Painful menstruation (dysmenorrhoea)

Reviewed by Dr Philip Owen, consultant obstetrician and gynaecologist

What are menstrual pains?
Many women experience pain or discomfort at the time of their periods. For most, the pain or unease is not so severe that it interferes with their daily lives or requires any special attention.

However, for some women their monthly period is problematic and almost disabling because of the pain and inconvenience caused. They may have to take time off from school or work and stay at home for one or two days.

Although painful, periods are only sometimes a sign of an actual disease.

If period pains are more than an inconvenience then it is wise to consult your doctor or gynaecologist.

What causes menstrual pains?
The natural pains are caused by contractions in the musculature of the uterus. The contractions are caused by the release of the body's prostaglandins, which are hormones produced by the lining of the womb.

How can you avoid menstrual pains?
The best thing to do yourself, besides convincing yourself that you are not sick, is to stay in good physical health. This can be achieved by a healthy lifestyle with daily exercise, plenty of sleep and rest and, if possible, try to avoid stress. Over-the-counter painkillers, in particular ibuprofen (eg Advil, Nurofen), are often helpful and your pharmacist can often give advise you further on which ones are right for you.

What can the doctor do?
If your period pains are not relieved by simple painkillers then your doctor may wish to perform a pelvic examination to rule out any underlying conditions that can cause dysmenorrhoea.

Depending on this, a pelvic ultrasound scan or laparoscopy may be suggested. Medical treatment includes NSAIDs (non-steroidal anti-inflammatory drugs) and also the contraceptive pill.

By preventing ovulation the contraceptive pill reduces the production of prostaglandins and pain. If the pain is found to be caused by a condition such as pelvic inflammatory disease, endometriosis or fibroids, then the treatment will be tailored towards that condition.

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