There are many women who suffer from painful periods. During which times, they experience discomfort referred to, technically, as menstrual cramps or dysmenorrhea, an ancient Greek expression, which literally means ‘difficult monthly flow.
Around 80 per cent of women experience painful period at some stage in their lifetime. Some suffer it from your early teens right up to the menopause.
Study shows that most women experience some discomfort during menstruation, especially on the first day. However, in five per cent to 10 per cent of women the pain is severe enough to disrupt their life. If your mother suffered period pains, you are more likely to suffer too. In 40 per cent of women, period pain is accompanied by premenstrual symptoms, such as bloating, tender breasts, swollen stomach, and lack of concentration, mood swings, clumsiness and tiredness.
According to experts, menstrual cramps can be really uncomfortable and painful, but they do happen for a reason. During a woman’s period, her uterus contracts, meaning it squeezes or cramps up. This makes the linings come off the walls of the uterus and leave the body. When your uterus cramps up, it’s helping the period blood flow out of your private part.
Cramps are usually worse during the first few days of your period, when your flow is the heaviest. Your periods may get more or less painful throughout your life. For many people, cramps become less painful as they know lots of ways to treat them.
A medical practitioner, Dr. Sunday Olalekan, said menstrual cramps (dysmenorrhea) are throbbing or cramping pains in the lower abdomen, adding: “For some women, the discomfort is merely annoying. For others, menstrual cramps can be severe enough to interfere with everyday activities for a few days every month. During your menstrual period, your uterus contracts to help expel its lining. Hormone-like substances (prostaglandins) involved in pain and inflammation rigger the uterine muscle contractions.”
Menstrual cramps may be caused by identifiable problems, such as endometriosis or uterine fibroids. Treating any underlying cause is key to reducing the pain. Menstrual cramps that aren’t caused by an underlying condition tend to lessen with age and often improve once a woman has given birth.”
Explaining further, an assistant professor of clinical obstetrics and gynecology, Jessica Shepherd, said: “When endometrial cells are broken down during your cycle, the prostaglandins are released and they are indirectly related to estrogen. On the flip side, prostaglandins (and cramps) are decreased when you are on hormonal birth control because you’re not building up that endometrial tissue.”
Maureen Whelihan, an obstetrics and gynecology at the Centre for Sexual Health and Education said cramps are mildly uncomfortable in some people but soul-crushing in others because of “a few factors: like heavier bleeding in some women, larger blood clots being pushed through the cervix, health conditions like adenomyosis (which causes endometrial tissue to grow into the uterine wall), and differences in pain tolerance.”
She said there are two different types of period pain: Primary dysmenorrhea and secondary dysmenorrhea.
Primary dysmenorrhoea: This commonly occurs in teenage girls and young women, towards the beginning of menstrual life. The cramping pains are caused by the womb contracting to shed its lining. There may also be pain caused by the decreased supply of blood to the womb. The pain is mainly in the lower part of the abdomen but can go into the back and down the front of the thighs. Some women feel nauseated at the same time. It is a perfectly natural condition and for many women is simply a mild monthly discomfort. Primary dysmenorrhoea can be eased with the contraceptive pill as well as some relaxation techniques.
Secondary dysmenorrhoea: This may not start until your mid-20s or later. It is unlikely to cease after childbirth. The pain is not restricted to “time of the month” bleeding and can occur throughout the cycle. Periods may become heavier and more prolonged, and intercourse may be painful.
Secondary dysmenorrhoea can be a sign of other conditions, including pelvic infections, which may need urgent attention. If you start to experience period pain as an adult you should not hesitate to consult a General Practitioner (GP).
Rebecca Johnson (35) has, over the past years, experienced menstrual cramps. She said the pain was a mild discomfort at the earlier years when she starting her cycle, explaining: “In recent years, my period pain has become as severe as a slipped disc. I speak from experience, having had two slipped discs in my life.
“Every month, I spent hours lying on the floor, unable to move, and literally crying out in agony. My hip and back muscles went into spasm, so that my body was twisted. There are months I do not go to work because of the unbearable pain that accompanies my cycle. I take pain medication whenever it starts, to control the pain.
“My heart always skips whenever the time sets in. Nothing goes into my stomach because I find it difficult to eat and easily get irritated and usually not in the mood to move.
“In most cases, I lie down with a heating pad on my tummy. During this period, I go for warm bath. I had to deal with monthly bouts of depression, suffered through migraines and even vomiting whenever I had my period.”
According to experts, conditions such as endometriosis or uterine fibroids can cause menstrual cramps. Treating the cause is key to reducing the pain. Menstrual cramps that aren’t caused by another condition tend to lessen with age and often improve after giving birth.
He said: “During your menstrual period, your uterus contracts to help expel its lining. Hormone-like substances (prostaglandins) involved in pain and inflammation trigger the uterine muscle contractions. Higher levels of prostaglandins are associated with more-severe menstrual cramps.
