MENSTRUATION: PAINFUL PERIODS
Dysmenorrhoea is the word doctors use to say ‘painful periods’. It can be ‘primary’ (painful from within a year or so of the first ever period), or ’secondary’ (initially not painful, then periods become painful years after the first period), and ends in ‘orrhoea’, which is an ending on many medical words, meaning ‘lots of’.
A significant number of women have period pain during their reproductive lives. About 10 per cent of women are incapacitated for one to three days each month. Days are lost from school, work, and other usual activities because of period pain. It is no wonder that so many people seek treatment.
Primary dysmenorrhoea is fairly common, although it may not become apparent until the ovaries are working properly, a year or so after the first period. It is usually not associated with any underlying problem, and in many cases gradually lessens with time. Very rarely there may be a physical cause, like a problem with the shape of the uterus, or the cervix not letting the blood out well enough.
If periods have been pain free for years and become painful much later it may indicate an underlying cause, like endometriosis or infection, so it is worth having this investigated. Often there will be associated pain at other tames too like mid-cycle and with intercourse. The pain is more likely to occur before the period, rather than starting with it, although this is not always the case.
Period pain may not feel the same to every person, even though the processes causing the pain may be the same. It will usually start dose to the rime bleeding starts, and may be felt in the lower abdomen, the back, the legs, and accompanied by nausea, dizziness, vomiting, headache and tiredness, all of which may be mild, moderate or severe.
Treating the problem begins with working out if it is primary or secondary. If it fits into the pattern of secondary dysmenorrhoea it should be investigated, and any underlying cause found should be treated. If there is no underlying cause, there are treatments available, with varying success achieved.
The most tried and true method is still the hot water bottle. Local heat does seem to help, but it can be a bit inconvenient if you need to be out and about.
It is, however, a cheap, simple, often helpful remedy, with no chemicals and no side effects (if you are careful not to bum yourself). Relaxation, yoga, and exercise have also been said to help, and arc worth trying.
The most simple medicinal treatments are either aspirin (trade names: Aspirin, Aspro, Buffet Disprin, Ecotrin, Solprin, Spreo, SRA, Winsprin), or paracetamol (trade names: Panado), Tylenol, Panamax, Paralgin) taken to the manufacturers’ recommendations. There are specific anti-uterus-pain medications on the market, such as mefanamk acid (Ponstan, Mcfic) and naproxen (Naprosyn, NaprogesicK and these are available over the counter (no prescription required) at pharmacies. These are related to the antinflammatory drugs used for arthritis, and like all anti-inflammatory drugs should be taken with food to avoid irritation to the lining of the stomach. They should be avoided by people with a history of stomach ulceration, and you should not take aspirin while taking these medicines; paracetamol would be preferable. These anti-uterus-pain tablets work by preventing the increase of a chemical, called prostaglandin. Prostaglandins have been found to be associated with painful periods. As anti-prostaglandins are a sort of ‘preventative’ medication, they work best if you use them just before, or at the very beginning of the period and continue using them for as long as needed.
Some people find that anti-spasm medicines, often used for spasm in other parts, like the bowel, are useful. One available on prescription is hyoscine-N-butylbromide (trade name: Buscopan).
The vast majority of women who have painful periods are able to cope with the methods outlined. Unfortunately some can’t, and in some cases the oral contraceptive pill is prescribed as a treatment for painful periods (and heavy periods), as one of the beneficial side-effects of the pill is that it tends to give lighter and less-painful periods. This is because it suppresses ovulation. Whether or not the pill is a suitable treatment for a particular person is a decision based on individual circumstances; it may not be ideal for everyone.
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