Understanding Period Pain And The Warning Signs

What is Period Pain?
Period pain, medically known as dysmenorrhoea, is characterized primarily by crampy discomfort in the lower abdomen. Interestingly, many

individuals experience painless periods initially, with pain often manifesting 6-12 months after menstruation begins.

Common Symptoms of Period Pain:

  • Crampy Pain: This typically originates in the lower abdomen but can radiate to the lower back and thighs.

  • Onset of Pain: Pain generally coincides with the start of bleeding, though it may begin up to a day prior.

  • Duration: The intensity and duration of pain can vary, often lasting between 12 to 24 hours, but it may extend up to 2-3 days in some cases.

  • Variability: Each menstrual cycle may present different levels of discomfort, with some periods being more painful than others.

  • Age Factor: Many women find that pain decreases with age or after childbirth.

Associated Symptoms: In addition to abdominal cramps, you might also experience:

  • Fatigue

  • Nausea

  • Breast tenderness

  • Headaches

  • Emotional fluctuations

  • Bloating

  • Diarrhea

When to Seek Medical Attention

Certain symptoms may indicate more serious underlying conditions and require prompt medical evaluation:

  • High Fever: Suggests a potential infection.

  • Vaginal Discharge: Could indicate infection or other issues.

  • Sudden Severe Abdominal Pain: This may signal complications such as ectopic pregnancy or ovarian torsion.

  • Pain During Intercourse: Can point to various reproductive health concerns.

  • Abnormal Bleeding: Such as bleeding between periods or after intercourse, should be evaluated by a healthcare professional.

Types of Dysmenorrhoea

  1. Primary Dysmenorrhoea: This common type of menstrual pain occurs without any underlying reproductive issues. It typically affects younger women, especially teens and those in their 20s.

  2. Secondary Dysmenorrhoea: This refers to period pain resulting from an underlying medical condition, often affecting women in their 30s and 40s. Conditions that may cause secondary dysmenorrhoea include:

    • Endometriosis

    • Uterine Fibroids

    • Pelvic Inflammatory Disease (PID)

Signs that may indicate Secondary Dysmenorrhoea:

  • Changes in pain patterns, such as increased severity or duration.

  • Pain extending beyond the usual timeframe, often starting days before menstruation.

  • Additional symptoms like irregular periods, heavy bleeding, or pelvic discomfort.

Diagnosis and Tests

For many, especially teenagers, the diagnosis is straightforward based on symptom discussion. A healthcare provider may perform an abdominal examination to confirm primary dysmenorrhoea. However, if symptoms are atypical, further investigations might include:

  • Internal Pelvic Examination: To assess for conditions like fibroids.

  • Ultrasound Scans: To visualize the uterus and pelvis.

  • Hysteroscopy or Laparoscopy: Advanced procedures to inspect internal reproductive structures.

Managing Period Pain

Most women can effectively manage mild to moderate period pain at home. However, if pain is severe and disrupts daily life, consult a healthcare provider. Here are some self-care strategies:

  • Stay Active: Gentle exercises, massages, and relaxation techniques can be beneficial.

  • Heat Therapy: Applying a warm compress or taking a hot bath may provide relief.

  • Pain Relief Medications:

    • Non-Steroidal Anti-Inflammatory Drugs (NSAIDs): Such as ibuprofen or mefenamic acid, are effective for many. It’s crucial to take them at the onset of pain or bleeding for maximum effect.

    • Paracetamol: A suitable alternative for those who cannot take NSAIDs.

Hormonal Options:

  • Combined Hormonal Contraceptives (CHC): Available in pill, patch, or ring forms, these can reduce pain and regulate heavy bleeding.

  • Intrauterine System (IUS): A long-term contraceptive that releases hormones to lessen pain and bleeding.

  • Progestogen-Only Options: For those who cannot use combined hormonal contraceptives.

Alternative Therapies:

  • TENS Machines: These devices provide electrical stimulation that can help alleviate pain without medication.

Addressing Secondary Dysmenorrhoea

Treatment for secondary dysmenorrhoea is focused on the underlying cause. If you have an intrauterine device (IUD) and experience painful periods, treatments for primary dysmenorrhoea can be effective. However, some may opt for removal if symptoms persist despite treatment.

If you are struggling with period pain that prevents you from carrying out your daily activities, you should speak to a Gynaecologist.

Dr Kohli can discuss your concerns in detail and make a personalised treatment plan for you based on your unique circumstances