Period pain: What it is and how to relieve it

Period pain: What it is and how to relieve it
Photo source: Getty images

Pain in the lower abdomen, nausea, headache, weakness, fatigue, period, monthly cycles. Not everyone is fortunate enough to go through menstruation without any difficulties. More than two-thirds of adolescents and half of those who have reported on it experience pain and cramps.

Menstrual pain is professionally called dysmenorrhea. It is a consequence of the body's coping with the hormonal changes that come during the cycle.

What causes severe to excruciating menstrual pain? 
Does the pain shoot up your lower back, your rectum, all the way down to your feet?
Is a delayed or missed period a problem?
How can these conditions and situations be alleviated or helped?

What causes it?

Increased production of endometrial prostaglandins results in uterine spasms. These are manifested by pain in the lower abdomen.

Hormones also affect the digestive tract. They are the cause of increased motility, i.e. the ability of an organism to move independently, like the stomach and the intestines. This is what causes nausea, vomiting and other digestive discomforts.

In addition to abdominal and lower abdominal pain, women also experience:

  • headache, especially migraine headache
  • nausea, feeling like vomiting (nausea)
  • vomiting
  • diarrhea
  • distended abdomen
  • fatigue
  • nervousness, irritability

Many women also complain of shooting pain from the lower abdomen to the back, sacrum, through the gluteal area, anus and into the legs.

cartoon picture of mother and daughter
Photo: Thinkstockphotos

Pain during menstruation accompanies almost half of women and more than two thirds of adolescent girls. And in most cases it is primary dysmenorrhea, which is not caused by any disease.

These difficulties are often hereditary. The cause is a genetically induced increased production of the aforementioned hormones. And it is highly probable that if the mother suffers from it, it will also occur in the daughter.

Length of menstrual cycle

The average length of the menstrual cycle is 28 days, usually a maximum of 35 days, a minimum of 22 days. If the cycle lasts shorter or longer, it may be a disorder or a symptom of a more serious medical condition and problem.

In particular, a short cycle is dangerous. As for the period of menstruation, it is usually 3 to 5 days. If it is longer and a woman bleeds for a longer period of time, with or without pain, she should undergo a medical examination.

Menstrual bleeding may be delayed until it does not occur at all or it may occur at shortened intervals or it may be too weak or, conversely, strong and intense.

When does it occur?

Pain during menstruation is caused by uterine cramps. Sometimes it starts a day or two before the start of menstruation. Sometimes it is on the day of menstruation. 

It is a short-term pain that returns and recurs periodically, mainly in intervals. In some cases, it persists for a long time.

pills hrmonal contraception
Photo: Thinkstockphotos

It is alleviated mainly by the administration of analgesics and antispasmodics. These serve to control pain and relieve spasms. But this is not a permanent solution. This can be the deployment of hormonal contraceptives.

However, in that case, the possible negative consequences and impacts must also be considered. The gynaecologist decides on the use of hormonal treatment on the basis of examinations.

Nowadays, analgesics and antispasmodics designed for women with menstrual pain can be bought. Your doctor or pharmacist at the pharmacy can advise you on the appropriate choice.

Primary and secondary dysmenorrhoea

We talk about primary dysmenorrhea in the case when it is not a symptom of any disease. Otherwise, it is also referred to as functional or spastic.

But apart from this situation, pain can also be caused secondarily, when it is a symptom of a disease. Then it is referred to as secondary dysmenorrhea or also algomenorrhea.

The most common is endometriosis. This is caused by the presence of endometrium in places where it does not otherwise occur.

Particles of the uterine lining appear outside the uterus, for example on the ovaries, fallopian tubes, bladder or bowel.

However, these so-called lost particles of mucous membrane also react to hormonal changes during the cycle and so they also bleed at each menstruation.

a woman lying on the bed has lower abdominal pain and has a red thermoform on her abdomen
Photo: Thinkstockphotos

This, of course, causes pain, for example in the lower abdomen. Alternatively, there may be blood in the urine or excessive bleeding during menstruation.

The problem is that cysts also form around these deposits later on. What makes this disease very dangerous is that it can be responsible for almost half of all cases of infertility in women.

In addition to menstrual pain, however, various diseases can also cause, for example, cycle disruptions, especially excessive bleeding or irregular cycles, or very long bleeding periods.

In addition to primary and secondary, we also know dysmenorrhea membranacea. And this is a condition where the entire endometrium detaches during menstruation and comes off in one piece, like a sac.

