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Dysmenorrhoea (painful periods)

What is dysmenorrhoea?

It is the medical term for painful periods. These can occur as part of an otherwise normal menstruation cycle-this is known as primary dysmenorrhoea.

On the other hand, painful periods can be caused by a problem that has developed in the womb, such as fibroid tumours or an infection-this is called secondary dysmenorrhoea.

What causes primary dysmenorrhoea?

It is caused by high levels of prostaglandins, which are natural substances produced by the lining of the womb. One of the actions of prostaglandins is to cause the muscles of the womb to contract tightly, thus producing cramping sensations of pain. The problem is associated within the onset of ovulation, that is when the ovary starts releasing eggs.

What are the symptoms?

Period pains vary a lot in strength and in position. Some women have a dull dragging pain in the abdomen or lower back or in both areas; others have more severe cramping abdominal pain. In some the pain may be felt in front of the thighs.

The pain is worse at the beginning of the period and may even commence up to 12 hours before the menses appear. It usually lasts for 24 hours, but may persist for 2 or 3 days.

Some women may get nausea and vomiting, and in severe cases fainting may occur.

What are the risks?

Dysmenorrhoea is very common, but most cases are mild and do not require medical attention. There is no risk at all unless it is a symptom of an underlying problem such as pelvic infection.

What is the treatment?

For most women pain-killers such as paracetamol relieve the pain. If the pain is severe, your doctor may prescribe a stronger analgesic that neutralises the effect of prostaglandins. Taking the contraceptive pill usually stops dysmenorrhoea. It often disappears after you have a baby or as you get older.

Keeping fit by leading a healthy lifestyle (including avoiding smoking and excessive alcohol and undertaking regular exercise) seems to help, as does practising relaxation techniques such as yoga.

If you get severe pain, rest in bed.

Simple measures such as placing a hot-water bottle over the painful area and curling your knees up to your chest as you lie on your side may provide relief.

When should you consult your doctor?

Consult your general practitioner if the pain worsens or if you develop period pain following 3 or 4 years of relatively pain-free periods.

Copyright 1995: John Murtagh, Professor of General Practice
Monash University, Melbourne, Australia