Period pain or dysmenorrhea is one of the most common concerns faced by gynecologists or OB/GYNs. Many women and girls are affected and put up with their suffering. To understand why period pain occurs and how to treat and prevent it, read this article.
What is period pain?
Primary period pain (technical term: dysmenorrhea) is the type of pain that starts during menstruation. Usually, this is already the case in affected girls and women from the first menstrual period. Period pain can often last until menopause if it is not treated. The accompanying symptoms can be individually different and also vary greatly in their severity. Very young or very slim women are affected by period pain with above-average frequency. Stress or emotional problems are factors that can aggravate the suffering.
Causes
Apart from so-called secondary period pains, which can be caused by gynecological diseases such as cysts or fibroids, the “usual” type of period pain is promoted by the fact that pain messengers cause the muscles of the uterus to contract when the uterine lining is shed each month. The contraction of the muscles ensures a reduced blood supply to the uterus and this causes the sometimes unbearable pain. So this is a purely biological process that has nothing to do with any abstruse theories.
Symptoms, complaints and signs
The pain that many women experience during monthly bleeding can be of varying intensity. For example, some affected women are plagued only by mild symptoms. Others complain of such severe discomfort that normal daily life is hardly possible. Typical symptoms of period pain are painful sensations in the lower abdomen. These can be felt as pulling, but severe cramps are also possible. Other complaints associated with period pain include diffuse abdominal pain, back pain, nausea, bloating and headaches. The intensity of these symptoms can also vary greatly. Signs of period pain manifest in some women in the days leading up to their period. For most of those affected, the discomfort is most pronounced with the onset of menstruation and continues through the first few days of the period, before slowly subsiding. Especially when the symptoms are associated with heavy bleeding over several days, they are experienced by the affected women as extremely stressful. For this reason, at the first signs of period pain, many women turn to appropriate medications that can alleviate the symptoms. Severe period pain can also be a sign of an organic disease in the abdomen and should accordingly be clarified by a doctor if symptoms persist.
Course of the disease
Women affected by primary period pain often are from the first menstrual period until menopause. However, period pain often subsides even after a few years of menstruation. This is because in young women the complex hormonal cycle first has to settle down. Once this has happened, the complaints also improve. Also, no woman or girl today has to live with these accompanying symptoms. This is because a range of therapies has been developed, from naturopathic to chemical to nutritional medications, which provide relief. Many women experience their menstruation without any problems, but for others, abdominal pain, headaches, nausea, fatigue, mood swings or bloating even make them unable to work. In extreme cases, fainting can occur. Severe general malaise and uncomfortable diarrhea may be other symptoms.
Complications
Serious complications are rare with period pain and vary depending on the cause and form of dysmenorrhea. As a result of primary dysmenorrhea, there is mainly a severe decrease in quality of life. Affected women usually feel uncomfortable and suffer from the severe discomfort. Secondary menstrual pain can be caused by serious diseases such as uterine inflammation or fibroids. If these causes are not treated, further complications usually arise.Basically, as a result of the bleeding, anemia and resulting deficiency symptoms and a physical malaise can occur. Vaginitis and similar complaints cannot be ruled out in connection with menstrual pain. Rarely, severe pain is due to a malformation or positional anomaly of the uterus. More often, recurrent dysmenorrhea indicates stress and other psychological strains as well as an unhealthy lifestyle. Hormonal disorders may also underlie and cause further complications if not treated. The treatment of menstrual pain involves, at most, the use of painkillers. Although mild preparations are usually prescribed, these can also cause headaches, gastrointestinal complaints and allergic reactions. Regular use can damage the liver and kidneys.
When should you see a doctor?
Sexually mature girls or women have a very different experience of pain when they have their period. In addition, period pain can vary in intensity and severity from cycle to cycle. Many sufferers experience pain as early as the middle of the menstrual cycle, when ovulation occurs. This is a natural process that does not require medical attention. With the onset of menstruation, the pain increases. In most cases, it is not necessary to consult a doctor. Self-help measures and avoidance of strenuous physical activities are often sufficient. The majority of those affected learn over time to cope well with the discomfort and find individual solutions to improve the discomfort. In addition to sports activities, hot water bottles and relaxation techniques help. If the period pain continues intensively for more than two or three days, a doctor should be consulted. An increase in pain or severe impairment due to the discomfort over a longer period of time should be clarified. A pale appearance, internal weakness, or a severe feeling of illness should be investigated. Dizziness, nausea, vomiting, or a disturbance of consciousness should be presented to a physician. If pain leads to loss of consciousness, an emergency physician should be called.
Treatment and therapy
It has been shown that certain contraceptive preparations, such as various forms of the pill, can substantially alleviate or even completely eliminate menstrual symptoms and thus period pain. Which birth control pill is appropriate must be clarified with the gynecologist. In addition, the painkiller ibuprofen apparently inhibits the body’s own pain messengers that cause the complaints. Increased intake of iron and magnesium before and during menstruation can also relieve the pain. It has also been proven that regular exercise can be helpful because it improves blood flow to the pelvis as a whole, thus preventing unpleasant accompanying symptoms. Heat can also be a helpful factor. Hot water bottles, sauna sessions and a warm bath can sometimes relieve the cramps in the uterus and thus provide relief to those affected. Many women prefer to resort to natural remedies such as lady’s mantle, yarrow or lemon balm in the form of teas. Relaxation techniques such as yoga can sometimes also help. Acupuncture or acupressure with a doctor trained in this area is also recommended. Which methods are used must ultimately be adapted to the individual case. However, help is available in any case.
Aftercare
Aftercare for period pain essentially depends on the causes of dysmenorrhea. Since these are often harmless in nature and also do not require a separate therapy, a special aftercare is unnecessary. However, if those affected take medication because of their period pain, for example, this should be discussed with the attending physician during regular check-ups in order to prevent side effects and long-term stress on the internal organs such as the liver or kidneys. However, period pain sometimes also necessitates an operation on the abdomen, for example in the case of endometriosis. After an operation, follow-up appointments are very important, for example to check the wound or the structure of the uterus in the ultrasound.If unexpected pain or bleeding occurs in connection with menstrual pain and an operation that has been performed, a specialist should be contacted as soon as possible, even outside the appointments for aftercare. He or she can then determine whether the complaints are still within the expected range during follow-up care or whether special treatment is necessary. Period pain can also be associated with cancer in rare cases. Here, too, it is important for the patient to keep her follow-up appointments after the therapy has been completed. Here, follow-up care is primarily about being able to detect new tumorous changes at an early stage and act accordingly.
What you can do yourself
Various home remedies and measures help with period pain. Proven remedies such as heat in the form of hot water bottles and compresses, bed rest and a walk in the fresh air bring relief from cramps and pain. If the symptoms are severe, antispasmodic remedies from the pharmacy, such as yarrow or aloe vera, will help. Teas made from chamomile, goose cinquefoil and lady’s mantle have a similar effect and can be taken in conjunction with a relaxing bath. Relaxation and breathing exercises are useful as a method of distraction. Exercises from the field of autogenic training help the body to calm down during intense discomfort. This relieves the pain and also prevents the typical accompanying symptoms such as fatigue and listlessness. In consultation with the doctor, alternative healing methods such as homeopathy or acupuncture can be tested. If the dysmenorrhea does not decrease despite all measures, it is best to consult the gynecologist. The specialist can determine the causes of the intense pain and prescribe appropriate countermeasures. Sometimes, severe menstrual pain is due to poor diet or lack of exercise, which must be treated in collaboration with a nutritionist or physiotherapist.