By Suzannah Patterson, Period Pro from the University of Central Florida College of Medicine
If you’re reading this because you experience period pain and want to know more about what is going on with your body…you are not alone!
Over half of people who menstruate experience period pain (usually mild) for one to two days each month. Cramps in the lower abdomen or back, bloating, breast tenderness, moodiness, food cravings, and acne are all normal period symptoms that we must deal with from time to time. But one thing is certain: while periods can be inconvenient and even downright uncomfortable, your period pain should never stop you from living your life and doing the activities you love. So, how do you know when period pain is something you should talk to your doctor about?
What is “normal” period pain and how can I manage it?
First let’s talk about what is considered normal. Dysmenorrhea is a fancy word that just means period pain. Primary dysmenorrhea is that typical cramping pain that feels like a dull, continuous ache in the lower abdomen (where your uterus is located), sometimes radiating to the lower back and thighs. There is also secondary dysmenorrhea, but we’ll get to that in a moment.
So what causes these period cramps anyway? Well, the lining of the uterus (Remember what it’s called? The endometrium!) produces natural chemicals called prostaglandins that behave similarly to hormones. Prostaglandin levels are high at the beginning of menstruation, and they promote contraction of the muscular walls of the uterus, causing pain. However, as your period continues and the endometrial lining is shed, prostaglandin levels drop. This is why period cramps tend to get better after the first few days of your period.
Let’s face it, period cramps are no fun—but there are steps you can take to alleviate the pain. Nonsteroidal anti-inflammatory drugs such as ibuprofen (called Motrin) and naproxen (called Aleve), are medications you can buy over the counter that block the action of prostaglandins and thus block the pain they cause. Exercise also produces natural chemicals in your body that block pain, so staying active while on your period is a great way to keep menstrual pain in check. Many people find relief by applying heating pads to their abdomen or lower back. Eating healthy foods, getting plenty of sleep, and managing your stress are also important in controlling period symptoms (see: “Can Stress Really Affect the Menstrual Cycle?” by Kelly Sutter). If none of these methods can reduce your symptoms and your pain is interfering with your daily activities, then it’s time to seek help from a medical professional.
How much pain is too much? Know when it’s time to see a doctor.
In addition to the regular period cramps described above, many menstruators experience intense pain when menstruating, sometimes with other severe symptoms like diarrhea, nausea, vomiting, headaches, and dizziness. This may indicate a disorder of the reproductive organs (Do you remember your female anatomy? I’m talking about the uterus, endometrium, cervix, ovaries, and fallopian tubes!). This kind of period pain is called secondary dysmenorrhea and is caused by a health condition. Some include endometriosis (when endometrial tissue becomes implanted in another location, such as the fallopian tubes or ovaries), uterine fibroids (abnormal muscular growths in the walls of the uterus), and adenomyosis (when endometrial tissue grows into the uterine wall, causing the uterus to thicken and enlarge). Sexually transmitted infections can also cause or worsen menstrual pain. Now hold up for a moment – I know this all sounds scary! But if you are experiencing severe period pain due to one of these conditions, your doctor CAN help.
Just to make it clear, here are some signs that you should see your doctor:
- Bleeding for more days than usual or more heavily than usual (Remember, periods should NOT last more than 1 week and you should not be bleeding through more than 6 period products per day!)
- Bleeding between periods (Your cycle should last 21-45 days—that means 3-6 weeks between periods! If you regularly experience significant bleeding more frequently than this, tell your doc!)
- Severe pain, nausea, or other symptoms that are interfering with your ability to sleep, focus, attend school, stay physically active, and participate in social activities
If this sounds like you, check out our other post on How to Talk with Your Doctor about Period Pain so you get the most out of your visit and receive appropriate treatment!