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Period pain

Many people suffer with discomfort and pain around the time of their period. Here we look at the causes, different types, symptoms, and how to get relief.

Period pain causes

The exact cause of period pain is not fully understood but, during the normal monthly cycle there are changes both in prostaglandin levels and how much the womb contracts. It’s thought that a woman produces more prostaglandins before her period starts. When periods are painful, this could be due to an over-production of prostaglandins.1

A young woman is eating a hamburger in a restaurant

Prostaglandins are hormones that are involved in the process of inflammation and blood clotting that takes place when someone has an injury. This is part of the natural healing process. In this case, prostaglandins helpfully cause contraction of the blood vessels to stop the bleeding. However, excessive prostaglandin production can cause chronic pain. Painful menstruation and heavy menstrual bleeding are thought to be linked to excessive prostaglandin levels.2

Period pain occurs when prostaglandins cause narrowing of the blood supply to the womb and increased contraction of the womb, increasing the sensitivity of the nerve endings.3

As with the level of pain experienced, heavy bleeding could be caused by an underlying cause such as fibroids or endometriosis, but it’s not always the case. If you’re unsure of whether you have heavy periods, this checklist could help. Do you:3

• need to change your sanitary products as often as every 1-2 hours?
• pass blood clots larger than the size of a ten pence coin?
• double up on sanitary products, for example using a tampon and a pad at the same time?

It’s also thought that lifestyle factors such as dietary choices and stress levels, the age at which a woman starts her periods, and premenstrual syndrome, can all contribute to period pain.1

Period pain types

There are two types of period pain – primary or secondary.1 Primary dysmenorrhoea might be described as ‘normal’ period pain. Secondary dysmenorrhoea is a more severe period pain that is caused by conditions such as endometriosis, chronic pelvic inflammation and fibroids.1

For the purposes of this section, we will refer to primary dysmenorrhoea as period pain.1

Period pain symptoms

Pain, or a cramping sensation, is common before and during a period. It can be felt in the lower stomach area, and can also spread to the back and thighs. The medical term for this pain is ‘dysmenorrhoea’.4

Period pain can begin a few hours before a period starts and last for a few days. The pain is generally worse during the first 24-36 hours. While it lasts, and depending on its severity, it can stop sufferers from both going to work and enjoying their free time.1

Period pain relief

There are a variety of things you can try if you suffer with period pain. These include lifestyle measures and other ways to try and reduce the discomfort.4

Woman lying down and holding a hot water bottle on her abdomen

• Avoiding fast food and processed foods – research suggests that following a healthy diet can help to reduce period pain,5 so it’s worth eating plenty of fresh fruit and vegetables and avoiding ready-made and take-away foods where possible.4

• Stopping smoking – smoking is thought to increase the risk of period pain, so people who suffer from menstrual discomfort are advised to take measures to try and quit.4

• Taking gentle exercise – although it might be difficult to feel motivated to exercise while experiencing period pain, it might alleviate the pain or be a welcome distraction from it. Walking, swimming or cycling, for example, could help.4

• Using relaxation techniques – yoga or pilates can help you to focus on your breathing, and the movements involved may take your mind off period pain, as well as relax you.4

• You may find that applying heat to the area where you are experiencing pain can relieve it. A hot water bottle (make sure it’s covered to protect your skin) or a heat pad may feel comforting.

• A warm bath can be very calming and may alleviate period pains.

• Massage – gently rubbing the painful area may help.

• TENS machine – TENS stands for transcutaneous electronic nerve stimulation. Many people find TENS machines very helpful at alleviating pain or causing a distraction from it. You can buy them in pharmacies and, after placing small adhesive pads onto the affected area, you can control the electrical pulses that go to the site of pain. TENS machines come with full instructions and are easy to use once you get the hang of them.6

Period pain is very common and is usually manageable using the tips above and, if necessary, by taking pain relief medication. Ask your pharmacist if you’re not sure about which pain relief to use, should you need it after having tried the self-help measures described above.

However, some women experience periods that are much heavier and longer than normal and some even suffer with constant period pain. If you find that you have intense period pain that is regularly stopping you from doing the things you want and need to do, and that your periods last for longer than five days, and the bleeding is very heavy, you should make an appointment to discuss this with your GP as soon as possible.

