Richmond Practice - Are pains cramping your style?

Are pains cramping your style?
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Why do I have period pain cramps?

Period pain (dysmenorrhoea) is common. The menstrual pain is usually a mild, crampy, pain in your lower abdomen and may last for 2-3 days. However, it becomes a medical condition if the pain is severe and affects your daily life.

Primary dysmenorrhoea is the most common type of painful periods. It most often occurs in teenagers and women in their 20s and is where there is no underlying problem of the uterus (womb) or pelvis. The cause is not clear but may be related to a build up of too many prostaglandins in the lining of the uterus. Prostaglandins help the uterus to contract and shed the lining of the uterus during a period. If the uterus contracts too hard, the blood supply may be reduced and this may lead to pain.

The pain:
  • may spread to your lower back, or to the top of your legs
  • usually starts as the bleeding starts, but it may start up to a day before
  • usually lasts 12-24 hours, but lasts 2-3 days in some cases
  • can vary with each period - some periods are worse than others
  • tends to become less severe as you get older or after having a baby.

Most women with mild menstrual pain would find relief by holding a hot water bottle against their tummy and using painkillers.

Secondary dysmenorrhoea is less common and is more likely to occur in women in their 30s or 40s. It is where the pain is caused by a problem of the uterus or pelvis. Here, severely painful periods could be associated with endometriosis, contraceptive coils, fibroids, or infections. With secondary dysmenorrhoea you may notice a change in your usual pattern of pain.
The pain:

  • may be more painful and/or last longer than it used to
  • may start several days before the period begins
  • may last all the way through the period (uncommon with primary dysmenorrhoea.)

For further investigation into the cause of secondary dysmenorrhoea your doctor might suggest a referral to a gynaecologist. Treatment would depend on the underlying cause but may include an ultrasound scan to look at your uterus and pelvis and a swab to look for signs of infection.

Consult your doctor if:
  • the pain is affecting your daily life
  • the pain is not eased with painkillers
  • there is also vaginal discharge
  • there is also irregular bleeding
  • the bleeding becomes heavier than previously
  • you also find it difficult to conceive
  • there is pain or bleeding during, or after, sexual intercourse
  • you should urgently get medical help if you are in extreme pain or losing a great deal of blood

At Elsbeth's Doctors our female consultant gynaecologists are specialists who can assess your condition, and then make recommendations.



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