Period pain- symptoms, tests & treatment
Painful periods- what is dysmenorrhoea?
- Dysmenorrhoea is a medical term for period pain that is bad enough to affect a woman’s usual daily activities.
- Often non-sufferers don’t fully understand just how painful periods can be
- Other symptoms such as fainting, vomiting, diarrhoea, and thigh pain often occur
- Often, even with bed-rest, hot water bottles and painkillers, the symptoms for the first few days of a period can be very debilitating for some women.

Risk factors for painful periods
Certain risk factors for dysmenorrhoea have been identified.
- It occurs less often in women who have had their children earlier in life, and in women who exercise more.
- It is more common in women whose periods start before the age of twelve, women who have a low body weight or who are obese, and in women who are smokers- especially girls who start smoking in their early teens.
So, what causes painful periods and what are prostaglandins?
- In dysmenorrhoea, the uterus works harder than normal to shed its lining and the resulting contractions lead to pain.
- The hormone-like compounds that cause these contractions are called prostaglandins.
- If you prevent prostaglandins forming in the first place, by taking an anti-inflammatory, the pain may be a lot less.
- However, once prostaglandins have formed, the pain can be hard to reverse.
What tests should be done if you have painful periods?
- It’s important to see your doctor to exclude underlying causes- such as
- endometriosis
- fibroids
- adenomyosis
- pelvic infection
- There may be a need for
- a physical examination
- blood tests
- STI tests (this may involve blood tests, urine tests and genital swabs)
- a pelvic ultrasound scan
- In certain cases, referral to a specialist may be arranged- for example, if endometriosis is suspected, a gynaecologist may need to perform keyhole surgery to make the diagnosis.
What’s the best treatment for period pain?
- To help with the pain, anti-inflammatories, also known as NSAIDs, are often a good place to start (assuming you have no contraindications to these meds- always check the patient information leaflet if unsure). Some anti-inflammatory medications can reduce the heaviness periods too. But here’s an important fact that a lot of women don’t know- anti-inflammatories will minimise pain only if they are taken very early in a period, or just prior to a period- before prostaglandins get a chance to form in the uterus (womb).
Other treatment for painful periods
- Hormonal treatment such as the contraceptive pill, depo injection or an intrauterine device, can be helpful in managing painful periods.
- These options obviously make sense if a woman also needs birth control, and are worth discussing with a GP.
So the take home messages- consider EARLY use of anti-inflammatories, try to exercise more, avoid smoking, maintain a healthy weight, and consult your doctor to exclude underlying problems, and perhaps to explore further treatment options.
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