Why women have painful periods

Menstrual pain, called dysmenorrhea, may have several causes.

Primary dysmenorrhea occurs when substances in your body called prostaglandins cause your uterine muscles to contract. This helps push out the blood in the lining of your uterus. It’s a natural process. That blood would have helped a baby grow if you were pregnant. If you’re not pregnant, your uterus doesn’t need it. But high levels of prostaglandins can cause more severe cramping.

Secondary dysmenorrhea can be caused by conditions such as endometriosis, uterine fibroids and pelvic inflammatory disease. Medications or surgery can help ease pain from endometriosis and fibroids. Simple antibiotics can treat pelvic inflammatory disease.

Your OB/Gyn can help you find out what is causing your period pain, and what to do about it.

What’s Normal?

Some women never have period cramps; others have severe pain. There is no “normal.” The questions to ask yourself are: Do you miss school or work because of painful periods? Do you cancel social events? Do you change the routine of your life because your periods are so painful? If you answer “yes” then talk to your doctor.

Ways to Ease Period Pain at Home

Yes, several self-care strategies can help, Dr. Sackschewsky says.

• Over-the-counter medicines like ibuprofen (sold as Motrin® and Advil®) or naproxen (sold as Aleve®) may help ease mild cramps.
• A disposable heat wrap that you place around your lower abdomen may also help. The warmth can last up to six hours — long enough to help you get through the school day or work.
• Light exercise releases endorphins, hormones in the body that help fight inflammation.
• Reducing sugar and carbs in your diet can also help fight inflammation, Dr. Sackschewsky says.

Medical Treatment for Period Discomfort

Prescription strength pain relievers such as celecoxib, diclofenac, ketorolac or ibuprofen and naproxen (among others) help many women.

Birth control pills, however, are usually the most effective medical treatment for painful periods, Dr. Sackschewsky says. Birth control pills decrease the amount of prostaglandins in your body — those chemicals that make your body’s muscles contract. They can also decrease the blood flow during your period.

Myths About Birth Control

“There are two common myths about birth control pills. One, that they affect fertility. Two, that they cause weight gain.

“It’s just not true,” says Dr. Sackschewsky. “The old, original birth control pills came in much higher doses and they did stimulate appetite. But no studies have shown that today’s low-dose birth control pills cause weight gain. And years of study show that birth control pills do not affect fertility.”

With severe period pain, she says it’s possible to take continuous birth control so a woman doesn’t have a period.

Talk Solutions With Your Doctor

“I believe in shared decision making with my patients,” says Dr. Sackschewsky. “So, we try to figure out what’s the biggest problem for them. Is it missing school or work? Is it heavy bleeding? Is it pain? Then we talk about all the reasonable options and how they would fit into the woman’s life.”

If she could talk to women with period pain right now, she would offer these words:

“You don’t have to suffer. This should not interfere with your life. Go in and get the symptoms treated. You can always try a treatment and stop. Nothing is forever. But you can get help, and you can get it now.”