Painful Periods

What are painful periods?

The medical name for painful periods is dysmenorrhea. It's one of the most common types of menstrual disorders, with more than 50% of women who menstruate experiencing pain for at least one or two days each month.

Primary dysmenorrhea

Painful periods are most often due to primary dysmenorrhea, or pain caused by having menstrual cramps. Periods cause cramping because of high levels of prostaglandins, which are natural chemicals made in the lining of your uterus.

Prostaglandin levels are typically highest at the start of your period, which is why the first day is usually the most painful. As you shed the lining of your uterus, prostaglandin levels decrease and the pain eases. Primary dysmenorrhea typically begins soon after your first period.

Secondary dysmenorrhea

You could also develop secondary dysmenorrhea, which means you have painful periods because of a reproductive system disorder. The pain of secondary dysmenorrhea often worsens rather than improving over time.

It might start a few days before your period and continue after your period ends. Secondary dysmenorrhea might not begin until your 20s or 30s.

What conditions cause painful periods?

Painful periods that are due to secondary dysmenorrhea could be a result of endometriosis. This is a condition where the tissue lining your uterus — the endometrium — starts growing in other places, including:

• Ovaries
• Fallopian tubes
• Behind the uterus
• Bladder

Just like the tissue inside your uterus, these endometrial plugs respond to the hormones released during your menstrual cycle. That means they break down and bleed, but the blood and tissue can't escape through your vagina as they would normally.

The result is the formation of areas of scar tissue inside your pelvis, known as adhesions. The adhesions cause your organs and other tissues to stick together. The result is pain, which can be particularly severe during your period.

Adenomyosis is a similar condition, but in this case, the endometrial tissue grows within the muscle wall of your uterus. Uterine fibroids — noncancerous growths in your uterus — can cause painful periods as well.

How are painful periods treated?

If your painful periods are due to primary dysmenorrhea, medication to relieve the pain and cramping can be helpful. Anti-inflammatories like ibuprofen target the prostaglandins causing the pain.

Hormonal medication can resolve period pain and help with other problems like heavy bleeding and mood swings. You could take birth control pills, have an injection or implant, use a patch or vaginal ring, or have a hormonal intrauterine device (IUD) fitted.

If you have secondary dysmenorrhea, the team at Philadelphia Women's Health & Wellness can advise you on the most appropriate treatment. That could include taking medication like gonadotropin-releasing hormone agonists. Or you might need uterine artery embolization or endometrial ablation.

If no other treatments relieve your painful periods, you might need surgery.

For help with painful periods, call Philadelphia Women's Health & Wellness or book an appointment online today.