There is unspoken solidarity amongst women when it comes to that ‘time of the month’. Although the symptoms that come with a monthly period vary depending on the person, there is no doubt that the symptom ‘period pain’ is an almost universal one. There are many reasons why women explain period pain, but simply put, experiencing period pain is as a result of the shedding of your uterus lining.
To fully understand what causes period pain, understanding what a period is and the changes that occur throughout a woman’s body during this time will provide a solid foundation. A period is a stage in what is known as the menstrual cycle, the result of a period is bleeding from the vagina for anywhere from 2-7 days.
The menstrual cycle is what a woman goes through each month to prepare for pregnancy. During this time there are various hormonal changes and the point at which you bleed is also known as menstruation. The menstrual cycle is counted from the first day of your first period to your next one. On average this is 28 days but can be more or less depending on other factors.
The changes that occur throughout your menstrual cycle are responsible for some of the symptoms that females can experience. These can be more severe with things such as nausea, dizziness and headaches and others can be more manageable, such as a dull continuous ache which can be easily treated with painkillers or rest.
So what happens during a period?
Your period is just one part of a very complex process and marks the beginning of the menstrual cycle. Following your period there is an overlap of two cycles that occur in two different parts of the body; ovaries and uterus. The cycles are maintained by hormonal signals that are sent via the blood between the ovaries, uterus and the brain.
There are 6 stages which describe what is happening during the menstrual cycle and they are broken into the following:
- Menstruation – it’s at this point that you experience bleeding and it is as a result of the shedding of the old lining of your uterus.
- The follicular phase – at this point there is an increase in two hormones: follicle-stimulating hormone (FSH) and luteinizing hormone (LH) which give rise to the production of 15-20 eggs as well as the rise in oestrogen. From the numerous eggs, there is one that dominates and matures.
- The proliferative phase – during this stage we begin to see the rebuilding of the lining as the endometrium becomes exposed to the FSH and LH hormones previously released
- Ovulation – this point is when women are most fertile and it involves a rapid increase in oestrogen as well as the rupturing of the dominant follicle and release of the mature egg which then travels to the Fallopian tube.
- The luteal phase – the body experiences a peak in progesterone ready for a possible pregnancy. The hormonal changes that occur at this stage often cause many women to experience premenstrual symptoms such as mood and appetite changes or cramps.
- The secretory phase – the chemicals that are released here can produce two possible outcomes. If an egg was fertilised the body will begin to prepare for early pregnancy, if this is not the cause the lining will begin to break down and shed indicating the completion of the cycle.
Why does my period hurt?
Period pain is expected during your menstrual cycle but the pain should not be excessive and cause disruption to daily activities. Excessive period pains are known as dysmenorrhea and can be classified as primary and secondary.
If you have dysmenorrhea, you tend to experience periods of pain before and throughout menstruation. Primary dysmenorrhea is said to occur in at least 90% of females. For those who have secondary dysmenorrhea, this may be as a result of having regular periods which turn into painful periods later in life.
Secondary dysmenorrhea occurs due to reproductive disorders such as endometriosis and fibroids. This causes period cramps to get worse over time rather than improving and can often be debilitating for those experiencing it.
Pain during your period is as a result of an increased number of prostaglandins within the lining of the uterus. This hormone’s levels may rise 1-3 days before a period is due to begin and slowly decreases as the period progresses.
How can I manage painful periods?
There are numerous remedies available to manage the pain that comes with having a period. These can involve medication or take a more holistic approach by making changes to your lifestyle to ensure a minimally painful period.
Apply heat to your abdomen – Numerous studies have been carried out and proven that this remedy works. Applying heat can come in many forms and are not limited to a hot water bottle or a heating pad. Studies have shown that taking a hot bath can also be just as effective.
The effectiveness of this method is thought to be because of its ability to relax the myometrium which is tense during the menstrual cycle. The exposure of heat to the abdomen is said to reduce the constriction in blood vessels and as a result, improved blood flow and reduced pain.
