Menstrual Pain
About Menstrual Pain & Discomfort
It’s normal for your menstrual pain and discomfort to vary from period to period. In fact, studies show that 40% to 80% of women suffer from premenstrual syndrome (PMS) and menstrual pain is the leading cause of missed workdays for women. The good news is that you can do something to relieve menstrual pain and discomfort and take steps to help prevent them.
It’s also important to prepare yourself and investigate what causes your menstrual pain and discomfort so that you have a better understanding of how your body works and why, for some women, pain just comes with the territory.
Different types of menstrual pain
There are two types of menstrual pain (or dysmenorrhea): primary and secondary. Here’s the difference:
- Primary dysmenorrhea is considered to be part of a normal cycle. It’s caused by the over-production of prostaglandins (hormone-like substances). An excess of this substance makes the normally painless contractions of the muscles in your uterus much longer and tighter. Longer contractions deprive your uterus of oxygen — and that’s what causes menstrual pain.
- Secondary dysmenorrhea is caused by a disorder or disease, like pelvic inflammatory disease, endometriosis (the cells from the lining of the uterus are in an abnormal location) or uterine fibroids (non-cancerous growths). The menstrual pain from secondary dysmenorrhea is different from that felt with primary type because it can:
- Last longer, occur more often, during and after menstruation
- Come during or after sexual intercourse
- Be associated with abnormal bowel function
- Be associated with unusually heavy or irregular bleeding
If you think your menstrual pain may be caused by secondary dysmenorrhea, see your doctor for a proper diagnosis.
Common causes of menstrual pain and discomfort
A woman’s menstrual cycle lasts approximately 28 days — but it is normal to have a shorter or longer cycle. Generally, a menstrual cycle works as follows:
Menstruation:
- Happens during days 5 to 10 of the menstrual cycle.
- The lining of the uterus is shed and causes menstruation or a period.
- An excess of prostaglandins makes the normally painless contractions of the muscles in your uterus much longer and tighter. Longer contractions deprive your uterus of oxygen — and that’s what causes menstrual pain.
- During your period, menstrual pain and discomfort can include abdominal or back pain, nausea, vomiting and diarrhea.
After menstruation:
- Estrogen (a hormone) levels rise
- Around day 14, ovulation occurs and an egg is released from an ovary
- Ovulation can be painful for some women because a small drop of blood escapes from the ovary into the abdominal cavity and irritates other organs
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Around the time you ovulate, menstrual pain and discomfort can include abdominal or lower back pain, acne, dizziness or a headache
After ovulation:
- Estrogen and progesterone (another hormone) continue to increase
- Estrogen and progesterone levels will plummet about four days before the next period if the egg is not fertilized (meaning, the woman does not become pregnant)
- It’s this rapid hormonal rollercoaster that may be the cause of PMS
- About a week before your period, PMS symptoms include headaches, breast tenderness, bloating, acne, clumsiness, insomnia, fatigue, changes in appetite, nausea, and changes in your sex drive and moods (irritability, depression, anxiety)
While your menstrual pain and other symptoms will stop after menopause, some women report that their symptoms eased after having children.
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