Period Pain (Dysmenorrhoea)

Period Pain or dysmenorrhoea is very common and occurs in between 45-95% of reproductive women (eTG 2012).

The pain is associated with menstrual bleeding and although it can be debilitating resulting in absences from work or school it is not life threatening.

Causes of Period Pain

Women are more likely to experience Period Pain if they:

• Are overweight or obese
• Started their periods at an early age (before 11 years)
• Have never had children
• Smoke or Drink Alcohol
• Periods last longer than 5 days 

Period Pain or dysmenorrhoea can be classified as Primary (where no underlying abnormalities are found) or Secondary (where the pain can be caused by an underlying condition such as endometriosis or other abnormal pathology).

Primary dysmenorrhea is caused by prostaglandins, which are chemicals in the body that cause strong physiological changes including muscle contraction and blood vessel constriction.  Prostaglandins are made by the uterine tissue and are released during periods causing contraction of the uterine muscles and constriction of blood vessels in the uterine area causing lack of oxygen to these muscles.

If you have always had period pain it is likely to be primary dysmenorrhea although if painful periods start suddenly, suddenly increase in severity or occur in later years it is important to have further investigations to check for secondary causes such as infection, ovarian cysts, endometriosis, or fibroids.

Symptoms of Period Pain

Normal symptoms can include:

• Lower back pain
• Cramps
• Nausea
• Vomiting
• Diarrhoea
• Headaches

The following symptoms indicate further investigation are needed and you should see your doctor:

• Menstrual cramps that are stronger or last longer than usual
• Excessive bleeding where maternity pads or tampons require changing more frequently than every hour
• Signs of infection such as fever, chills and body aches at the time of your period
• If Period Pain starts for the first time and you are over 25 years of age

The following symptoms indicate that you should go to the hospital:

• If you faint or feel dizzy on standing
• If you get severe pain causing you to double over in agony
• If you pass clots of silvery-greyish tissue with the blood
• If you think you are pregnant and you begin feeling period pain

Diagnosis usually occurs through asking questions to establish if the period pain is primary or secondary.  If secondary period pain is suspected further diagnostic tests such as an ultrasound or internal examinations by your doctor or gynaecologist may be necessary.

Treatment of Period Pain

Treatment of primary period pain is usually symptomatic.  Heat packs are usually tried first and then anti-inflammatory pain relief can be given by speaking to your Pharmacist and establishing if these medications are suitable for you with consideration given to any other medical conditions or medicines you may take.

There are also some nutritional supplements as well as lifestyle advice that can help to relieve your symptoms such as weight loss, reducing the amount of salt in your diet and some herbs that are useful at relieving period pain.

Next Steps

Come into a Pharmacy 777 Pharmacy and speak to your pharmacist about the symptoms you are experiencing and what you have already tried for the period pain.

Answer their questions to establish if there are other over the counter products that may assist.

The Pharmacist may also choose to perform an in store Medicine Use Review to help establish the best course of action for managing your symptoms with medication.

If our Pharmacists feel it is necessary you will be referred to a GP and on request the Pharmacist can write a referral outlining the treatment used to date and the concerns that need to be investigated.

Bibliography:
eTG. 2012 "Dysmenorrhea [Amended June 2010]." Therapeutic Guidelines Limited 2012, http://online.tg.org.au/complete/tgc.htm