B-6 and magnesium supplements may effectively reduce menstrual cramps.
– Avoiding alcohol and tobacco. These substances can make menstrual cramps worse.
– Reducing stress. Psychological stress may increase your risk of menstrual cramps and their severity.