Period pain is common among women of childbearing age. In a study reported by the NIH, over 84% of women experience menstrual pain at some point. And 43% of those interviewed reported experiencing painful periods every month. That’s a lot of women in pain!
Thankfully, for most women, ibuprofen and an afternoon spent on the couch with a heating pad does the trick. But for 5%-10% of women, the pain is so debilitating that they may require a day or two to deal with it. Many of these women reported missing work or school at least once during every cycle. Pain that severe isn’t necessarily common, and if you suffer to that degree, you should see your doctor to find out why.
What Causes Period Pain?
Each month, your body goes through a series of events centered on reproduction, called your menstrual cycle. The ovaries release an egg for fertilization, and your uterus prepares for that fertilized egg/embryo by forming a lining. The lining creates a place for the fertilized egg to attach, grow, and develop during pregnancy. In the event fertilization doesn’t occur, your body sheds the uterine lining through your period.
For your uterus to shed the lining, your body creates a surge of a hormone-like substance called prostaglandins. This causes strong contractions of the uterus that result in menstrual cramps. Doctors find that some women produce more prostaglandins than others, resulting in much more painful periods.
Severity of Painful Periods
Doctors refer to debilitatingly painful periods by the name dysmenorrhea. This type of period pain goes far beyond cramping. Those with dysmenorrhea may experience cramps in the lower back, pelvis, and abdomen, and also find they become lightheaded, dizzy, nauseous, and have severe headaches. Dysmenorrhea may also cause vomiting, diarrhea, shooting pains in the back, thighs, and legs, and even fainting. These symptoms typically occur during the first few days of your period.
This version of dysmenorrhea, called primary dysmenorrhea, is most common, and the painful periods and associated symptoms often weaken over time, becoming much more tolerable. For some women, they disappear completely after the birth of a baby. Some women experience primary dysmenorrhea off and on until menopause.
Secondary dysmenorrhea produces many of the same symptoms, but they are much more severe. The pain is intense, and the symptoms last longer, often for your entire period. Women experiencing secondary dysmenorrhea usually have an underlying cause associated with their extremely painful periods.
Causes Associated With Secondary Dysmenorrhea
Painful periods, such as those experienced with secondary dysmenorrhea, often have a root cause in a medical condition or infection in the reproductive organs. You may notice your menstrual cramps begin much earlier, often a few days before your period, and continue until the bleeding ceases. Some common conditions associated with secondary dysmenorrhea are:
Endometriosis
According to a report by the American Medical Association, one out of 10 women (10%) suffers from endometriosis, making it a fairly common condition. Endometriosis occurs when a woman has cells similar to the ones that make up the lining of the uterus outside of the uterus in their pelvic region. These cells attach to reproductive and other organs and grow. Lesions can be found on the fallopian tubes, ovaries, and exterior surface of the uterus. The cells may also attach to the intestines and rectum, bladder, and the membrane of the abdominal organs (peritoneum).
Because endometriosis responds to the same hormones that cause the uterine lining to grow and shed during your menstrual cycle, these cells also grow and shed. This creates inflammation and scar tissue, which causes painful periods and other symptoms associated with secondary dysmenorrhea.
Fibroids
The uterus is quite a muscular organ, given its purpose. Sometimes non-cancerous (benign) fibroid tumors grow in the muscle layer of the uterus and cause heavy and painful periods. Depending on the size, number, and location of these fibroids, you may experience, in addition to heavy, painful periods, pain and pressure in the pelvic region, recurrent miscarriages, and failure to conceive.
Pelvic Inflammatory Disease (PID)
Sometimes women contract a sexually transmitted disease and remain unaware. The infection may spread to the uterus, fallopian tubes, and ovaries. When that happens, inflammation occurs, which leads to lesions and scar tissue on the affected organs and results in many of the symptoms of secondary dysmenorrhea. Two of the most common causes of PID are gonorrhea and chlamydia.
Intrauterine Device (IUD)
IUDs are common birth control devices. Your doctor inserts your IUD directly into your uterine cavity to prevent pregnancy. While pain is common for the first few months of your period, severely painful periods are not. In some cases, an IUD may cause secondary dysmenorrhea, and if the pain doesn’t subside, your doctor must remove your IUD.
How is Dysmenorrhea Diagnosed?
Your doctor diagnoses dysmenorrhea after taking a thorough medical and sexual history, a pelvic exam, and taking cultures for your pap test and to test for infections. Your doctor also takes blood and typically performs an ultrasound to look for fibroids, cysts, and any other malformations.
Sometimes, diagnosis requires that your doctor perform a laparoscopy. This allows them to look directly inside your uterus and pelvic region, seek out any evidence of endometriosis, fibroids, and adhesions in the pelvic region. During a laparoscopy, your doctor may treat your condition, if possible. As it is minimally invasive, your doctor performs a laparoscopy as an outpatient procedure while you’re under general anesthesia.
Treating Both Types of Dysmenorrhea
Depending on the underlying cause of your secondary dysmenorrhea, medical or surgical treatment usually relieves your painful periods. Primary dysmenorrhea often requires OTC or prescription NSAIDS, which help block the production of prostaglandins. Your doctor may also prescribe birth control pills. The hormones in oral birth control pills help your body grow less uterine lining, which results in lighter periods, lower prostaglandins, and far less cramping.
Lifestyle changes such as increased exercise, stress management, and getting more sleep also help eliminate painful periods. Some women also report relief from dysmenorrhea symptoms following orgasms.
If you suffer from painful periods, understand that you don’t have to. Please contact LA IVF today for a consultation. No one needs to live in pain. Let us help.
