Advanced Gynaecological Surgery Centre
 
My Symptoms

Painful Periods (Dysmenorrhoea)

Dysmenorrhoea is an extremely common and sometimes debilitating condition for women of reproductive age.

Although some pain during your period is normal, excessive pain is not.

It occurs in up to 50% of menstruating females and can cause significant disruption in quality of life and is the leading cause of lost time from school and work among women in their teens and 20s.

The optimal management of this symptom depends on an understanding of the underlying cause.
Painful menstrual periods fall into two groups, depending on the cause:

  • Primary Dysmenorrhoea
  • Secondary Dysmenorrhoea

Causes

Primary Dysmenorrhoea is menstrual pain that occurs around the time that menstrual periods first begin in otherwise healthy young women. This pain is usually not related to a specific problem with the uterus or other pelvic organs. Increased activity of the hormone prostaglandin, which is produced in the uterus, is thought to play a role in this condition.

Secondary Dysmenorrhoea is menstrual pain that develops later in women who have had normal periods and is often related to problems in the uterus or other pelvic organs, such as:

Risk factors

The following Risk factors have been associated with more severe episodes of dysmenorrhoea

  • First period at a young age
  • Long menstrual periods
  • Heavy menstrual flow
  • Smoking
  • Positive family history

Obesity and alcohol consumption were found to be associated with dysmenorrhea in some (not all) studies.  Physical activity and the duration of the menstrual cycle do not appear to be associated with increased menstrual pain

Investigations

Tests and procedures that may be done include:

  • Pelvic examination
  • Ultrasound
  • MRI
  • Vaginal swabs to rule out sexually transmitted infections
  • Laparoscopy
  • Hysteroscopy

Treatment options

Lifestyle and Medicinal

The following Suggestions may help both Primary and Secondary Dysmenorrhoea (Painful Periods):

  • Apply a heating pad to the painful area.
  • Do light circular massage with your fingertips around your lower abdomen.
  • Follow a healthy diet high in complex carbohydrates such as whole grains, fruits, and vegetables, but low in salt, sugar, alcohol, and caffeine.
  • Practice relaxation techniques such as meditation or yoga.
  • Try over-the-counter non steroidal anti-inflammatory medicine, such as ibuprofen. Start taking it the day before your period is expected to start, and continue taking it regularly for the first few days of your period.
  • Paracetamol is an alternative painkiller that you can try if you cannot take non-steroidal anti-inflammatory painkillers. Also, paracetamol can be used in combination with a non-steroidal anti-inflammatory painkiller if the anti-inflammatory alone is not enough.
  • Try vitamin B6, calcium, and magnesium supplements, especially if your pain is from PMS.  Consult your GP prior to commencing these supplements.
  • Walk or exercise regularly.
  • Lose weight if you are overweight.
  • Get regular, aerobic exercise.

The Oral Contraceptive Pill ('The Pill')

  • This is an option if you also need contraception.
  • Heavy periods are much less likely if you take 'the pill'.
  • You can also take the pill, so that you have fewer periods in a year.
  • This will reduce the number of times you have pain.

Intrauterine Device

  • A special intrauterine contraceptive device called a mirena is an option especially if you also need long-term contraception.
  • This device slowly releases a progestogen hormone. This 'thins' the lining of the uterus.
  • It is a good contraceptive, but also reduces the amount of pain and bleeding during periods.

Alternative Medicine Treatments

  • There is not enough evidence so far to support the use of other treatments for painful periods. For example, herbal and dietary supplements, acupuncture etc. Some small studies have shown that some of these treatments may help but, overall, the effectiveness of these treatments is not clear.
  • More studies are needed to help decide if these treatments are helpful or not for painful periods.

Surgical Treatment Options