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How To Overcome Painful Period Cramps

Written by Dr. Pramod Mane on Fri, 11 November 2022

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More than half of the women who menstruate are familiar with various intensities of pain during their period. For many, the pain is a mild, achy soreness that lingers all over the pelvic area; some experience it as acute spasms scattered at odd intervals. But for some the pain can become so unbearable that it feels like a 24-hour cinch in their daily lives; the pain allows them to focus on nothing else but the suffering. This condition of the severely painful period is known as dysmenorrhea.

Typically, it starts on the day of the period, but it may arrive a day before the bleeding begins. A majority of women who suffer from dysmenorrhea habitually seek relief in painkillers as an anticipatory measure.

For some women, painkillers offer a bare modicum of relief; much of their day is spent in bed, crying through the unbearable misery. So much so, that their professional and daily chores are brought to a near halt these days. This explains why it's important to first fully understand dysmenorrhea before you seek the right treatment for it.

The fundamentals of dysmenorrhea

Most women begin having dysmenorrhea during adolescence. There's always a pattern—some days are more painful than others. (Usually, the pain is more nagging in the first two days.) Sometimes, the pain feels aggravated when there are clots in the menstrual blood.

Dysmenorrhea can also tag along with other symptoms such as headache, nausea, vomiting, diarrhea, constipation, or dizziness. However, it's also common for the pain to weaken with time—many women notice a marked reduction in menstrual distress when they enter their 30s.

Some others would experience a drastic cut-down—or even a complete absence of cramps—after they have had a baby. Based on the pain pattern, dysmenorrhea can be classified into two types:

 Primary dysmenorrhea

  • It's the cramping pain that comes before or during a period caused by prostaglandins, a type of lipid compound that is produced by our tissues.
  • When the endometrial cells in the uterus lining begin to come apart, they release a large number of inflammatory prostaglandins that cause the muscles and blood vessels of the uterus to contract.
  • On the first day of the period, the prostaglandin levels in a woman's body are rather high, and, therefore, stimulate severe pain. As bleeding continues and the lining of the uterus gets shed, the levels drop and, consequently, the pain becomes less distracting.

Secondary dysmenorrhea

Secondary dysmenorrhea is typically caused by some disorder in the reproductive organs. The pain tends to get worse over time, and it often lasts longer than normal menstrual cramps. This is an indication that the uterus is likely to be suffering from one of the following conditions:

Endometriosis: Tissue similar to the lining of the uterus grows in other areas of the body, such as on the ovaries and fallopian tubes, behind the uterus, and on the bladder. This tissue breaks down and bleeds in response to changes in hormones, thus setting off acute pain—especially around the time of a woman's period.

Uterine Fibroids: Fibroids are benign growths that form on the outside, on the inside, or the walls of the uterus. When located on the walls of the uterus, they become painful.

Adenomyosis: This is when tissue that normally lines the uterus begins to grow in the muscle wall of the uterus. It can cause severe cramping or sharp pelvic pain during the period.

Other medical conditions: Some conditions like Crohn's disease and urinary disorders can flare up during a period and cause pain.

How is a painful period treated?

Talk to your doctor about the pain during the period. If needed, your ob-gyn may undertake a pelvic exam and, in some cases, recommend a laparoscopy. Here are a few ways in which they will treat your period pain:

Medication

This is the first line of treatment—both primary and secondary. Certain pain relievers target prostaglandins. They are called non-steroidal anti-inflammatory drugs (NSAIDs) and reduce prostaglandins to lessen their effects that cause pain. Most NSAIDs can be bought over the counter.

Birth control methods

Birth control methods that contain estrogen and progestin, such as the pill, the patch, and the hormonal intrauterine device (IUD) can be used to treat painful periods, too. Many women who have had an IUD placed in the uterus may experience a less substantial menstrual flow as the years go by. In some cases, the IUD could also bring a halt to the bleeding.

Alternative healing techniques

Other than medicines, there are a variety of healing techniques to effectively alleviate period pain, such as heat therapy (heating pads/hot water bags), gentle aerobic exercises (walking or light jogging), acupuncture, acupressure, and nerve stimulation therapies.

GnRH

In case your pain is caused by endometriosis, your ob-gyn may recommend a birth control measure or a medication called gonadotropin-releasing hormone (GnRH) to counter the pain. A similar line of treatment would be advised for fibroids (supplemented with an option to go in for uterine artery embolization (UAE)). In case you have adenomyosis, you will be prescribed NSAIDs, birth control measures, or advised to opt for UAE.

When should surgery be considered a treatment option?

Before suggesting any surgical intervention, your doctor may first recommend that you tweak your lifestyle for the better with exercise, a healthy diet, and vitamin supplements. Lowering body fat percentage and limiting alcohol and caffeine intake can also help decrease estrogen levels, which helps lighten the severity of many symptoms.

However, if the pain persists despite other treatments and even after you have adopted a healthier lifestyle, your doctor may recommend surgery to remove endometriosis tissue or fibroids. Hysterectomy, usually the last resort, maybe done for adenomyosis.

When you are in pain, life is no fairytale. But it is said that fairytales are more than true—not because they tell us that dragons exist, but because they show us that dragons can be slain. Indeed, period pain can seem like a dragon. But you are no less a warrior queen. Go slay it!

Conclusion:

  • Period cramps typically lessen with the passage of years. If they intensify, meet a gynecologist to rule out our underlying symptoms.
  • A healthier lifestyle with a balanced diet and exercise can be of significant aid in keeping the symptoms from getting severe (especially because a lower fat percentage can prevent hormone imbalances that tend to aggravate dysmenorrhea).
  • Weigh your choices carefully. Ask your doctor about all the pros and cons of prescribed drugs or any surgical treatment that has been advised.
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Dr. Pramod Mane

A Doctor of Medicine (MD) in Pharmacology., currently based in Mumbai, India, Dr Pramod Mane, comes with an experience of more than 20 years of working in Medical Affairs in the Pharmaceuticals & Nutraceutical Industry. Director of Medical Services at Mega Lifesciences since 2008, Dr Mane has been associated with several MNCS in the areas of Medical Affairs, Medical Services, Medico-marketing, Pharmacovigilance & Clinical trials in his illustrious career.

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