Brief overview
- Treatment: Exercise, heat, medicinal plants (lady’s mantle, yarrow, monk’s pepper, St. John’s wort), pain and antispasmodic medications, treatment of underlying condition
- Prevention: hormonal contraceptives, endurance sports, balanced diet.
- Causes: Contractions of the uterine muscles; primary period pain not due to disease, secondary period pain due to an underlying disease such as endometriosis
- When to see a doctor? In case of sudden onset of period pain, painful bleeding after menopause, noticeable changes in the intensity and duration of period pain, and altered bleeding.
- Diagnosis: patient interview (anamnesis), gynecological examination, imaging procedures such as ultrasound or magnetic resonance imaging (MRI)
What is period pain?
Period pains are contraction-like lower abdominal pains shortly before and during menstruation. Doctors also speak of dysmenorrhea.
The pain is triggered by contractions of the uterine muscles. During menstruation, the organ contracts spasmodically to expel the newly formed uterine lining each month if fertilization has failed.
Menstrual pain can be divided into:
- Primary period pains: They often occur during the first menstrual period (menarche) and accompany the affected women until menopause. There is no physical illness involved.
- Secondary menstrual pain: Usually occurs after the age of 30 or 40 and is due to a gynecological disease, such as endometriosis. Endometrium is a condition in which the lining of the uterus grows outside the uterus. Polyps, inflammation of the fallopian tubes and contraceptives such as the IUD are also possible triggers for secondary period pain.
What helps against period pain?
For secondary period pain, it is necessary to treat the underlying condition (such as endometriosis or tubal inflammation).
Medications for menstrual pain
The following medications have been shown to be helpful in treating severe period pain:
- Painkillers: non-steroidal anti-inflammatory drugs (NSAIDs) with active ingredients such as ibuprofen, paracetamol and acetylsalicylic acid are particularly effective in reducing pain. However, these medications often attack the stomach lining when taken frequently. Therefore, use them sparingly or take an additional stomach-protecting preparation.
- Antispasmodics: Antispasmodics such as butylscopolamine relax the muscles and thus relieve period pain.
- Hormone preparations: Women who do not currently wish to become pregnant often resort to hormonal contraceptives such as the “pill” for period pain. They often greatly reduce period pain.
Home remedies
Various home remedies are said to help against period pain. These can be used at home without much effort.
Heat
A warm grain pillow (cherry pit pillow) or a hot water bottle are also said to help against menstrual cramps.
Apply these home remedies only as long as the heat is comfortable. For those with heart disease or neurological conditions, it is recommended that you always consult with your doctor before using heat.
Abdominal compress with chamomile
A hot and humid abdominal compress with chamomile is said to have an analgesic, antispasmodic and also relaxing effect. To do this, pour half a liter of boiling water over one to two tablespoons of chamomile flowers. Allow the decoction to steep, covered, for a maximum of five minutes and then strain off the plant ingredients.
Then place a rolled-up inner cloth in a second cloth and roll the whole thing up into a poultice. Let it soak in the hot tea with the ends hanging out and then wring it out (caution: danger of scalding!).
Read more about the effects of chamomile in the medicinal plants article about chamomile.
Potato wrap
A potato wrap on the abdomen is also suitable as a home remedy for period pain. The potatoes store the heat particularly well and give it off for a long time.
How to properly prepare and apply the wrap, you will learn in our article potato wrap.
Tea
What to do for period pain? Drink tea! Because many medicinal herbal teas can have an analgesic, antispasmodic and relaxing effect. Teas made from the following medicinal plants are especially good for menstrual cramps:
- Anise
- Vervain
- Melissa leaves
- Sage
- Ginger
- Lady’s mantle
- Yarrow
- Monk’s pepper
- St. John’s wort
Home remedies have their limits. If the symptoms persist over a longer period of time, do not get better or even get worse, please always consult a doctor.
General tips
Movement: The painful contractions of the uterus are associated with reduced blood flow to the organ. This often aggravates the pain. Gentle sports such as yoga, Nordic walking or cycling stimulate blood circulation, loosen the muscles in the pelvis and can thus help against the pain. Even a walk is often enough to relieve acute menstrual cramps.
Nutrition: Legumes, whole-grain rice and nuts are particularly rich in magnesium, which prevents cramps of all kinds.
Sex: During orgasm, the body releases happiness hormones. In addition, the pelvic muscles relax during the sexual climax and blood flow to the entire abdomen increases.
