Painful periods, or dysmenorrhoea, affect 40-70% of women and can cause significant disruption to your daily life.

What are painful periods?

Painful period symptoms usually start with the onset of bleeding and last between one and three days.  Women experience lower abdominal and pelvic pain with their periods, such as cramping, a continuous ache or even sharp pains. The pain may also be felt in the lower back and legs. It is sometimes associated with headaches, emotional irritability, abdominal bloating, nausea, vomiting and diarrhea.

What causes painful periods?

There are two main types of painful periods and their causes are different:

Primary dysmenorrhoea

This is not associated with any underlying abnormality. Symptoms are thought to be caused by the increased activity of the hormones prostaglandins, which are produced by the uterus.

Secondary dysmenorrhoea

This is usually related to a specific issue, which can include:

  • Endometriosis: where the tissue that is lining the inside of the womb is found elsewhere in the pelvis
  • Fibroids: usually a noncancerous ball of fibrous tissue in the muscle wall of the womb
  • Adenomyosis: where the tissue that is lining the inside of the womb is found growing into the muscle wall of the uterus
  • Pelvic infections
  • Non-hormonal intrauterine contraceptive devices (IUDs)
  • Developmental problems affecting the uterus (womb), vagina or hymen

How do I know if I have painful periods?

You’ll experience lower abdominal and pelvic pain during the first one to three days of your period. You may also have pain in the lower back and legs, headaches, emotional irritability, abdominal bloating, nausea, vomiting and diarrhoea.

How are painful periods treated?

Primary dysmenorrhoea

  • Non-medical home management: Hot water bottles and TENS (transcutaneous electrical nerve stimulation) machines, gentle exercise
  • Non-steroidal anti-inflammatory drugs: These include Ponstan® and Naprogesic®.
  • Oral contraceptive pill (OCP): The Pill may help reduce period pain and allow you to safely skip periods. It also reduces menstrual blood loss by 30-50%
  • Mirena® device: This is a modified intrauterine device that can reduce blood loss by over 90% and help to reduce painful symptoms. Pluscaine® anaesthetic gel, co-invented by Prof Vancaillie, enables comfortable insertion at WHRIA, often avoiding the need for a general anaesthetic
  • Allied health services at WHRIA: in addition to traditional medicine we also offer acupuncture and Chinese medicine, osteopathy, pelvic floor physiotherapy and psychology

Secondary dysmenorrhoea

Treatment will depend on the underlying issue that has been identified and will need to be discussed with your WHRIA doctor.

Helpful resources

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