Period pain is so common that we think it is normal! Truth be told, period pain that leaves you on the floor, in your bed, or reaching for painkillers is not normal. The degree of pain you feel can point to an excess of inflammation or an underlying medical condition.
You should not have to suffer in silence, and many of us do because no one takes us seriously or we don’t take our own pain seriously. In this post, we’ll dive into the different types of period pain and what they may mean. We’ll also discuss various ways we can reduce this pain and how to combat it before and during the cramps.
Which type of period pain do you have?
Period pain or cramping in fancy terms is called dysmenorrhea. There are two different types, primary and secondary, which represent the reasoning behind the pain. You may have one or the other, or both.
1. Primary Dysmenorrhea
This type of period pain onsets once you get your first period. It is the pain from “having your period” — the contractions of your uterus — not from an underlying medical condition.
- Cramping related to period – uterine muscles working to push out blood – can be worse due to high prostaglandins causing inflammation and contractions / constricting blood flow to the area. Generally the higher the prostaglandins the higher the pain. A higher estrogen ratio can cause increased prostaglandins as well.
- Pain can be felt in the pelvic region or lower back.
- Pain begins just before or after period starts. lasting from hours to a few days.
- Should not interrupt daily activities and can be relieved or improved through diet and lifestyle.
2. Secondary Dysmenorrhea
This type of period pain is caused by an underlying medical condition associated with the reproductive organs. Often characterized by increased and prolonged pain during the menstrual cycle. This pain often starts before the onset of the menstrual phase, even 1-2 weeks before and can continue after that cycles bleeding ceases. Prolonged spotting is commonly seen with this type of cramping as well.
- Pain is often throbbing, aching, searing or stabbing.
- Often in the pelvic region, back and lower thighs, and legs.
- Often comes with heavier bleeding spotting and irregular cycles
- Can cause nausea, vomiting, dizziness and fainting
- We often see higher inflammation and prostaglandins contributing to pain
- Can get worse as you age, then tends to get better at menopause.
Medical conditions that can be associated with secondary dysmenorrhea:
- Endometriosis
- Adenomyosis
- Ovarian cysts
- Uterine fibroids
- Uterine polyp
- Obstructions / pelvic adhesions(scarring)
- Cervical stenosis (narrowing of cervix)
- Pelvic inflammatory disease
- Infections
- Other conditions like Crohn’s etc.
Evaluation for Period Cramps
Receiving the proper evaluation from a medical expert is imperative to receiving the correct treatment. Reach out to your naturopathic doctor, General practitioner, gynecologist or health clinic to get to the root of your pain.
Gaslighting is known to occur when dealing with women’s and reproductive health issues. If you feel you are not being taken seriously or invalidated find a new practitioner. Read more Here.
A good practitioner will evaluate your health history, and family history — family history of endo can 10 x increase the risk of having endometriosis — current lifestyle and diet, infection risk, and commonly include bloodwork, a pelvic exam, or ultrasound. More extreme interventions can include hysteroscopy or laparoscopy for example.
Solutions for Period Cramping
As stated above, treatment would depend on the root cause, your personal history and type of period pain you are experiencing.
Allopathic methods for Period Pain:
- NSAIDs like Ibuprofin, ie. Advil or naproxen to reduce prostaglandins. This works to reduce severity and inflammation and is used by many, but can be hard on the stomach, kidneys and liver – especially if used chronically. Try to avoid taking it on an empty stomach if you choose to take this medication.
- Hormonal Birth Control is commonly prescribed to reduce period pain. Often touted as “regulating your menstrual cycle” although this is NOT what it does. Hormonal birth control like the combined pills, patch and ring will “shut down” your natural cycle and production of hormones, thus eliminating the natural ebs and flows of your cycle therefore often reducing flow and cramping. IUDs and mini progestin-only-pills can work similarily to reduce flow and cramping although they don’t aim at preventing ovulation like the combo pils, patch and rings do. Often period pain or underlying medical condition is still there and may continue to worsen or reappear once hormonal contraception is discontinued. Talk to your doctor if a hormonal birth control method is right for you.
