Is period pain normal?
It's almost come to be accepted that periods will be painful. We see images of people on the sofa with a hot water bottle pushed to their stomach as a way to ease the cramps that make an appearance each month, but this doesn't necessarily have to be the case.
At Evana, we don't believe women should suffer with severely painful periods month after month. That's why we've written this guide that will explain why periods might be painful, as well as the underlying causes of pain and when you should seek medical advice.
Are periods supposed to be painful?
Mild period pains are considered 'normal'. The NHS states that it is common to experience a bit of pain right before your period starts or for the duration of your period. In fact, it's thought that dysmenorrhoea (also known as period pain) affects up to 91 per cent of women of reproductive age. That is a huge figure, and yet pain during your epriod isn't a topic that is brought up frequently.
Whether periods are 'supposed' to be painful opens up more questions. How painful is painful? A bit of tugging, cramping sensation is liekly to be expected, but if the pain is severe enough to stop you from going about your daily activities, you might be experiencing something other than a standard period cramp.
There are two main types of period pain: primary and secondary. Primary pain starts approximately six to 12 months after the first menstrual cycle (known as menarche). It can come on right before menstruation and could last up to 72 hours. The pain usually subsides by the last couple of days of bleeding.
Primary dysmenorrhoea is usually confined to the lower abdomen but may move to the lower back and even the inner thighs.
Secondary dysmenorrhoea is caused by something other than a period, such as endometriosis or fibroids. Tests would be required to come to this conclusion. Primary and secondary dysmenorrhoea are discussed more in the section below.
Why do you get period pain?
Primary and secondary period pain are caused by two different things.
Primary dysmenorrhoea is due to an increase or imbalance in the amount of prostaglandins prior to menstruation, but these compounds are necessary for the uterine lining to shed and a woman's period to start.
Pain that is experienced in secondary dysmenorrhoea will have a separate underlying cause, but can sometimes be confused with primary dysmenorrhoea, particularly if the symptoms get worse while you're on your period.
Endometriosis, for example, is more likely to flare up just before menstruation, meaning many women mistake it for standard period pain. FIbroids are another example of lower abdominal pain that occurs during menstruation, and you may also experience heavy periods with this condition.
When is period pain not normal?
Period pain may not be 'normal' if it stops you from going about your day-to-day activities, such as work and social events, or leaves you unable to get out of bed or off the sofa. These symptoms may be a result of primary dysmenorrhoea.
If your period is disrupting your life in this way, you may wish to seek treatment for period pain. Your pharmacist is a good place to start, as they may be able to recommend over the counter medicines such as NSAIDs. NSAIDs work by blocking prostaglandin production, resulting in a reduced amount of pain.
Unusually painful dysmenorrhoea could be due to something else, including endometriosis/ adenomyosis, fibroids, pelvic inflammatory disease or an ectopic pregnancy. If your period pain is becoming problematic, and you are experiencing additional symptoms such as bleeding between periods, or pain when going to the toilet or having sex, it is recommended that you seek advice from your GP or gynaecologist.
You should never feel that you're wasting medical time or that you'll be told the pain is 'normal'. In a government publsic survey, it was found that 92 per cent of respondents thought they didn't have access to enough information about certain gynaecological conditions, including fibroids and endometriosis, and 83% per cent didn't think there was enough information on menstrual health. The survey was part of the Women's Health Strategy for England, and the government collected more than 100,000 responses from women across the country in 2022.
The survey flagged that many women had their worries pushed aside and were told they would 'grow out' of the problem. It can take months or even years to get a diagnosis for a condition like endometriosis. The good news is, the UK government is working on these issues and have laid out their 10-year plan here.
If you're finding that your pain is resulting in sick days off work or cancelled plans, then you might want to seek advice from a pharmacist.
Sources
https://cks.nice.org.uk/topics/dysmenorrhoea/management/secondary-dysmenorrhoea/
https://www.nhs.uk/conditions/period-pain/
https://cks.nice.org.uk/topics/dysmenorrhoea/
Marjoribanks J, Ayeleke RO, Farquhar C, Proctor M. Nonsteroidal anti‐inflammatory drugs for dysmenorrhoea. Cochrane Database of Systematic Reviews 2015, Issue 7. Accessed at https://www.cochranelibrary.com/cdsr/doi/10.1002/14651858.CD001751.pub3/full
https://cks.nice.org.uk/topics/dysmenorrhoea/diagnosis/assessment/