Period Pain: Understand the mechanism

Periods can be a very uncomfortable time of the month for a lot of women. While some can predict their symptoms and dates like clockwork and some lucky souls rarely even experience period cramps, there is still a large majority of women that face irregular symptoms with distressing pain especially in their lower abdomen and back just before or during their periods.

What is dysmenorrhea?

Menstruation is ideally the loss of blood and tissue from the uterus. The cycle generally helps the body prepare for pregnancy and is controlled by hormones like estrogen and progesterone. Though period pain and cramps are associated with unease, it is essentially not a bad thing. It signifies the start of another healthy menstrual cycle.

Usually, cramps vary from mild nagging pain to a sharp stabbing pain that goes right from the belly to the lower back. This severe pain is generally called dysmenorrhea. It is caused due to the change in the hormone-like substance, prostaglandins, that causes the uterine walls to contract and eventually shed its lining resulting in periods. The degree of pain is often co-related to the levels of prostaglandin in a women’s body.

Other conditions that may result in pain or cause cramps are:

  • Endometriosis which causes the lining of the uterus forming outside, i.e. in the fallopian tube or the lining of the pelvis causing chronic pain
  • Uterine fibroids are non-cancerous growths that occur on the uterus walls and cause pain in the areas that they grow.
  • Adenomyosis makes the tissue lining of the uterus grow into the uterine walls
  • Pelvic Inflammatory diseases is a sexually transmitted disease that often affects female reproductive organs and is caused due to bacteria exchange during sex
  • Cervical stenosis restricts the flow of menstrual blood increasing pressure on the uterus and causing severe pain.

The study published in the Journal of women’s health surveyed over 3302 women and found the presence of CRP(C – reactive protein) that triggers acute inflammation causes the symptoms of PMS. Previous research on CRP and its co-relation to abdominal cramps, back pain, appetite, cravings, and bloating have all been associated with higher levels of the hormone. The result also suggests that factors related to each premenstrual symptom are complex and need further studies in the area. Women are often recommended to take anti-inflammatory drugs to ease pain and discomfort. However, the social taboo about periods has restricted scientific research, and the avenue has remained unexplored as compared to other health issues.

Professor John Guillebaud, a famous professor of reproductive health from the University College London reignited the debate in February about the quality of scientific research on menstrual pain, after saying that period pain is “as bad as a heart attack.

He said: “Men don’t get it and it hasn’t been given the centrality it should have. I do believe it’s something that should be taken care of, like anything else in medicine.”

Symptoms of menstrual cramps:

Symptoms may often include a throbbing or cramping pain in the lower abdomen from 1 to 3 days before the beginning of the period. This pain peaks 24 hours after the onset of the period and subsides within 2 to 3 days into the period. Some women may also experience a dull, continuous ache radiating to the lower back and thighs coupled with nausea, loose motions, headaches and dizziness.

When to visit a doctor?

The symptoms are often overlooked as part and parcel of the menstrual cycle, but it is very important to know when to visit a doctor. No matter how regular it is, if the pain begins to hamper everyday activity and disrupt life while getting progressively worse, you may need professional medical attention.

Tough individually, menstrual cramps do not pose any severe complications but the conditions associated with the cramps may be of concern. Endometriosis causes fertility problems while pelvic inflammatory disease can scar the fallopian tubes making it difficult for the fertilised egg to implant inside the uterus.

Tackling menstrual cramps

Managing period cramps may vary from individual to individual depending on the severity of their pain. Time and again over the counter pain relievers like non-steroidal anti-inflammatory drugs (NSAIDs) like Ibuprofen and Naproxen help lessen the amount of prostaglandin released in the body hence relieving the pain. However, these must be avoided in case of stomach problems, ulcers, liver disease etc.

Homemade remedies play a very important role in easing out period cramps like taking hot water baths with aromatherapy oils or snuggling in with a hot water bottle may help women relax. Back and stomach massages have often proven to be comforting to women. Certain foods such as salmon, fruits, dark chocolate etc. help with providing essential nutrients to the body in the form of vitamin d, B6, Omega-3. They also help in release serotonin, i.e. the “happy hormone” that helps regulate not only cramps but also mood swings, bloating, and food cravings.

Wearing loose fitting clothes and gentle exercises like yoga may help one stretch and ease the pain. Regular relaxation programs a few days before or during periods help relax muscles and increase blood supply to the pelvic area. Women also must make sure to stay healthy and make sure they opt for the best period products suited for their well being be it sanitary napkins, tampons, menstrual cups or disposable pads. Women must pick what they feel comfortable in and what is best suited for her life and schedule. Sanitary napkins for periods should be chosen basis the flow of the period and also by what size of napkin is best suited for the individual.

Lifestyle changes:

Research shows that a few lifestyle changes can help ease period pains. Some of them include getting adequate rest and sleep, regular physical activity and exercise along with cutting down on smoking and alcohol consumption. These methods have been proven to increase the supply of oxygen to the pelvic area hence relaxing the body. Consumption of high fibre foods that are rich in vitamin E as

well as lean meats like chicken and fish while reducing amounts of salt and sugar help relieve heaviness and bloating.

Taking supplements containing gamma-linolenic acids (GLA) such as evening primrose oil, starflower oil or vitamin B6, helps maintain hormonal balance. If pain persists, a visit to the Gynecologist is always advisable who may help with other more medically supported treatments such as non-hormonal treatments or contraceptive pills that may help reduce pain, regulate periods and make them lighter. Intra-Uterine systems may also be useful for some women as not only an effective method of contraception but also to reduce blood loss and period pains.

Thus it might seem impossible to evict period pains from a woman’s life completely but small changes can help go a long way.