My Health Matters – Painful periods

Some women don’t have much trouble with
their painful periods while others have so much pain that it negatively affects their
quality of life causing them to miss work or school.
Menstrual cramps are often the result of uterine contractions. The uterine muscles contract
to help shed the lining and to control the amount of bleeding. The contractions are triggered
by hormones called prostaglandins. This process usually happens during ovalatory cycles when
a woman has released a monthly egg. But painful periods can also be caused by secondary reasons
such as medical conditions. One of the most common causes is endometriosis. But painful
periods can also be caused by conditions such as adenomyosis, infections such as pelvic
inflammatory disease, or structural abnormalities such as polyps or fibroids.
For treating menstrual cramps over- the- counter medications are a great place to start. These
include acetaminophen in addition to anti-inflammatory medication such as ibuprofen or naproxen.
Anti-inflammatories help because they actually block the production of prostaglandins which
trigger the uterine contractions that cause the pain. Women can start taking the over-the-counter
medications as soon as they have any cramping, even before their period starts. Starting
the medication early can decrease the pain as well as decrease bleeding. Some studies
have found that women often do not take enough over-the-counter medications for them to be
effective. Read the label to find the recommended dose as well as the suggested timing of doses.
If over-the-counter pain medications haven’t helped, a doctor can recommend other options.
The birth control pill, patch, or ring help to control cramps because they control the
menstrual cycle. They suppress ovulation, decrease the amount of bleeding, and decrease
the production of prostaglandins. Hormonal contraceptives as well as the progesterone
intrauterine system, or IUD, can help suppress endometriosis and decrease bleeding. That’s
the first line treatment for endometriosis; but some cases may require surgery. Structural
causes such as fibroids may also require surgery. Lifestyle modifications may also help to manage
painful periods. Research has shown that exercising three times per week can decrease menstrual
pain and also improve mood and stress levels. In contrast smoking has been linked to increased
menstrual pain. So the modifiable things that women can do to improve painful periods include
exercising regularly and not smoking.

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