Natural or Holistic Methods for Period Cramps:
- Exercise – aim for 20-30 min every day – yoga, pilates, walks, strength training, resistance training.
- Sleep – aim for 7-9 hours of uninterrupted sleep — read this post on the top 10 sleep tips for balanced hormones
- Reduce Stress – do things you enjoy, meditation, music, drawing, dancing etc
- Quit smoking – reduce inflammation and toxic load on the body which can worsen cramping.
- Supplements – magnesium bysglycinate, vitamin b6 P5P, vitamin B1, vitamin E, zinc, omega 3, turmeric, NAC— Read 5 nutrients for hormone balance – check with your doctor before supplementing.
- Topical Magnesium spray/lotion
- Dietary changes – lower caffeine consumed, try avoiding dairy OR opting for A2 dairy like goat, buffalo and sheep, avoiding gluten as some react poorly increasing inflammation or contributing to “leaky gut”, limit or avoid alcohol, avoid highly processed foods, avoid excess sugary soda.
- Opt for whole foods, fruits, veggies, organic or grass-fed meats and pastured eggs and poultry, omega-3-rich seafood, nuts and seeds.
- Include olive oil in diet, cook with avocado oil, coconut oil or ghee, reduce or eliminate refined vegetable oils
- Hydrate ~ 2 L of water daily, and add in minerals or sea salt/electrolytes
- Ginger tea, red raspberry, dandelion tea
- Spend time in nature, walks, nature-bathe, grounding
- Acupuncture or pelvic massage
- TENS machine for pain reduction
- Red light therapy for reducing inflammation and relaxing pelvic muscles.
- Sauna/heat packs
Pain should improve in 3-6 months using some of the recommendations above. If you are not seeing improvement, you may need to look into secondary dysmenorrhea and associated medical conditions.
Conclusion: What is Normal and Not Normal Period Pain
No amount of pain during your period is considered “normal” depending on who you talk to, but more than 50% of menstruators experience a mild pain/ache lasting a day or two around your period. This is due to the normal and natural prostaglandins which cause the uterine muscles and blood vessels to contract and shed your lining. The level of prostaglandins is higher in the first couple days of your period and then decreases.
This type of pain should improve with natural treatments like lifestyle, diet and supplements.
What is NOT normal is severe pain that is constant, long-lasting, searing, stabbing, high on the scale of 1-10, burning, migrating to other places, makes you miss school, work or other activities or makes you want to throw up.
This may suggest an underlying medical problem like endometriosis, adenomyosis, a fibroid, polyp or ovarian cyst, etc. as stated above. If this is you, you shouldn’t have to suffer, I suggest being evaluated by a medical professional to help you on your journey.
This Post Was all about “What Your period pain says about you“
Citations
- American College of Obstetricians and Gynecologists (ACOG). (2020). Dysmenorrhea: Painful Periods. Retrieved from: https://www.acog.org/womens-health/faqs/dysmenorrhea-painful-periods
- Proctor, M., Farquhar, C., Stones, W., & He L. (2006). Diagnosis and management of dysmenorrhoea. BMJ, 332(7550), 1134–1138. doi:10.1136/bmj.332.7550.1134
- Iacovides, S., Avidon, I., & Baker, F. C. (2015). What we know about primary dysmenorrhea today: a critical review. Human Reproduction Update, 21(6), 762–778. doi:10.1093/humupd/dmv039
- ACOG Committee Opinion No. 760. (2018). Dysmenorrhea and Endometriosis in the Adolescent. Obstetrics & Gynecology, 132(6), e249–e258. doi:10.1097/AOG.0000000000002968
- De Sanctis, V., Soliman, A. T., Elsedfy, H., Soliman, N., Elalaily, R., El Kholy, M., & Elalaily, R. (2015). Dysmenorrhea in adolescents and young adults: a review in different country. Acta Biomedica, 86(2), 149–158.
- National Institute for Health and Care Excellence. (2018). Dysmenorrhea – Symptoms and Diagnosis. Retrieved from: https://cks.nice.org.uk/topics/dysmenorrhoea/diagnosis/symptoms/