It’s important that any underlying health conditions are considered and either ruled out or diagnosed, in case medical treatment could help alleviate your symptoms, improve your quality of life, and help you to get on with life.

The menopause is the term that describes the time when a woman stops having periods. Most women experience the menopause between the ages of 45 and 55. The average age is 51.7

The process is usually gradual, meaning that most women find that their periods become less frequent before stopping altogether. Many women also experience symptoms, which can include:7

• hot flushes – these can happen without warning and can be unpleasant for some women. You may suddenly feel flushed and sweaty
• night sweats – you may find that your body temperature seems much hotter at night and you can wake up feeling drenched in sweat
• vaginal dryness – this can feel uncomfortable or sore and can make sex painful
• difficulty sleeping – some women find it harder to get to sleep and stay asleep while they are going through the menopause
• feeling low or anxious – you may find that you feel more down and worried about things than usual
• reduced memory and concentration – many women refer to a feeling of ‘brain fog’ during the menopause. You may forget where you’ve put things, for example

Women who have suffered with heavy periods and really bad period pain sometimes feel relieved when they reach the menopause. But if you are experiencing symptoms of the menopause which are causing you to struggle with everyday life, you should consult your GP, as there are treatments available that can help.

You can take ibuprofen8 or paracetamol9 to help manage period pain. If these are not effective on their own, a stronger painkiller, such as codeine, could help. You should talk to your GP before taking codeine.

Ask your pharmacist for more advice about period pain relief, and try Solpadeine Plus or Solpadeine Max. It’s important to listen to your body and not ignore persistent symptoms or pain, so talk to your GP if you have any concerns.

 

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References:

1. Barcikowska Z, Rajkowska-Labon E, Grzybowska ME, Hansdorfer-Korzon R, Zorena K. Inflammatory Markers in Dysmenorrhea and Therapeutic Options. International Journal of Environmental Research and Public Health. 2020; 17(4):1191. https://doi.org/10.3390/ijerph17041191
2. Hormone Health Network. What is Prostaglandins? Available at: https://www.hormone.org/your-health-and-hormones/glands-and-hormones-a-to-z/hormones/prostaglandins Accessed June 2021.
3. NHS. Heavy periods. Available at: https://www.nhs.uk/conditions/heavy-periods/ Accessed June 2021.
4. NHS. Period pain. Available at: https://www.nhs.uk/conditions/period-pain/ Accessed June 2021.
5. Park, S., Chung, C. Effects of a dietary modification intervention on menstrual pain and urinary BPA levels: a single group clinical trial. BMC Women’s Health 21, 58 (2021). https://doi.org/10.1186/s12905-021-01199-3
6. NHS: Back pain. Available at: https://www.nhs.uk/conditions/back-pain/ Accessed July 2021.
7. NHS. Menopause. Available at: https://www.nhs.uk/conditions/menopause/ Accessed June 2021.
8. Ibuprofen Summary of Product Characteristics. Available at: https://www.medicines.org.uk/emc/product/7020/smpc Accessed June 2021.
9. Paracetamol Summary of Product Characteristics. Available at: https://www.medicines.org.uk/emc/product/5916/smpc Accessed June 2021.

Find out more about other pain types

Select a type of pain to read about causes, what you can do to help relieve it, and which treatments are most appropriate.

Solpadeine® Max Soluble Tablets, Paracetamol 500mg, Codeine Phosphate Hemihydrate 12.8mg, Caffeine 30mg For the treatment of acute moderate pain which is not relieved by paracetamol or ibuprofen alone. Contains codeine. Can cause addiction. Use for 3 days only. Always read the leaflet.

Solpadeine® Headache Soluble Tablets contain Paracetamol and Caffeine – a mild analgesic and antipyretic formulated to give extra pain relief. Always read the leaflet.

Solpadeine® Plus, Solpadeine® Max and Solpadeine® Headache products are not recommended for children under 12 years of age.

SolpaOne® 1000mg Effervescent Tablets contains paracetamol only. For the treatment of mild to moderate pain and/or fever. For adults and adolescents over 50kg of body weight aged 16 years and above. Always read the leaflet.

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*New pack size of 24 soluble tablets for 3 day use in adults