Managing period pain

Period pain, also called dysmenorrhoea, is common.

People experience period pain differently. It can range from mild to severe and may stop you from doing your normal activities.

Period pain is considered normal if it:

• happens on the first 2 days of your period
• doesn't affect your daily life
• goes away with pain-relief medicines or a heat pack

There are 2 types of period pain:

1. primary dysmenorrhoea
2. secondary dysmenorrhoea

Primary dysmenorrhoea

Primary dysmenorrhoea often happens in the first year after you get your period. It's more common in teenagers and people under 30 years.

Secondary dysmenorrhoea

Secondary dysmenorrhoea often happens years after the start of your periods.

Period pain is felt in your lower abdomen (tummy). It happens just before and during menstruation (your period). You might have cramping, aching or heaviness.

You might also get pain in your lower back and legs.

Other possible symptoms are:

• vomiting
• nausea
• diarrhoea
• fatigue
• headache
• greater sensitivity to pain

Primary dysmenorrhoea

This type of period pain is caused by chemicals called prostaglandins. These cause the muscles of your uterus (womb) to tighten.

Primary dysmenorrhoea is the most common type of period pain. It usually happens within a few years of your first period.

Secondary dysmenorrhoea

This type of period pain is caused by an underlying health condition, such as:

• endometriosis
• adenomyosis
• fibroids and polyps in your uterus
• pelvic inflammatory disease

It can also be caused by an intrauterine contraceptive device (IUD).

See your doctor if your period pain stops you from doing your normal daily activities. For example, if you need to have time off school or work.

It can help to keep a record of your periods to share with your doctor. You may want to record:

• when you get your period
• how long it lasts
• how heavy it is
• what symptoms you have

Your doctor will ask about your symptoms. They may want to examine you. In some cases, they may organise for you to have further tests, such as:

• an ultrasound scan
• an MRI scan or CT scan
• a hysteroscopy — a procedure that uses a small camera to look inside your uterus

There are a few treatments you can try to help with period pain.

If you have secondary dysmenorrhoea, it's best to treat the underlying cause.

Self-care at home

Some people find their period pain is relieved by:

• using a heat pack
• gentle exercise
• transcutaneous electrical nerve stimulation (TENS) (a pain-relief method that uses a small, portable machine)
• acupuncture
• relaxation or meditation to reduce stress
• supplements such as magnesium

There is evidence to show that foods rich in omega-3 fatty acids can help improve your period pain. These foods include:

• chia seeds
• walnuts
• flaxseeds
• salmon, herring, sardines and mackerel
• oysters
• edamame beans

There is also some evidence that foods rich in vitamin E can help with period pain. Foods rich in vitamin E are:

• sunflower seeds
• nuts
• spinach
• broccoli
• kiwifruit
• mango
• tomato

Ginger can help with period pain and reduces nausea.

Pain-relief medicines for period pain

Non-steroidal anti-inflammatory medicines (NSAIDs) such as ibuprofen, mefenamic acid and naproxen stop your body from making prostaglandins.

They work best if you start taking them 1 to 2 days before you expect to get your period. You should keep taking these medicines regularly for the first 2 to 3 days of bleeding. You can buy them over-the-counter in a pharmacy.

Remember to take NSAIDs with food. These medicines may not be suitable for everyone. Speak to your doctor or pharmacist to check that they are safe for you.

Paracetamol can also help for mild cramps.

Hormone treatments for period pain

Your doctor might prescribe hormonal contraception for your period pain. Examples are the:

• combined oral contraceptive pill
• contraceptive vaginal ring
• progestogen implant
• hormonal intrauterine device (IUD)

You can use pain-relief medicines as well as hormonal treatment.

Visit Jean Hailes for Women's Health for more information about period pain. Jean Hailes also has factsheets in languages other than English.

Family Planning Australia has information on period problems.

You can also call the healthdirect helpline on 1800 022 222 (known as NURSE-ON-CALL in Victoria). A registered nurse is available to speak with 24 hours a day, 7 days a week.