Pain during your period is called dysmenorrhea, and it is extremely common. It is usually associated with cycles that release an egg (ovulatory cycles). When young women first start to get their periods, they may not release an egg every month so their periods may not be as painful.
When your period starts (menstruation), chemicals called prostaglandins are released which cause your uterus to contract. The endometrial lining (the lining of your uterus), which has become thick, is shed from the uterus through the cervix during these contractions. Typically, these contractions are the most painful during the first day or two of your period, and then gradually get better. However, some women have pain throughout their entire period. Painful periods may also be accompanied by other symptoms, such as nausea, vomiting, dizziness, diarrhea, and headaches.
This pain may sometimes be treated with non-steroidal anti-inflammatory drugs (NSAIDs), such as ibuprofen, that help decrease the amount of prostaglandins your body releases. These drugs work best if you take them before the pain gets very bad. If you have a predictable cycle, you can start taking the medication the day before your period starts. Most of the time, you will only need to take the medication for a day or two to get over the worst of the symptoms. Some women find exercise or a hot shower or bath can also help to ease the pain. If this does not work, and you need more help with pain control, please see your health care provider for more information.
There are other, less common, causes for painful periods. These include endometriosis, problems with the development of the female reproductive tract resulting in a partial or complete blockage of menstrual tissue, and untreated pelvic infections. Again, if you have monthly pain that is not responding to basic treatment such as over-the-counter medications, please see your health care provider for help.
Cramps with a woman’s period are common, and are caused by chemicals called “prostaglandins” that are released as the uterine lining is shed. Prostaglandins cause the muscle of the uterus to tighten, causing little “contractions” which are often perceived by the woman as painful. Many women get mild cramps which are tolerable, and which can be treated by hot baths, hot water bottles or exercise, or by taking an over-the-counter medication such as ibuprofen (Advil or Motrin).
Ibuprofen is an example of a non-steroidal anti-inflammatory medication (“NSAID”). This type of medication prevents prostaglandins from forming, and thus reduces the cramping. If an over-the-counter NSAID is not strong enough, ask your doctor for a prescription. Some examples of NSAIDS available by prescription only include naproxen, mefenamic acid, celecoxib, and ketorolac. If taking it as you need it is not working, try taking your anti-inflammatory at the first sign of pain, or just before your period even starts, and take it regularly according to directions for the first 2 or 3 days of your period. The medication can work even better if you start to take it before the prostaglandins have had a chance to form, rather than waiting until the pain is severe.
Hormonal contraceptives like the combined oral contraceptive pill or patch, Depo-Provera injections, or the intrauterine system are also used to treat painful periods due to various causes. These work by stopping ovulation and/or reducing the amount or frequency of bleeding.
Severely painful periods are not necessarily normal, and can be treated. A visit to your health care professional may be helpful to help figure out why you are having the pain and what type of treatment would work best for you. A woman should not have to “suffer through” pain that interferes with her life. Some other causes of painful periods include fibroids (benign uterine tumours), endometriosis and adenomyosis (benign conditions where small patches of the uterine lining grow outside of the uterus or into the uterine muscle, respectively). Pain that occurs at other times in the month may also be due to these, or could be from ovarian cysts, or bladder or intestinal conditions, among other things.
Talk to your doctor if you are concerned, or if the pain is severe.