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  • Janette O'toole

Period pain


Period pain is the most common type of pelvic pain.


But what is normal?


Have you wondered if your period pain is normal or if you cannot handle normal pain.



What is ‘normal’ period pain?


Period pain is normal if:

  • You only have pain on the first 1 or 2 days of your period, and,

  • it goes away if you take period pain medications or the Pill

If not, it is not normal.


Severe period pain in young women is a bigger problem now than in the past.


Today girls may start their periods earlier and be older when they become pregnant compared to women in the past. They may also have fewer pregnancies. Therefore, they may have up to 400 periods in their lifetime.


An Australian study found that 21% of the girls had severe pain with periods, and 26% had missed school because of period symptoms.


Painful periods can be due to:

  • Pain in the uterus (womb), especially if pain is on the first 1-2 days of a period.

or

  • Pain from endometriosis, especially if pain is there for more than 1-2 days, comes before a period or doesn’t get improve with medication.

Many women and people assigned female at birth with bad period pain have both these problems. We know that women and people assigned female at birth with endometriosis often have a painful uterus, even if it looks normal.


How can I manage my period pain?


Period pain medications

These work best when they are taken before the pain gets bad.

Common medications include ponstant 250mg, ibuprofen 200mg, naproxen 275mg, or diclofenac 25mg.

These medications can cause stomach irritation, so it is recommended that they are taken with food.


The Contraceptive Pill

A pill with more progestogen and less oestrogen may be best.

You can speak to you G.P about ‘skipping’ periods, fewer periods mean less pain.


A Mirena® intrauterine device (IUCD)

This is currently the most effective treatment for uterine pain and lasts up to 5 years. It slowly releases a progestogen medication that makes periods lighter and less painful.


What’s else can help?


  • relaxation/ meditation

  • stretching/ breathing exercises

  • TENS machine (this is a home unit, where a gentle electrical current is applied via electrodes, over the area of pain.


Pelvic floor physiotherapy can help provide self management strategies to help.


We also know that women with pelvic pain can often have other problems. This may include a painful bladder, an irritable bowel, headaches, painful vulva or pelvic muscle pain.


Pelvic floor physiotherapy can provide advice, support and treatment to also help with these conditions.


What’s next?


If simple measures do not help, speak to your G.P regarding a referral to a specialist. They may recommend a laparoscopy. This is an operation to look inside your pelvis. They can then:

  • diagnose if any endometriosis is present, and

  • remove the endometriosis as completely as possible

We also know that women with pelvic pain can often have other problems. This may include a painful bladder, an irritable bowel, headaches, painful vulva or pelvic muscle pain.




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