WE all either know somebody who suffers badly during their “time of the month”, or are that person ourselves. The monthly visit of our menstruation cycle can be annoying, inconvenient, and sometimes incredibly painful.
Painful periods, also known as dysmennhorea, affect up to three quarters of young women, with that proportion reducing to 25-50% for older women. The pain severity can range from not too severe to debilitating, and can be in the tummy, sides and even thighs, lasting 12-72 hours typically.
The pain can sometimes be accompanied by other symptoms such as pressure, headache, cramping, backache, nausea or vomiting.
Symptoms start either one to two days before your period, or on the day your period begins. The pain is caused by increased levels of chemicals called prostaglandins which make the muscle contract, but if they contract too much it can cut off some of the nearby blood vessels supplying oxygen to the muscle, and this triggers the pain.
So what can you do to improve the monthly experience? It’s not something that you need to just tolerate. Although exercise may be the last thing you feel like doing, it can be very helpful because it firstly distracts from the symptoms, and also helps to release feel-good endorphins that distract from the pain.
Heat will be your best friend, whether that’s in the form of a hot water bottle, a heat patch, or a warm bath. It helps to relax the muscles and reduce the cramping, and can be really soothing as a precursor or addition to medication.
Anti-inflammatories can help with the pain by reducing the levels of prostaglandins and therefore the cramping, and can even be started a few days before the period arrives to help with the symptoms.
Ibuprofen is available without prescription. Stronger anti-inflammatories such as Ponstan are available on prescription if the ibuprofen isn’t working well enough.
Paracetamol is suitable to take in conjunction with the anti-inflammatories, and at its maximum dose can provide good relief.
Buscopan is an anti-spasmodic that is available over the counter and can be helpful for any cramping.
Codeine can be used very short term in some cases after consultation with your pharmacist, and if other pain relief has not been successful at curbing the pain, but it can cause drowsiness and sometimes constipation.
With any of the above over the counter medications, there are specific reasons why they may not suit you so always make sure to seek advice first.
While primary dysmennorhea is not due to any specific issue, secondary dysmennorhea is when an underlying cause leads to the painful periods, and most commonly occurs in your late thirties. This could range from fibroids, endometriosis, pelvic inflammatory disease, or issues with the intra-uterine coil. Secondary dysmennorhea pain lasts longer than primary pain, and doesn’t usually come with the additional symptoms. For this reason it’s important to get recurrent severe period pain checked out, to rule out any of the above conditions.
We tend to think period pain is just part of the package, and we should suffer in silence. However, if it’s affecting your work or daily life, if it makes you bed-bound or needing to take sick leave, then it’s something that can be improved for you with appropriate treatment.
As well as the avenues mentioned above, oral hormonal contraception may be advised to reduce the pain and/or heaviness/frequency of the bleed. It’s worth ruling out anything secondary, and then taking the appropriate steps to manage it so that it doesn’t become a looming fear on the horizon every month.
Dr Michelle O’Driscoll is a pharmacist, researcher and founder of InTuition, a health and wellness education company.
Her research lies in the area of mental health education, and through InTuition she delivers health promotion workshops to corporate and academic organisations nationally.