Dysmenorrhoea or Painful cramps

Painful periods are very common and nearly all women experience them at some time in their life. It’s common for women to have some pain in their lower abdomen (tummy) during their periods and feel that it’s a normal part of life. Its common for women to feel tired, sick and have pain at this time and most women develop their own ways of coping and dealing with the monthly pains.

Some women experience pain that is so severe if affects their day to day activities and can lead to time off work or school. For some, over the counter pain killers help manage the pain, yet, for other these don’t work, and the pain is more severe.

Types of period problems

There are two different types of painful periods;

• Primary Dysmenorrhoea. This is period pain which has no one definitive cause. It typically starts within 6-12 months of your periods first starting. The pain typically starts when your period starts each month and usually lasts 1-3 days.
• Secondary Dysmenorrhoea. This is period pain which occurs due to an underlying medical condition like Endometriosis and Fibroids. This type of pain starts years after your periods begin, often when you’re older for example 30 or 40. The pain may also occur at other times during your monthly cycle. In some cases, this pain may get worse rather than improve and get better as your period goes on.

Some common tests carried out are;

• A urine and or a blood test
• Ultrasound where high-frequency sound waves are used to produce an image of the inside of your body; it’s painless and will show any abnormalities in your reproductive organs
• Laparoscopy – under general anaesthetic, a small cut is made in your abdomen through which a fibre-optic telescope is inserted; it can be used to look at your internal organs, as well as take samples of tissue (Biopsy)
• Hysteroscopy – allows the inside of the womb to be examined using a fibre-optic telescope; it’s passed through your vagina and into the womb to check for abnormalities

Symptoms associated with Primary Dysmenorrhoea

The main symptom we associate Primary Dysmenorrhoea with is the cramping of the lower abdomen, the pain often spreads to the lower back and thighs. Women may experience other symptoms too, such as;

• Tiredness
• Feeling sick/being sick
• Diarrhoea
• Headaches
• Bloating
• Emotional symptoms

If you have Secondary Dysmenorrhoea you may experience other symptoms such as;

• Heavy or irregular periods
• Bleeding in-between periods
• Unusual discharge from the vagina
• Sex may be painful, and you may bleed afterwards

Causes of painful periods

Primary Dysmenorrhoea isn’t brought on by any specific condition. Whereas, Secondary Dysmenorrhoea may occur from a number of different conditions, these include;

• Endometriosis- This is the most common cause of Secondary Dysmenorrhoea
• Fibroids- non-cancerous growths in the womb
• Pelvic Inflammatory Disease- Infection in the uterus, fallopian tubes and sometime ovaries
• Adenomyosis- A condition where the glands that are usually in the lining of your uterus grow inside the walls of your uterus.

Treatments for menstrual problems

There are a range of options for treating period problems. The treatment will depend on the cause of the problem.

If no specific causes are found, then a treatment plan to manage the pain and look for alternative ways of treating the problem. These may include trying the contraceptive pill. This reduces the womb lining, and this can ease the symptoms in many cases. It can also mean periods are lighter. If you cannot take the pill, other alternatives may be suggested such as a contraceptive implant or injection

The Mirena intrauterine device (IUS) can also sometimes help with painful periods.

Pain relief may also be considered and will be discussed with you.

Here are some self-help tips that some women say help with painful periods

• Stopping smoking – smoking is thought to increase the risk of period pain
• Exercise – you may not feel like exercising during a painful period but being active may reduce pain; try some gentle forms of walking, swimming or cycling.
• heat – putting a heat pad or hot water bottle (wrapped in a tea towel) on your tummy may help reduce pain
• warm bath or shower – taking a warm bath or shower can relieve pain and help you relax
• massage – light, circular massage around your lower abdomen may also help reduce pain
• relaxation techniques – relaxing activities, such as Yoga or Pilates , may help distract you from feelings of pain and discomfort

Talk to someone

Whatever the discomfort or pain it helps to talk to someone about your period problems, sometimes its good just to reassure yourself there is no serious problem.