“Severe contractions may constrict the blood vessels feeding the uterus. The resulting pain can be compared to the chest pain that occurs when blocked blood vessels starve portions of the heart of food and oxygen.”
Menstrual cramps may also be caused by the following:
Endometriosis: In this painful condition, the tissue that lines your uterus becomes implanted outside your uterus, most commonly on your fallopian tubes, ovaries or the tissue lining your pelvis.
Uterine fibroids: These noncancerous growths in the wall of the uterus may be the cause of pain.
Adenomyosis: In this condition, the tissue that lines your uterus begins to grow into the muscular walls of the uterus.
Pelvic inflammatory disease (PID): This infection of the female reproductive organs is usually caused by sexually transmitted bacteria.
Cervical stenosis: In some women, the opening of the cervix may be so small that it impedes menstrual flow, causing a painful increase of pressure within the uterus.
Symptoms of menstrual cramps include: throbbing or cramping pain in your lower abdomen that can be intense and pain that starts 1 to 3 days before your period, peaks 24 hours after the onset of your period and subsides in 2 to 3 days
Also, dull and continuous ache and pain that radiates to your lower back and thighs. Some women also have: Nausea. loose stools, headache and dizziness
Treatment and drugs
Menstrual cramps are treatable. Your doctor may recommend the following:
Pain relievers: Your doctor may suggest taking over-the-counter pain relievers, such as ibuprofen (Advil, Motrin IB, others) or naproxen sodium (Aleve), at regular doses starting the day before you expect your period to begin. Nonsteroidal anti-inflammatory drugs (NSAIDs), such as mefenamic acid (Ponstel), also are available. If you can’t take NSAIDs, acetaminophen (Tylenol, others) may lessen your pain.
Start taking the pain reliever at the beginning of your period or as soon as you feel symptoms, and continue taking the medicine as directed for two to three days, or until your symptoms have gone away.
Hormonal birth control: Oral birth control pills contain hormones that prevent ovulation and reduce the severity of menstrual cramps. These hormones can also be delivered in several other forms: an injection, a patch you wear on your skin, an implant placed under the skin of your arm, a flexible ring that you insert into your vagina, or an intrauterine device (IUD).
Surgery: If your menstrual cramps are caused by an underlying disorder, such as endometriosis or fibroids, surgery to correct the problem may help reduce your symptoms. Surgical removal of the uterus also may be an option if you›re not planning to have children.
Tests and diagnosis
Your doctor will review your medical history and perform a physical examination, including a pelvic exam. During the pelvic exam, your doctor will check for any abnormalities in your reproductive organs and look for signs of infection.
If your doctor suspects that your menstrual cramps are being caused by an underlying disorder, he or she may recommend other tests, such as:
Ultrasound: This test uses sound waves to create an image of your uterus, cervix, fallopian tubes and ovaries.
Other imaging tests: A CT scan or magnetic resonance imaging (MRI) provides more detail than an ultrasound and can help your doctor diagnose underlying conditions. A CT scan combines X-ray images taken from many angles to produce cross-sectional images of bones, organs and other soft tissues inside your body.
MRI uses radio waves and a powerful magnetic field to produce detailed images of internal structures. Both tests are noninvasive and painless.
Laparoscopy: Laparoscopy usually isn›t necessary for the diagnosis of menstrual cramps, but it can help detect an underlying condition, such as endometriosis, adhesions, fibroids, ovarian cysts and ectopic pregnancy. During this outpatient surgery, your doctor views your abdominal cavity and reproductive organs by making tiny incisions in your abdomen and inserting a fiber-optic tube with a small camera lens.
Lifestyle and home remedies
Things you may want to try at home include:
Exercise: Studies have found that physical activity may ease the pain of menstrual cramps.
Heat: Soaking in a hot bath or using a heating pad, hot water bottle or heat patch on your lower abdomen may ease menstrual cramps. Applying heat may be just as effective as over-the-counter pain medication for relieving menstrual cramps.
Dietary supplements: A number of studies have indicated that Vitamin E, omega-3 fatty acids, Vitamin B-1 (thiamine), Vitamin B-6 and magnesium supplements may effectively reduce menstrual cramps.
Avoiding alcohol and tobacco: These substances can make menstrual cramps worse.
Reducing stress: Psychological stress may increase your risk of menstrual cramps and their severity.
You may be at greater risk of menstrual cramps if:
• You are younger than age 30;
• You started puberty early, at age 11 or younger;
• You have heavy bleeding during periods (menorrhagia);
• You have irregular menstrual bleeding (metrorrhagia);
• You have never given birth;
• You have a family history of dysmenorrhea;
• You are a smoker.
Menstrual cramps do not cause any other medical complications, but they can interfere with school, work and social activities. Certain conditions associated with menstrual cramps may have complications, though. For example, endometriosis can cause fertility problems. Pelvic inflammatory disease can scar your fallopian tubes, increasing the risk of a fertilised egg implanting outside of your uterus (ectopic pregnancy).