Periods are highly unpredictable. For most women, the associated pain and flow differ from one month to another. Several factors affect the severity of period cramps and symptoms you experience. However, if you consistently have unbearable pain and heavy periods, they can be a sign of a problem like endometriosis or uterine fibroids.
What are painful periods?
Period, or menstruation, refers to vaginal bleeding experienced by women as part of their monthly cycle. The pain associated with periods is most often menstrual cramps, which cause throbbing, cramping pain or discomfort in the lower abdomen. Many women have painful periods, known as dysmenorrhea. Some women experience other symptoms like nausea, headaches, diarrhoea, and lower back pain. Premenstrual syndrome (PMS) is different from period cramps. PMS leads to several different symptoms, including fatigue, irritability, bloating, and weight gain. PMS begins around a week or two before the period starts.
What causes painful periods?
Dysmenorrhea is a medical condition causing cramping and severe pain during your monthly cycle. There are two types of dysmenorrhea – primary and secondary. Primary dysmenorrhea refers to the most common type of menstrual cramps and is not caused by any underlying condition. The uterus produces chemicals known as prostaglandins and having too many prostaglandins result in pain. They tighten and relax the muscles of your uterus, and therefore, you experience cramps.
Secondary dysmenorrhea is mostly experienced later in life. Underlying conditions, such as uterine fibroids and endometriosis that affect your uterus or other reproductive organs, cause this type of pain. Generally, the pain tends to worsen with time. It can begin before the onset of your period and continue even after the period ends.
Endometriosis causes the uterine tissue to grow outside the uterus. The condition can be extremely debilitating and painful. Pelvic pain also arises due to fibroids. The condition makes periods heavier than normal. Additionally, during your menstrual cycle, the hormonal levels tend to fluctuate. With age, these hormonal changes can cause disruptions and changes to your periods.
Period cramps can start a day or two before the menstrual cycle. The pain can last for the first two days, but for some women, it can last longer. Girls experience menstrual pain during their teen years as soon as they start getting periods. Many times, the pain starts reducing as you get older. The pain is also seen to improve after childbirth.
Normal Period Pain vs Endometriosis vs Fibroids vs PMS
Pain is a subjective synonym, which means no one other than the afflicted person can detect or observe its severity. There is no clinical test or device to measure pain. The patient must accurately describe the type of pain and severity experienced. In the case of period pain, women can track their symptoms to understand if the pain interferes with daily routine, concentration and basic needs or demands bedrest.
Mild to moderate pain, which you can ignore, is normal. If it does not restrict you from performing tasks and concentrating on activities, it is not caused by any underlying condition. While you can have occasional bad cramps, they shouldn’t last for more than 10 minutes or three days consecutively. You can alleviate period pain in different ways like taking painkillers, introducing simple lifestyle changes, or wearing a pain-relieving device.
Endometriosis is associated with menstrual cramps that are severe enough to not let you perform daily activities. They can disrupt your sleep and last for more than three days consecutively. They can also arise before, during, or after menstruation. The pain can worsen with time and extend to the lower back or pelvic area as well. A bloating feeling with abdominal discomfort throughout the cycle is also common. Other signs of endometriosis include pain while passing faeces or urine and during sex.
A gynaecologist can advise on how to reduce or eliminate endometriosis pain. A patient can try painkillers, lifestyle changes, hot water bottles, hormonal medication, or pain-relieving devices.
Fibroids pain is similar to endometriosis pain. Those with fibroids can also feel a hard lump inside the abdomen. Moreover, the period flow can be very heavy. The other symptoms common during the menstrual cycle include diarrhoea and/or constipation. It is suggested you seek medical help at the earliest to prevent the fibroid from growing. Not treating the fibroid on time can leave surgery as the only treatment option.
PMS pain refers to menstrual pain that occurs in most cycles and is quite severe. It causes discomfort and interferes with daily life, making it tougher for women to attend office, complete household chores, and exercise. The pain can rise to its peak causing you to wake up at night. However, the duration of the pain will not be more than 10 minutes. Moreover, it will not last for three days in a row. PMS pain can be experienced in the abdomen, leg, and vulva. It lasts longer than cramp pain but occurs only throughout the menstruation cycle.
PMS pain is easy to eliminate with lifestyle changes, heating pads, painkillers, and pain relief devices.
How much period pain and flow is normal?
Mild to moderate cramps on the first two days of your menstrual cycle is normal. However, menstrual pain for many women is intense and can interfere with everyday activities and exercise.
No one knows your body better than you. You need to consult a doctor and understand treatment options if you feel that your period cramps are causing significant discomfort and making it difficult for you to complete day-to-day activities. If the flow of your period is rather heavy, requiring you to change sanitary pads every two to three hours, it is a cause of concern.
Underlying conditions aren’t always the cause of period cramps and heavier flows. However, you must monitor your menstrual cycle to know what is normal for your body. If you observe anything unusual or experience any out-of-the-ordinary changes to your menstrual cycle, you must schedule an examination immediately. Diagnosing the underlying condition at an early stage can help in effective treatment.