When young women get painful periods it’s likely to be due to the womb going into a spasm. This causes a cramp-like pain as soon as the period starts, or a dull ache in the abdomen and back. Doctors call this primary dysmenor-rhoea, to distinguish it from secondary dysmenhorroea, the kind of period pain that mainly affects older women.
Secondary dysmenorrhoea can be caused by disorders such as endometriosis (when the womb-lining tissue develops outside the womb), fibroids (benign tumours of the womb’s muscular wall) or a continuing infection – pelvic inflammatory disease, for example.
In most cases painful periods are not a sign of ill health, but women who suddenly develop them should go to see their doctor, so that the cause can be treated appropriately. An ultrasound scan may occasionally be needed to detect -or rule out – any underlying disorder.
Sufferers from primary dysmenorrhoea sometimes have more of a chemical called prostaglandin in their menstrual flow than most women. The production of an egg, or ovum, in the middle of the month triggers the release of this excess prostaglandin, which sends pain signals to the brain – so when a woman doesn’t ovulate she usually doesn’t experience pain. That’s why many women who suffer from painful periods are advised to take the contraceptive Pill, which generally works by preventing ovulation – this is a relatively straightforward form of bringing relief.
Painkillers also help you cope with period pain . An anti-inflammatory one containing ibuprofen can inhibit the production of prostaglandin, which is why it can be so effective in relieving symptoms. Aspirin has the same effect. Mefenamic acid, which is an even more powerful prostaglandin dampener, has to be prescribed by your doctor. There are also antispasmodic medicines available on prescription – these will relieve symptoms by relaxing the uterine muscles. Some over-the-counter remedies contain antispasmodic agents – hyoscine hydrobromide, for example – as well as a mild anti-prostaglandin drug (paracetamol) and a mild diuretic (caffeine) to make you urinate more often. The diuretic helps relieve congestion in and around the womb.
Hot baths and hot water can also be soothing for period pain. Heat can help reduce muscle spasm, as can brisk exercise such as cycling, swimming and fast walking. A good, well-balanced diet with enough Vitamin B6 and other B vitamins is helpful, too .
Once a woman has her first baby, the painful periods of the primary dysmenorrhoea kind will usually go for good.