Painful periods affect many women. For some, it’s merely annoying; for others, it can be so bad that getting out of bed seems impossible.
The term for severe pain during menstruation is dysmenorrhea. It is marked by different types of pain in the abdomen and lower back. In most cases, the pain is normal and is not related to a specific problem with the reproductive organs. But sometimes there is an underlying disorder that could be causing the pain. This is a condition known as secondary dysmenorrhea.
So just what exactly is going on when the pain from your period starts to settle in? And what should you do about it?
Prevalence of Dysmenorrhea
If you’re hurting from your periods, you’re not alone. According to the American College of Obstetricians and Gynecologists (ACOG), dysmenorrhea is the most reported menstrual disorder. More than 50% of all women who menstruate suffer from pain 1-2 days each month.
Many women with dysmenorrhea begin to suffer from period pain early in life. Often it begins soon after they start having menstrual periods. In most cases, the pain will get less severe as they get older or after they give birth.
On the other hand, secondary dysmenorrhea sets in later in life as women get further into adulthood. The pain will usually get worse, not better, over time.
What Causes the Pain?
Period pain usually occurs because the uterus is shedding its lining. It does this in preparation for the next menstrual cycle. To shed its lining, the muscular wall of the uterus will contract. This will block off blood vessels, causing pain. At the same time, the body will release prostaglandins, hormone-like compounds that cause the uterus to further contract, leading to even more pain.
There could be other causes of the pain, however. Sometimes the pain is so severe that you are missing school, work, or other types of regular activity. If this is the case, or if it persists when you aren’t on your period, get in touch with your healthcare provider to get a diagnosis. You might be suffering from secondary dysmenorrhea.
Possible Causes of Secondary Dysmenorrhea
There are a few possible causes for secondary dysmenorrhea:
Fibroids. Uterine fibroids are fairly common, especially for African American women. They are non-cancerous tumors that grow on or within the muscle tissue of the uterus. Symptoms of fibroids include heavy menstrual bleeding, pelvic pain and pressure, frequent trips to the bathroom, and loss of bladder control.
Endometriosis. Endometriosis occurs when tissue similar to the lining of your uterus grows outside your uterus. The tissue bleeds monthly just like your period. The tissue could be in your ovaries, fallopian tubes, behind the uterus, or on the bladder.
Adenomyosis. This is when tissue that normally lines the walls of the uterus begins to grow in the muscle in the wall of the uterus.
There are a few treatment options available if you suffer from painful periods.
Mild pain can be relieved by placing a heating pad on your abdomen or taking a hot shower. It also helps to get plenty of rest, to massage the affected area, and to avoid salty and caffeinated foods.
If the pain is enough to prevent you from doing everyday activities, start by talking to a healthcare provider. He or she may start by asking you to take anti-inflammatory drugs like ibuprofen. These should be taken at the first sign of menstrual pain and should not be used for more than two days. Your healthcare provider may also recommend using birth control pills if the drugs aren’t working.
Your healthcare provider may also want to run some tests or do a procedure to figure out what’s going on. He or she may perform a pelvic exam or an ultrasound exam. In some cases, a laparoscopy may be necessary. This is a surgery that lets your healthcare provider look inside the pelvic region.
Once your doctor finds the cause of the period pain, there are a few treatment options. If endometriosis or adenomyosis is causing the pain, there are some hormonal treatments, such as birth control pills, that can help to relieve the pain.
If fibroids are causing your period pain, there is a treatment called uterine fibroid embolization (UFE). This focuses on cutting off the blood flow to the fibroids. It is a minimally-invasive outpatient procedure.
If other treatment options don’t work and you’re still in pain, then surgery may be needed. A hysterectomy can be performed, usually as a last resort. This will result in the removal of your uterus and will lead to infertility.
Finding more information
Our website goes into more depth on how to know if you have uterine fibroids. If you are interested in finding a physician who can perform the UFE procedure, we have a tool that can help you find one in your area. Simply enter your zip code to get a list of physicians who perform UFE in your area.
PLEASE NOTE: The above information should not be construed as providing specific medical advice, but rather to offer readers information to better understand their lives and health. It is not intended to provide an alternative to professional treatment or to replace the services of a physician.