Taking a more natural approach to easing your period pains can also be seen as a feasible solution. A lifestyle change such as this means that the solution could be more prolonged and also positively impact other areas of your health.
Menstrual pain can be due to swelling and muscle contractions and herbal remedies that have anti-inflammatory and antispasmodic components are believed to be a great long term solution to painful periods.
Effective herbs are chamomile tea, fennel seeds, cinnamon, ginger and dill. The key to ensuring that these herbal remedies take effect is taking them before your period starts. You can take them in various forms but the more potent come in capsules or tea.
Creating a balanced lifestyle with a healthy diet and regular exercise
There is no clear understanding of why women who exercise are less likely to suffer menstrual pain. However, it is predicted that it could be due to the release of hormones such as endorphins which naturally enhance an individual’s mood.
When it comes to diet there is more evidence that has suggested omega-3 fatty acids found in foods such as fish, calcium and vitamin D, a reduction of salt and caffeine can assist in decreasing the less desirable symptoms that come with premenstrual syndrome.
A healthy diet consists of vegetables, fruit, nuts, seeds, fish and low-fat dairy food, good servings of proteins and wholemeal products. Plenty of water can also help.
An introduction of nutritional supplements to your diet can also make a difference with key sources being: vitamin d, vitamin b6, vitamin b1, vitamin e and magnesium. These vitamins all play different roles in reducing the symptoms of period pain. They can contribute by reducing blood flow, improving mood, reducing fluid retention and relieving mood changes.
Birth control is an option that is not considered by many but the hormonal birth control pills containing progestin or progestin and oestrogen can be a great remedy. It is especially useful for those who have severe pain.
There are numerous options and types available and the one that is suitable for you can be dependent on lifestyle and other factors such as how your body reacts. Sometimes it may require trying a few until you find an option that fits, some examples of the options available are:
Combination contraceptive pills – this pill is made up of oestrogen and progestin, it is believed that taking this pill can help ease the pain that is associated with menstrual cycles, through the suppression of certain hormones. It is believed that taking this pill over prolonged periods and minimising the number of 7-day breaks after every 21 days increases its effectiveness.
Progestin – only contraceptive pill; this pill also known as the mini-pill and functions by thickening the mucus in the cervix, it is required to be taken every day.
Hormonal IUD – This is thought to help with period pain following continuous use and in some cases, its use can stop periods completely.
Use of contraceptive measures works because it thins out the womb lining, which results in a lighter period as well as reduces the need for the body to contract as intensely to shed the lining of the womb.
Sex can help with menstrual cramps. Although a seemingly unlikely solution, sex can play a role in reducing period pains. Many people do not indulge in sex during that ‘time of the month’ and for many, it is seen as taboo.
However, there is a science to how sex works with your body to decrease the pain that may be experienced. The reason why sex works as a pain reliever is due to orgasms. Orgasms also cause the muscles of your uterus to contract and release and this is where the easing of the pain occurs from period cramps.
Similar to exercise, sex releases endorphins which are known to make you feel good once they are released. It is also possible that the muscle contractions experienced during an orgasm contribute to shortening the length of your period.
Managing period pains can involve trying a few methods before finding one that works and fits your lifestyle. The best place to start in the management of period pain is in your lifestyle choices. This is considered a more holistic approach but it is something that can easily be adapted into day to day life choices and looks like making healthier food choices, exercising more and taking supplements.
The remedies that involve medication, will require seeking professional medical advice and can be obtained from your primary care doctor. These options can be combined with healthy lifestyle choices and done under the supervision of your medical doctor. You will be able to have care that is catered towards your individual needs and circumstances.
The more common treatment of period pain involves over the counter medication such as ibuprofen and paracetamol. These can be just as effective and are good alternatives for quick relief.
There are constant advances and studies taking place that provide further insight into how the female body functions during their menstrual cycle as well as the changes that take place.