Help for Bad Period Pain and Dysmenorrhoea

What is Dysmenorrhoea?

Dysmenorrhoea is also known as bad period pain.

Dysmenorrhoea is a word to describe the pain associated with menstruation that many women feel each month. The amount of pain a woman feels varies both from individual to individual, and from month to month. Some women are fortunate and seem rarely to encounter this, while at the other end of the spectrum others find it debilitating. Those women can be bedridden for a day or two and this has a big impact on their health, work and social/family life.

Why do I get bad period pain?

When you menstruate, you are shedding the lining of the uterus each month: this lining is called the endometrium. When the endometrium breaks down in preparation for your period, hormones called prostaglandins are released. This is normal and stimulates the muscular wall of the uterus to begin contracting, thus leading to cyclic bleeding for a few days. In other words, very often the pain reflects normal female physiology. However, sometimes this is not the case.

What else can cause dysmenorrhoea?

Sometimes when period pain is troubling, there can be abnormalities causing this. A variety of gynaecological disorders including endometrial polyps, uterine fibroids, adenomyosis and that well-known malady endometriosis are all possible. The investigation and treatment options vary with the diagnosis. If your period pain is worsening or affecting your life in an adverse manner then arrange an appointment to see what the cause might be and what can be done to help.

What can I do to help reduce dysmenorrhoea?

There are many time-honoured and simple things you can do to help with the pain. Firstly, getting adequate sleep and rest if possible is helpful. Using a heat pack or hot water bottle over the lower abdomen is comforting. Regular anti-inflammatory medication helps: soluble aspirin, ibuprofen (Nurofen), mefenamic acid (Ponstan), naproxen (Naprogesic) are all well-known and effective. These drugs are anti-prostaglandins and work to reduce muscular cramping. They need to be taken regularly throughout the days where you experience pain to achieve the best result. Combining them with paracetamol at the same time is safe and improves the relief from pain. The progesterone containing contraceptive (Mirena) is another alternative.

But I have tried everything, and my period pain is still bad, what can I do?

If the above options aren’t working, I usually recommend a trial of the oral contraceptive pill, which reduces both pain and heaviness of the period in most women who take it. If these strategies are not working, it is usual to investigate things further to see if there is any pathology causing the pain. A careful examination, swabs from the vagina and pap test (if it is due) and an ultrasound in the rooms give valuable information. Consideration is then given to a laparoscopy (a key-hole day surgery operation to look inside the pelvis) depending on the findings.

If you’re living with period pain, and it’s affecting your everyday activities, make an appointment to seek more help. Call the rooms for an appointment.

Author: Dr Peter England, Obstetrician and Gynaecologist.
Read more about Dr Peter England

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