What causes painful periods and how can you reduce the pain?
Did you know the medical term for menstrual cramps is “Dysmenorrhea”? Almost every woman can vouch to have experienced menstrual cramps severe enough to need medication. In reality, periods may be a permanent part of our lives, the severe pain associated with periods, on the other hand, need not be. The lack of awareness added to the social stigma associated with menstruation contributes to millions of women suffering silently from period pain. In this article, Dr Anjali Kumar, reputed obstetrician and gynaecologist in Delhi NCR talks about painful periods, its possible causes and preventive measures.
What are periods?
Before we understand why periods can cause extreme pain in some women, let us understand what happens in the body during this process.
Every month, the female body prepares itself for pregnancy by building up the uterine lining. When the matured egg released by the ovaries every month is not fertilised, the body starts shedding this excess uterine lining resulting in “periods”. In order to push out the excess lining from the vagina, the uterine muscles contract and relax. This may result in severe muscle cramps for some women, and be barely noticeable in others.
Period pain need not be limited to the abdomen, it can also manifest as pain in the back, legs, thighs etc. It can also cause nausea, vomiting and diarrhoea.
Types of period pain (menstrual pain)
Did you know that there are two different types of period pain? Doctors classify dysmenorrhoea (period pain) into two main categories:
- Primary dysmenorrhoea
- Secondary dysmenorrhoea
Primary dysmenorrhoea is pain that is mainly caused by the uterine muscle contractions. It is more common in women under the age of 30 years and women who experience heavy periods.
Secondary dysmenorrhoea is pain that is caused by factors other than muscle contractions. It can be due to benign growths in the uterus such as fibroids. It can also be due to conditions such as endometriosis.
What causes period pain?
As highlighted above, period pain develops majorly due to muscle contractions in the uterus. These contractions are triggered by hormone-like substances called prostaglandins. Higher levels of prostaglandins are associated with more severe menstrual cramps. They can be caused by:
Endometriosis: A condition where the endometrial lining (lining of the uterus) grows outside the uterus, usually on the fallopian tubes, ovaries etc.
Uterine fibroids: Uterine fibroids are benign (non-cancerous) growths in the wall of the uterus
Adenomyosis: Adenomyosis is a painful condition where the uterine lining grows into the muscular wall of the uterus
Pelvic inflammatory disease: PID is an infection of one or more of the upper reproductive organs such as the uterus, ovaries or fallopian tubes. It can spread through sexual intercourse.
Cervical stenosis: Is a condition where the cervical opening is too small causing issues in regular menstrual flow. This results in a painful increase in pressure inside the uterus.
Painful periods can also be the result of several other underlying conditions. Your gynaecologist can help in identifying the root cause of the pain for a more effective treatment plan.
Who is at a greater risk of having painful periods?
It is still unclear why some women have extremely painful periods while some experience no discomfort at all. Some of the risk factors of painful periods are:
- Starting periods very early (earlier than 11 years of age)
- Being younger than 30 years of age
- Having heavy periods
- Having irregular periods
- Having a history of menstrual cramps
How are painful cramps treated?
If you experience extremely severe pain every month that impacts your daily life, your doctor can recommend any of the following treatment options:
Pain relieving medications
This is the first line of defence against painful periods. Over the counter pain medications can be used to manage mild to moderate period pain. If required, your gynaecologist may also prescribe stronger pain killers.
Hormonal birth control
In some cases, gynaecologists might recommend the use of hormonal birth control to prevent ovulation and reduce the severity of period pains. They should be used only if recommended. These medications also have several side effects, so make sure you are aware of them before you start taking them.
If your period pains are caused due to conditions such as endometriosis, your gynaecologist might recommend a surgery to treat the underlying condition. In some cases, hysterectomy (surgically removing the uterus) might also be done. However, this is the last resort.
Managing period pains at home
If you believe that your pain is not severe enough to warrant a trip to the hospital, the following tips can help you relive some of the pain at home itself.
Use a warm compress
Apply a hot water bag or warm compress to your lower abdomen and back. You can even take a long hot water bath. This will help in relaxing your uterine muscles, giving you much needed relief from the pain.
While the dull ache in our muscles during our periods can make exercising tougher, physical activity is a proven solution for period cramps. Light exercise such as walking has been shown to reduce the intensity of period pains in some women. Yoga also has several exercises which are designed to relax the uterine muscles and reduce period pain.
Drink a lot of water and keep yourself hydrated during your periods for a smoother and less painful cycle.
While there is insufficient evidence to show the link between period cramps and diet, eating a balanced diet rich in vitamins and fibre such as lean meat, fresh fruit, green vegetables and whole grains, has shown to have a positive impact on our menstrual health.
Even today, there is a lot of stigma around menstruation and periods. There have also been several initiatives that started to address the problems caused by period pains such as corporates recognising “period leaves” every month. However, there is a long way to go in increasing awareness about menstrual cramps and pain. To know more about how to have a pain-free and smooth menstrual cycle, you can consult Dr Anjali Kumar at the CK Birla Hospital, Gurgaon.
Also, read: Lifestyle and diet tips for PMS