Painful Periods: What You Should Know

“Ouch, my stomach…I think I’m getting my periods!”. This is something every woman would have said many, many times in her life. And something only a woman can understand. Abdomen cramps, back pain, leg pain, vaginal cramps, nausea, dizziness, fatigue, mood swings…mensuration related discomforts can show up days before the bleeding begins.

Menstrual pain or dysmenorrhea is characterised by dull or intense cramps in the lower abdomen and back, can set in a couple of days before the bleeding begins and go on till the third day of the period. Annoying to say the least, period cramps can actually affect one’s normal life and

So what causes this pain? The span of a menstrual cycle is approximately 28 days (day 1 of the bleeding to day 1 of the next bleeding). During these days, if there is no sperm to fertilise the egg released during ovulation and start a pregnancy, the uterus contracts to expel its lining (endometrium) and begins to form a new one. The process of shedding of endometrium through the vagina is called mensuration or menses or periods. The hormones at play during the menstrual cycle are oestrogen (which helps build the endometrial lining) and progesterone (which help shed the lining of the uterus). The change in hormone levels is what causes mood swings prior and during the menstrual cycle.

Periods are triggered by a hormone-like substance called prostaglandins, which are chemicals that form in the lining of the uterus at the time of menstruation. Prostaglandins cause muscle contractions and cramps in the uterus (to force-shed the lining), which is very similar to labour pain. Besides, these contractions also inhibit the blood flow to the lining of the uterus, making the cramps worse. They also cause nausea and diarrhoea.

When should you seek medical help?

Menstrual pain is normal and should go off in a few days. However, if you experience symptoms including severe, prolonged pain/ cramps in the lower abdomen, pelvis or back, heavy bleeding and irregular cycles, we recommended you consult a Gynaecologist without delay, as there can be possible underlying causes like:

1. Endometriosis or abnormal growth of endometrium outside the uterus – on the pelvis, ovaries, fallopian tubes etc. This can in turn lead to conditions like chocolate cysts (blood-filled cysts), internal bleeding and adhesions. If not treated early, endometriosis can cause severe dame to the uterus and even lead to infertility.

2. Adenomyosis – a condition that is similar to endometriosis, except that the endometrium implants deep within the uterine muscle, causing extreme abdominal cramping and pain during intercourse.

3. Uterine fibroids that increases bleeding and severity of cramps.

4. Pelvic inflammatory disease or infection of the reproductive tract caused by untreated sexually transmitted infections. This condition, if untreated, can lead to complications including infertility and cervical cancer.

How can period cramps be managed?

Many women take tablets to get rid of menstrual cramps, but the effect may not last long. Here are 9 simple yet effective ways to deal with menstrual pain.

1. Drink plenty of water

Staying hydrated will help manage bloating, which makes cramps worse. Drink as much water as you can. You could even flavour the water by adding a sprig of mint and/ or a wedge of fresh lemon.

2. Avoid salty food

Salt can pull water out of your body, leaving you dehydrated and fatigues. Stay away from high-salt, fried food.

3. Eat right

A good diet also helps reduce pain. Include whole grains, lentils, vegetables, green leafy vegetables, nuts, fruits and oily fish like sardine and salmon that are rich in nutrients such like Vitamin B1, B6, Omega-3, Magnesium and Zinc. These reduce the hormone-like substances that cause painful cramps and help relieve inflammation.

4. Keep away from tea and coffee

Caffeine makes cramps worse, so say no to tea, coffee and call caffeinated drinks/ food when your periods are on.

5. Heat packs

Hot compresses help alleviate pain. Use heat pads, hot water bags or simply fill a glass bottle with hot water, wrap in a thin towel and hold near the lower abdomen –pelvic area.

6. Exercise

Physical activity reduces cramping by increasing blood flow and easing muscle tension. 30 minutes of brisk walking is the easiest you can do.

7. Essential oil

Fragrant, natural essential oils like lavender and marjoram oils can ease pain and stress. Just rub a few drops on your stomach to feel better.

8. Take a warm bath

A warm, relaxing bath soothes the muscles and relives cramping. It will also make you feel fresh and less tired.

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