Painful periods (dysmenorrhoea) tend to peak quite soon after puberty, so if your periods are getting more painful as you get older, see your healthcare provider.
There are 2 types of painful periods: primary dysmenorrhoea and secondary dysmenorrhoea.
Primary dysmenorrhoea is the term used for painful periods that have no known cause.
- Primary dysmenorrhoea is very common, affecting more than half of all women at some stage.
- The symptoms tend to only last 1–2 days and are thought to be caused by prostaglandins, hormone-like substances found in many body tissues.
- Prostaglandins stimulate contractions of the muscles of your uterus during your period.
- These contractions compress the blood vessels to the uterus, temporarily cutting off the blood supply and depriving the tissues of blood, which triggers pain.
Secondary dysmenorrhoea is the term used for painful periods that are due to an underlying condition such as:
- endometriosis (the most common cause)
- inflammation of your fallopian tubes
- fibroids (growths in your uterus)
- some types of intrauterine device (IUD) used for contraception.
Diagnosis is mostly based on history and will look at the pattern, duration and how severe the symptoms are. A small number need further investigations, such as a laproscopy to look inside your pelvis for any sign of endometriosis or inflammation.
What are the symptoms of painful periods?
The common symptoms of dysmenorrhoea are pain and cramps in the lower abdomen. The pain and discomfort is usually most severe for the first day or two of your period. Other symptoms that may be related to dysmenorrhoea include:
- constipation or diarrhoea (runny poo)
What is the treatment for painful periods?
If you have painful periods, see your doctor to discuss what treatment options are the best for you. Commonly used treatments include:
- non-steroidal anti-inflammatory drugs (NSAIDs) such as ibuprofen, naproxen and diclofenac
- aspirin or paracetamol
- contraception – some women find taking the combined pill helpful
- Mirena (intrauterine contraceptive device or IUCD) reduces pain and bleeding for most women.
The treatment with the best evidence is use NSAIDs such as ibuprofen, naproxen and diclofenac. A systematic review of 73 studies showed that these medicines work better than paracetamol for painful periods. However, they can cause side effects such as gastric upset in some people, so make sure to take them with food and watch for any symptoms.
The following treatments need more research to know whether they help or not:
- fish oil
- uterine nerve ablation
- vitamin B-12
- other intra-uterine systems (IUS).
Self-care for painful periods
There are a range of things you can do that may help such as:
- heat packs or a hot water bottle placed on your lower abdomen (several studies show this helps)
- relaxation and exercise
- acupuncture – shown to be somewhat helpful
- taking vitamin B1 & magnesium may be helpful, but more research is needed.
- Brown J, Brown S. Exercise for dysmenorrhoea Cochrane Database of Systematic Reviews 2010, Issue 2. Art. No.: CD004142. DOI: 10.1002/14651858.CD004142.pub2
- Chaudhuri A, Singh A, Dhaliwal L. A randomised controlled trial of exercise and hot water bottle in the management of dysmenorrhoea in school girls of Chandigarh, India Indian J Physiol Pharmacol. 2013 Apr-Jun;57(2):114-22.
- Dysmenorrhoea, painful periods: frequently asked questions American College of Obstetricians & Gynaecologists, 2015
Chen HM, Wang HH, et al. Effects of acupressure on menstrual distress and low back pain in dysmenorrheic young adult women – an experimental study Pain Manag Nurs. 2015 Jun;16(3):188-97. Epub 2014 Aug 28.