Painful Periods - When periods hurt...

Painful periods, or dysmenorrhoea, affect about 50-80% of women during the fertile period of their life [1],[2]. According to a study[3] published in 2005, 50-70% of adolescent girls have regular or occasional dysmenorrhoea, and 15-20% of them must limit their activity during their periods and even have to lie down. This phenomenon is far from negligible considering that, in France, painful periods are the leading cause of school absenteeism among teenage girls and professional absenteeism among young women[4].

Their causes can be varied, with their intensity ranging from moderate to intense, and there is a wide range of solutions to alleviate them.

What if we take a look at painful periods?

Where do they come from?

To expel blood and mucous membranes during our periods, several molecules trigger spasms in the uterine muscle. Among them, prostaglandins, produced by the endometrium (the mucous membrane that lines the inner wall of the uterus) are the most active molecules. It is mainly due to their action that the uterine muscle contracts. An excess of prostaglandins causes an abnormal increase in these contractions, which has the effect of compressing the small blood vessels of the uterine muscle and thus partially depriving it of oxygen. It is this lack of oxygen, called hypoxia that causes most menstrual pain.

Are there different "types" of painful periods?

While we are all affected by periods, unfortunately, we are not all equal in the face of pain. For some people, the contractions are quite tolerable, but for others, they are simply unbearable. We now know that in 10-15% of women suffering from dysmenorrhoea, the pain is so severe that it seriously interferes with daily life. 1-2

We all have a friend, sister or colleague who is unable to go to work or leave bed when she has her period.

You should know that the term ‘menstrual pain’ is used to cover two types of dysmenorrhoea:

• Primary dysmenorrhoea: the famous natural cramps mentioned above. They are very common and are mainly due to the action of prostaglandins. This pain occurs most frequently during adolescence and tends to decrease, or even disappear completely, with age.
• Secondary dysmenorrhoea: It affects adult women, who may not have suffered from menstrual pain until then. Its causes are physiological, related to a medical or gynaecological problem: genital infections, ovarian lesions, pelvic inflammatory disease, etc. There can be many different medical conditions which cause secondary dysmenorrhoea, including endometriosis: a chronic gynaecological disease that has been widely discussed in recent years.

So, when should you consult a healthcare professional?

You need to learn to listen to your body. If menstrual cramps are a hindrance to social or family life, if they prevent you from going to work, school or ruin your life to the point of lowering your morale, you should make an appointment with a healthcare professional: gynaecologist, pharmacist, midwife, etc. or even your general practitioner.

If your periods become abnormally painful when they were not before, or if they are suddenly accompanied by heavy bleeding, you should not hesitate to consult a doctor. Especially if you have a fever. A healthcare professional will be able to reassure you and answer all your questions.

How can you relieve menstrual pain?

The pain is not inevitable. There are of course medicines available to alleviate menstrual cramps, but before you pull out the big guns, you can first give natural solutions a try. There are many of them, but here are some that we can recommend to you:

• Place a hot water bottle on your lower abdomen or take a hot bath: heat acts directly on the vasodilation of blood vessels and helps relax the muscles that contract during menstruation. The heat brings immediate relief.
• Gently massage the painful area: this also ‘relaxes’ the muscles, especially the uterine muscle, to reduce spasms.
• Moan for a good ten minutes to your cat, your neighbour, your boyfriend, the postman (we agree, this does absolutely nothing, but at the time, it might make you feel a bit better)
• Reduce your consumption of refined sugar: the latter increases insulin production and excess insulin leads the production of prostaglandins. You can replace it with honey or agave syrup, for example.
• Try essential oils: apply them directly to your lower abdomen or put drops under your tongue. Peppermint, basil, dill, hemp, tarragon, sage, etc. There are a wide variety of plants known for their action on dysmenorrhoea. However, it is recommended that you consult a pharmacist who will guide you towards the most appropriate oil and dosage.

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1 Schroeder B. Dysmenorrhea and pelvic pain in adolescents. Pediatr Clin North Am June 1999; 46 (3): 555 – 71

2 Kwon JS. Dysmenorrhea. Journal SOGC August 1997: 955 – 62

3 College National des Gynécologues et Obstétriciens Français

4 Source: social security.