March 18, 2006
Period pains are cramping abdominal pains experienced during, and sometimes just before, a woman’s monthly period. They affect 80% of women at some time in their lives. Usually they are not a sign of a serious underlying problem and can be treated with self-help methods.
The medical term for painful periods is dysmenorrhoea. There are two types.
This term is used to describe normal period pain experienced by many women around the time of their period. There is no underlying medical problem. It most commonly affects teenagers and young women. This is the type of period pain discussed in this factsheet.
This term is used to describe pain around the time of the period that’s caused by an underlying problem. It is less common than primary dysmenorrhoea, and tends to affect women later in their reproductive lives.
What causes period pain?
Pains may start with the first-ever period. However, they are more likely to begin 6-12 months later, once cycles where an egg is released are established. It’s these cycles that appear to cause more pain.
The cause of period pain is not certain. Once an egg has been released from one of the ovaries, natural chemicals produced by the body called prostaglandins are made in the lining of the uterus (womb). Some prostaglandins cause the walls of the uterus to contract. Some women produce higher levels of prostaglandins, which may cause increased contractions of the uterus. These cramps may be more painful because there is reduced blood (and therefore oxygen) supply to the myometrium (muscle wall of the uterus) during the contractions.
Symptoms of painful periods
-Cramping lower abdominal pains are the most common symptom. Pain can also spread to the lower back and the thighs. When severe, the pain can be accompanied by nausea or vomiting, diarrhoea, constipation or feeling faint. Some women may also get headaches.
-Pain usually lasts two to three days and tends to happen in the first few days of the period, coinciding with the time of heaviest blood flow. Period pains do not cause any damage to the uterus and a pelvic examination or “internal” would show that the uterus and ovaries are normal.
-Up to 15% of women have period pains severe enough to interfere with their daily activities. This can lead to missing days at school or work or decreased participation in social or sporting activities.
-Period pains are often worse in adolescence and tend to improve as women get older. Many women notice that their periods are less painful after they have had a baby.
Exercise – you may not feel like it, but getting active is a good way to ease pain. Try gentle swimming, walking or cycling.
Painkillers – ibuprofen and aspirin can be particularly effective as they have anti-prostaglandin effects. Take them regularly throughout the day (following the packet instructions), not just when pain becomes difficult to cope with.
Complementary therapies – there are lots to try, including herbal treatments (evening primrose oil or raspberry leaf tea) or meditation. For more information, take a look at our Complementary medicine section.
Tens – transcutaneous electronic nerve stimulation, or Tens, is widely used for period pains, especially in Scandinavia. Small electrodes are placed on the abdomen to stimulate the nerve in the pelvic area in a way that reduces pain.
Could there be another problem?
As mentioned, period pains can sometimes be the result of an underlying gynaecological condition (secondary dysmenorrhoea). A doctor should be consulted if period pains are particularly severe, or new, or are associated with any of the following symptoms:
-bleeding between periods
-bleeding after intercourse
-pain during or after intercourse
-unusually heavy periods.
A doctor will carry out a pelvic examination and may then arrange further investigations or a referral to a gynaecologist. Tests might include, for example, an ultrasound scan of the pelvis to look at the uterus and ovaries. Other tests may take place in a hospital.
Hysteroscopy – a thin telescope is passed through the neck of the womb (cervix) to enable the inside of the uterus to be viewed.
Laparoscopy – where a small telescope is passed through a small cut in the wall of the abdomen allowing the pelvic organs to be viewed. Problems such as endometriosis can be diagnosed in this way (see the separate BUPA factsheet Endometriosis). Further treatment depends on the specific diagnosis.