Many women suffer from period pains at various stages of their menstrual cycle. Some may experience mild pain which is usually self limiting, at the other end of the spectrum some may experience severe pain which at times can be disabling. An individual may also have different symptoms throughout her lifetime. The important thing to note is that today there is treatment available for dysmenorrhoea, which is the medical term for painful menstruation.
Two types of dysmenorrhoea have been described, primary or spasmodic dysmenorrhoea and secondary dysmenorrhoea.
In the Primary Form
The pain usually starts 2-3 years after a woman has her first period. The pain is maximal between the ages of 15-25 years and decreases with age and usually ceases after childbirth. The typical symptoms include crampy pains that starts during the 24 hours before menstruation and may last for 24-72 hours.
The cramps are usually felt in the lower abdomen, but they can radiate to the back or down the inner surface of the thigh. A woman may describe the pain as mild and bearable or very severe and disabling. In severe cases vomiting, nausea and/or diarrhoea may accompany the cramps. In ¾ of affected women the cramps are mild or moderate, but in 25% of cases they are severe and incapacitating and warrant medical treatment.
It is understood that a complex interplay of factors involving hormones that are released during the menstrual cycle which all act together in the typical symptoms of pain. The hormone progesterone is released following ovulation and the pain experienced is due to uterine contractions and spasm of the blood vessels in the uterus due to the release of prostaglandins.
How can I Relieve the Symptoms of Period Pains?
Treatment consists of suppressing the production of the prostaglandin, which includes drugs such as brufen, mefenemic acid or naproxen. These can usually be obtained over the counter and treatment should be commenced prior to/or at the onset of symptoms and continued 6-8 hourly. This form of treatment will relieve symptoms in 80% of women with period pains.
Other forms of treatment include the suppression of ovulation by prescribing an oral contraceptive. An oral contraceptive may be preferred by a woman who is sexually active; as the pill will protect her against an unwanted pregnancy as well as alleviating the dymenorrhoea. Oral contraception will provide relief in more than 90% of women. It is best to speak to your doctor to find out which is the best oral contraceptive for you.
Acupuncture may also be recommended in addition to/instead of the above measures and may improve symptoms in 30-60% of cases.
Secondary Form
Secondary or acquired dysmenorrhoea is unusual before the age of 25 and uncommon before 30. The pain starts 1-2 weeks prior to the onset of menstruation and persists until or after the cessation of bleeding.