The most common causes

Secondary pain can be a symptom of disease, especially:

  • endometriosis
  • inflammation, infectious diseases of the pelvis
  • uterus in RVF position, i.e. retroverted/tilted backward, which means retroversio-flexio uteri, i.e. inverted position of the uterus
  • adhesions, i.e. adhesions in the uterus, for example after curettage
  • scarring in the uterus or cervix
  • polyps
  • cancer (myoma)
  • congenital malformation of Müllerian ducts as rudimentary uterine horn in uterus unicornis
  • the presence of an intrauterine corpus

How to relieve severe and unbearable discomfort? 

Question: How period pain be alleviated?

The infographic gives an insight into what can help with menstrual pain. In addition to medication, there are solutions available that don't have to be found far from home.

Each woman may have different difficulties: pain in the lower abdomen, ovaries during menstruation is typical. Some women report pain in the lower limbs, legs, in the anus.

Often there is a radiation of pain during menstruation into the llwer back. Some women experience mild and others strong menstrual pain.

In addition to difficulties with menstruation, pain can radiate to this area. Abdominal pain as with menstruation can also be a symptom of other diseases and difficulties.

That is why it is certainly not necessary to underestimate prolonged pain during menstruation and, of course, to have regular check-ups in a gynaecological outpatient clinic.

How to treat period cramps at home

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Interesting resources

  • Osayande AS, Mehulic S (March 2014). "Diagnosis and initial management of dysmenorrhea". American Family Physician89 (5): 341–346. 
  • American College of Obstetricians and Gynecologists (Jan 2015). "FAQ046 Dynsmenorrhea: Painful Periods" (PDF). 
  • "Menstruation and the menstrual cycle fact sheet". Office of Women's Health
  • "Dysmenorrhea and Endometriosis in the Adolescent". ACOG. American College of Obstetricians and Gynecologists. 20 November 2018. 
  • "Dysmenorrhea".
  • "Using Foods Against Menstrual Pain". Physicians Committee for Responsible Medicine
  • Gomathy N, Dhanasekar KR, Trayambak D, Amirtha R (November 2019). "Supportive therapy for dysmenorrhea: Time to look beyond mefenamic acid in primary care". Journal of Family Medicine and Primary Care8 (11): 3487–3491
  • Payne LA, Rapkin AJ, Seidman LC, Zeltzer LK, Tsao JC (2017). "Experimental and procedural pain responses in primary dysmenorrhea: a systematic review". Journal of Pain Research10: 2233–2246. 
  • "Dysmenorrhea - Gynecology and Obstetrics". Merck Manuals Professional Edition
  • "Period Pain". MedlinePlus. National Library of Medicine. March 1, 2018. Retrieved November 7, 2018.
  • Janssen EB, Rijkers AC, Hoppenbrouwers K, Meuleman C, D'Hooghe TM (2013). "Prevalence of endometriosis diagnosed by laparoscopy in adolescents with dysmenorrhea or chronic pelvic pain: a systematic review". Human Reproduction Update19 (5): 570–582. 
  • Hilário SG, Bozzini N, Borsari R, Baracat EC (January 2009). "Action of aromatase inhibitor for treatment of uterine leiomyoma in perimenopausal patients". Fertility and Sterility91 (1): 240–243. 
  • Nabeshima H, Murakami T, Nishimoto M, Sugawara N, Sato N (2008). "Successful total laparoscopic cystic adenomyomectomy after unsuccessful open surgery using transtrocar ultrasonographic guiding". Journal of Minimally Invasive Gynecology15 (2): 227–230. 
  • Hacker, Neville F., J. George Moore, and Joseph C. Gambone. Essentials of Obstetrics and Gynecology, 4th ed. Elsevier Saunders, 2004. ISBN 0-7216-0179-0
  • Acién P, Acién M, Fernández F, José Mayol M, Aranda I (November 2010). "The cavitated accessory uterine mass: a Müllerian anomaly in women with an otherwise normal uterus". Obstetrics and Gynecology116 (5): 1101–1109. 
  • Ju H, Jones M, Mishra G (2014). "The prevalence and risk factors of dysmenorrhea". Epidemiologic Reviews36: 104–113. 
  • Li Z, Chen J, Zhao Y, Wang Y, Xu J, Ji J, et al. (April 2017). "Common variants in ZMIZ1 and near NGF confer risk for primary dysmenorrhoea". Nature Communications8 (1): 14900. 
  • Ju H, Jones M, Mishra G (2014-01-01). "The prevalence and risk factors of dysmenorrhea". Epidemiologic Reviews36 (1): 104–113.
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