Understanding Period Pain: Causes, Management, and When to Seek Help

At some point you might come across a study that suggests that periods are as painful or rather more painful than heart attacks. So, how can you manage and tackle it? If the pain becomes intolerable and interferes with daily activities, it is advisable to consult a doctor. What is the source of this pain, and what are the appropriate ways to address it? In this article Let us discuss in detail the science behind period pain.

What is Period Pain?

Menstrual discomfort arises as the uterus contracts to expel its lining during the menstrual cycle. The contractions are triggered by prostaglandins, which are hormone-like substances released in the uterine lining. Although some of these chemicals are considered normal, elevated levels may lead to stronger contractions and increased discomfort.

There are two categories of menstrual unease:

Primary Dysmenorrhea  

The discomfort of cramping experienced prior to or during menstruation is referred to as primary dysmenorrhea. The discomfort is attributed to the prostaglandins. The uterine muscles and blood vessels contract because of prostaglandins. At the onset of a menstrual cycle, there is an elevated level of prostaglandins. The level decreases as the bleeding persists and the uterine lining extrudes. This is why pain usually subsides after the initial days of a period.

Primary dysmenorrhea typically commences shortly after a girl begins her menstrual cycle. For numerous women experiencing primary dysmenorrhea, menstrual pain tends to diminish with age. Post childbirth the menstrual discomfort may get better.

Secondary dysmenorrhea is caused by a problem that affects the female reproductive system. The discomfort typically intensifies over time and frequently endures for a longer duration than standard menstrual cramps. The feeling of pain might commence a few days before the onset of a menstrual cycle. The unease may intensify as the period progresses and could persist even after it concludes.

The pain that arises from underlying conditions, including uterine fibroids, endometriosis, or pelvic inflammatory disease (PID) can be classified under secondary dysmenorrhea.

Menstrual cramps and period pain are very prevalent, with research indicating that 50 to 90% of menstrual adults experience them at some stage in their lives.  Research states that primary dysmenorrhea is most common in adolescence and early adulthood but often diminishes with age or following childbirth. Nonetheless, intense pain that interferes with daily life is abnormal and may signify a treatable disorder.

For certain women, experiencing pain is simply bothersome. For some others, menstrual cramps may be intense enough to disrupt daily activities for several days each month. Some of the symptoms of menstrual cramps are listed below:

- The lower abdomen experiences intense aches or painful cramps.
- The pain starts 1 to 3 days before your period, peaks 24 hours later, and then gradually lessens over the next 2 to 3 days.
- A persistent, monotonous discomfort.
- The discomfort radiates to your lower back and thighs.
- Nausea
- Loose stools / Diarrhea
- Experiencing a headache
- Dizziness
- Constipation

Secondary dysmenorrhea may include additional symptoms, such as:

- Heavy or irregular bleeding
- Pain during sexual activity
- Spotting between periods

Secondary Dysmenorrhea: Causes

Multiple conditions may lead to secondary dysmenorrhea, which includes the following:

Endometriosis: Endometriosis is a condition in which tissue similar to the lining of the uterus grows in parts outside of the uterus, such as the ovaries, fallopian tubes, the region back of the uterus, and the urinary tract. Like the lining of the uterus, this tissue undergoes breakdown and bleeding in reaction to hormonal fluctuations. This bleeding may lead to discomfort, particularly during the menstrual cycle. Adhesions, which are a type of scar tissue, may develop within the pelvis in areas where bleeding has taken place. Adhesions may lead to the sticking of organs, which can result in discomfort.

Fibroids: Fibroids are growths that can develop on the exterior, interior, or within the uterus walls. Fibroids situated within the uterine wall may lead to discomfort. Usually, small fibroids do not result in pain.

Adenomyosis: Adenomyosis is a condition in which the tissue that commonly lines the uterus begins to develop inside the muscle wall of the uterus. This condition tends to be more prevalent among older women who have given birth.

Pelvic Inflammatory Disease: Pelvic inflammatory disease (PID) refers to an infection affecting the female reproductive system, including the womb, reproductive tract, fallopian tubes, and ovaries.

Issues with the fallopian tubes, uterus, and other reproductive organs. Some birth abnormalities can cause pain during a woman's menstrual cycle.

Certain medical conditions could worsen during a menstrual cycle, leading to discomfort. The conditions encompass inflammatory bowel disease as well as urinary disorders.

How to Manage Period Pain?

Medications and lifestyle modifications are two of the many effective methods for dealing with period discomfort.

- On an average, mild medications are the initial approach for addressing painful periods. Some pain relievers specifically focus on prostaglandins. These medications, known as nonsteroidal anti-inflammatory drugs (NSAIDs), work by reducing the prostaglandins produced by the body, thereby diminishing their effects. This alleviates the severity of menstruation cramps. Many NSAIDs, including ibuprofen, paracetamol, and naproxen, are available to reduce the pain.

- Applying heat to the lower abdomen helps relax the uterine muscles and enhances blood circulation, which can reduce pain.

- Period discomfort is lessened by regular exercise, such as yoga and aerobics, which improve circulation and reduce stress.

- Painful periods can be treated with birth control techniques that contain estrogen and progestin, including the patch, pills, and vaginal ring. Progestin-only birth control methods, including the implant and injection, may also minimize period pain. The hormonal intrauterine device (IUD) can also be utilized to help with painful periods. Many women with an IUD experience a reduction in menstrual bleeding as time goes on with the device in place. In certain instances, women with an IUD may experience a cessation of bleeding.

- Minimizing the intake of alcohol, caffeine, and salty items while increasing the intake of anti-inflammatory options may alleviate period pain.

- A TENS (transcutaneous electrical nerve stimulation) machine can be used to apply slight electrical stimuli to help relieve pain. 

When To See a Doctor?

Mild period pain is quite common, but specific symptoms, such as those listed below, may indicate a more serious underlying condition.

- Discomfort that hinders everyday tasks even with treatment
- Abrupt alterations in your menstrual cycle
- Heavy and significant bleeding
- Intense progressive discomfort
- Unease experienced during sexual activity, peeing, or while having a bowel movement
- Spotting between periods

You need to discuss your symptoms and menstrual cycle with your obstetrician-gynaecologist (ob-gyn) if you experience painful periods. Your ob-gyn may suggest a pelvic exam if necessary. One initial approach to treatment could involve the use of medications. If medications fail to reduce your pain, the next step in treatment should be to identify the underlying cause of your discomfort.

Holistic and Alternative Approaches

Treatments for painful periods may include acupressure, acupuncture, and nerve stimulation. Physiotherapy and physical activity that help trigger points may also assist in reducing pain. Some individuals experience relief from using turmeric, ginger, or chamomile tea, although the evidence supporting this is somewhat limited. Cognitive Behavioural Therapy (CBT) assists in managing pain perception using various mental strategies. It is advisable to consult with a healthcare provider regarding these options to guarantee effectiveness and safety.

Conclusion

Menstrual discomfort is a frequent yet manageable occurrence. By observing the root causes and examining different management approaches, you can achieve relief and improve your overall quality of life. Please consult a doctor to rule out any potential secondary causes in case of severe pain or unusual symptoms.