Understanding Painful Periods: Causes, Concerns, and Effective Solutions
Image by Sydney Sims
What Are Painful Periods?
Menstrual pain, medically known as dysmenorrhea, is a common experience for many people who menstruate. Characterised by cramps, bloating, and discomfort, these symptoms can range from mild to severe. So, what is normal vs something to be looked into further?
“Normal” period pain
Light cramps
Twinges
Mild pain
Dull ache
Lasting a day or two when your period starts
Doesn’t impact your day-to-day activities
Severe period pain
Disrupts your life, sleep, work and/or social activities
Pain that stops you in your tracts
Has you hugging a hot water bottle every cycle and dosing up on pain killers
Causes vomiting, diarrhoea, and impacts your mental health
Living on pain killers just to try to continue with day-to-day life
While some discomfort is typical, debilitating pain should not be considered normal. However, research by the brand Bodyform found 52% of people thought period pain was just something women had to deal with.
Dysmenorrhea can impact 45-95% of women. Worryingly, “despite the high prevalence, dysmenorrhea is often poorly treated, and even disregarded, by health professionals, pain researchers, and the women themselves, who may accept it as a normal part of the menstrual cycle” (1).
It is something that shouldn’t be ignored given research has found women with dysmenorrhea have reduced sleep quality, quality of life, physical activity, and poorer mood when in pain, as well as increased co-morbidity with chronic pelvic pain (CPP) conditions.
Interestingly, it has also been seen that throughout the menstrual cycle, women with dysmenorrhea have an increased sensitivity to painful stimuli, however, it is unknown whether the increased sensitivity to pain is the cause or effect of recurrent menstrual pain.
Every woman has the right to pain-free, easy periods.
Primary vs. Secondary Dysmenorrhea
Understanding the distinction between primary and secondary dysmenorrhea is important for appropriate treatment support and management.
Primary Dysmenorrhea:
Definition: Primary dysmenorrhea refers to menstrual cramps that are not associated with any other medical condition.
Cause: It is typically caused by the release of prostaglandins, which are chemicals in the uterus that make the muscles contract. Research has found women with primary dysmenorrhea have higher levels of a specific type of prostaglandin, PGF2a. Prostaglandins stimulate the muscular layer of the uterus, resulting in contractions in order to help shed the lining. Although there are a normal part of the process, too many prostaglandins can cause increase pain. Thankfully a lot can be done naturally to work on this balance.
Symptoms: Pain usually begins 1-2 days before menstruation and lasts for 2-3 days. It can include lower abdominal cramps, back pain, and thigh pain. Typically the pain can decrease with age.
There can still be causes for increased pain with primary dysmenorrhea, that is outside “normal” limits.
Secondary Dysmenorrhea:
Definition: Secondary dysmenorrhea is menstrual pain that is caused by another condition.
Cause: Conditions such as endometriosis, fibroids, pelvic inflammatory disease (PID), or adenomyosis can cause secondary dysmenorrhea. Several factors are important to consider as drivers behind these conditions, including hormonal balance, inflammation, and the immune system.
Symptoms: Pain may start earlier in the menstrual cycle and last longer than typical menstrual cramps. It can include severe cramping, heavy bleeding, and pain during intercourse or bowel movements. Typically, the pain can increase with age.
Why Painful Periods Shouldn't Be the Norm
Experiencing debilitating pain during periods is not normal and can indicate underlying health issues. Chronic menstrual pain can lead to significant disruptions in daily life, affecting productivity, mental health, and overall well-being. It's crucial to consult a healthcare provider if your periods are consistently painful to rule out serious conditions and receive appropriate treatment. Just remember, that despite it’s common occurance period pain is under-diagnosed and under-treated. So keep fighting and advocating for yourself if you know this isn’t “normal”.
Often the only solution offered is hormonal contraceptives. Whilst this can resolve issues for some, it is good to understand that ultimately it is masking the issue and often other conditions are not investigated or diagnosed. I often work with women who have come off the pill to try to conceive. Unfortunately, their painful periods or other period-related symptoms have come back. We then need to work on the root cause and resolving these symptoms. Ultimately, a healthy period lays the foundations for a healthy pregnancy.
A lot can be done to naturally support painful periods. It’s important that primary vs secondary dysmennorrhea is distinguished, then either supporting the condition or working on strategies to reduce inflammation and prostaglandin balance.
5 Diet and Lifestyle Tips to Support Painful Periods
Research supports various dietary and lifestyle changes that can alleviate painful periods. Personalisation is best, to get to the root cause of your painful periods and really target this with the best approach. But here are five general tips proven to help:
Increase Omega-3 Fatty Acids: Omega-3s have anti-inflammatory properties that can help reduce menstrual pain. Incorporate fatty fish like salmon, flaxseeds, and walnuts into your diet.
Stay Hydrated: Drinking plenty of water can help reduce bloating and alleviate pain. Aim for at least 8 glasses of water a day.
Exercise Regularly: Regular physical activity can help reduce the severity of menstrual cramps. Activities like yoga, walking, and swimming are particularly beneficial.
Limit Caffeine and Alcohol: Both caffeine and alcohol can increase inflammation and exacerbate menstrual pain. Try to reduce your intake during your period.
Consume Magnesium-Rich Foods: Magnesium can help relax muscles and reduce cramping. Include foods like spinach, almonds, and dark chocolate in your diet.
Ensuring adequate intakes of calcium and robust vitamin D levels: Calcium regulates the ability of muscle cells to respond to nerve stimulation, and vitamin D regulates prostaglandin levels
Need Personalised Nutrition Advice?
If you’re looking for more tailored nutrition advice to support your health goals, I’m here to help! As an MSc-level registered nutritionist, I can provide personalised guidance to help you balance your hormones, resolve period problems, increase energy, and support fertility.
Contact me today to schedule a consultation and start your journey to better health!
References
https://academic.oup.com/humupd/article/21/6/762/628858