Acupressure: Acupressure may also relieve menstrual cramps. One study provides evidence that three acupressure points may be effective against period pain. These are located
- a hand’s width below the belly button
- on the lower back in the area of the lumbar dimples
Gently apply pressure to these points with your hand and massage the areas. If you have any questions about this, consult your doctor.
Acupressure may also prevent period pain, according to the study. Massage the points regularly several days before menstruation starts.
While there is evidence that acupressure may help with various ailments. However, the concept itself and the specific effectiveness have not been clearly proven by studies.
What helps with intense period pain?
Sometimes period pains are particularly intense. Here, too, home remedies such as heat often provide relief. However, they are more likely to have a supportive effect, for example to reduce the necessary dose and number of conventional painkillers.
Preventing period pain
While most home remedies and pain-relieving medications are aimed at relieving existing acute period pain, some measures also help prevent it.
Taking the “pill
The most effective measure is also the one that has the greatest impact on the female hormone balance: oral contraceptives, i.e. the “birth control pill” with active ingredients such as chlormadinone acetate (CMA). The artificial hormones slow down the build-up of the uterine lining during the menstrual cycle. During the monthly abortion bleeding, correspondingly less mucous membrane is shed, so that the bleeding is significantly weaker. Often, period pain can even be completely eliminated in this way.
Prevention tips
Alternative methods to prevent menstrual cramps include:
- Regular endurance sports (such as jogging, swimming, cycling)
- Sustained adequate intake of magnesium (antispasmodic), omega-3 fatty acids and B vitamins
- Avoiding foods high in arachidonic acid (such as butter, pork, tuna)
- Not smoking (because it inhibits blood circulation)
There is currently evidence, but little robust scientific data, for the effectiveness of certain diets or supplements for dysmenorrhea.
Causes of period pain
The causes of period pain can be divided into primary period pain (without a specific trigger) and secondary period pain (triggered by diseases or external influences).
Causes of primary period pain
The following factors promote primary dysmenorrhea:
- Early onset of the first period (from about twelve years of age).
- Low body weight: very slim women (BMI below 20) are more likely to suffer from primary period pain.
- Familial predisposition: This is indicated if mother or sisters also suffer from period pain.
- A particularly long menstrual cycle
- Psychological strains such as anxiety or stress
Causes of secondary menstrual pain
Organic diseases are often responsible for secondary period pain, for example:
Endometriosis: It is the most common cause of secondary period pain. In affected individuals, endometrium is found scattered throughout the body, especially in the pelvic area. Like the mucous membrane inside the uterus, the pieces of mucous membrane are subject to hormonal changes during the menstrual cycle.
Pelvic vein syndrome: In pelvic vein syndrome, certain blood vessels in the pelvic area are abnormally dilated, causing blood to back up with varicose veins. This causes chronic abdominal pain that often worsens during menstruation. Long periods of sitting, standing or sexual intercourse also often cause pain to affected women. Often, pelvic vein syndrome first appears in women after they have experienced one or more births.
Myomas and polyps: These are benign growths of the muscle wall of the uterus (uterine fibroids) or of the lining of the uterus (uterine polyps). They cause spotting and increased menstrual pain, for example.
Inflammation of the reproductive organs: In some cases, an ascending vaginal infection (colpitis) leads to chronic inflammation of the fallopian tubes, which causes severe menstrual pain and discomfort during ovulation.
Contraceptives: a common side effect of the IUD (intrauterine device, IUD) is menstrual cramps. These include period pain and increased bleeding.
Period pain: When to see a doctor?
If you have been suffering from menstrual pain for a long time, there is usually no cause for concern. If the period pain is new or unusually severe, it is advisable to have it clarified by a gynecologist. It is also advisable to consult a gynecologist if the duration and intensity of the bleeding changes. This is because vaginal infections in particular can be detected and treated at an early stage without resulting in secondary diseases.
A visit to the gynecologist is also recommended if you experience unusually severe period pains that interfere with your everyday life. It is possible that endometriosis or another disease is behind it.
Period pain: examinations and diagnosis
First, the gynecologist will talk to you and ask you in detail about your complaints and medical history (anamnesis).
During the subsequent gynecological examination, the doctor will examine the mucous membrane, vagina, uterus and ovaries to rule out a physical illness as the cause of the period pain. He also checks the correct fit of contraceptives such as the IUD.
Once the doctor has identified the cause of your period pain, he or she will initiate the appropriate therapy.
