Primary dysmenorrhoea, known more commonly as period pain or menstrual cramps, is an uncomfortable pain in the lower abdominal region and is a common occurrence for women just before or during their period. 

What is period pain?

Primary dysmenorrhoea is not due to disease, instead, it happens when the uterus contracts, i.e. when it squeezes and cramps, during menstruation. This contraction is normal and causes the lining of the uterus to shed and leave the body along with period blood through the vagina. Unfortunately, it also causes muscle cramps in the tummy, which can spread to the back and thighs; and which, for a large number of women, makes life very uncomfortable around the time of their period.

It is unknown why some women experience more pronounced period pain than others. It is also unknown why the type and intensity of pain can vary with each period; sometimes manifesting as a muscular spasm, other times as a dull, constant ache. What does seem to be fairly consistent is that the pain is usually worse when bleeding is at its heaviest and eases off after 48 to 72 hours. Women also tend to notice an improvement after childbirth and as they get older.  

Secondary dysmenorrhoea

Secondary dysmenorrhoea typically lasts longer and starts earlier in the menstrual cycle. It is caused by a disorder of the female reproductive organs, such as endometriosis, adenomyosis, uterine fibroids, or pelvic inflammatory disease. If you suffer from any of these conditions, you will usually need to be under the care of a specialised health care professional and they will be able to further advise you on symptom management.

Managing period pain

Period pain can often be managed at home without the need to consult a doctor. Whilst uncomfortable and inconvenient, it rarely warrants a trip to a specialist and there are certainly things you might want to try before seeking medical assistance. 

• Over-the-counter pain relief. Painkillers, such as ibuprofen and aspirin can be very effective at easing uncomfortable menstrual cramps. Paracetamol is less effective. If the pain is severe, your doctor should be able to prescribe something a little stronger.
• Exercise. Whilst it might be the last thing you feel like doing, a gentle walk, swim or bike ride can help to distract you and relieve the pain.
• Heat. Applying a heat pack or a hot water bottle to the affected region can reduce pain. Likewise, a warm bath or shower can also improve any discomfort. There is some evidence that heat can be as effective as pharmaceutical painkillers, without the side effects.
• Gentle massage to the abdomen, using light circular movements can help.
• Reducing stress can lessen the severity of period pain. You might find that relaxation techniques, such as yoga and pilates help with this.
• TENS (Transcutaneous Electronic Nerve Stimulation) has also been recommended as a means of easing period pain. A mild electric current is delivered to the nerves, via electrodes attached to the skin of the abdomen. It is thought that this raises the threshold for pain sensitivity, as well as stimulating the release of endorphins.

What about dietary supplements?    

There are some scientific publications advocating a role for dietary supplements in the management of period pain. However, the reality is that this is an under-researched area, and the studies that are available are typically of poor quality, with small sample sizes. There is also a shortage of safety data on dietary supplements. There is limited data supporting a beneficial role for fenugreek, ginger, zinc sulphate, fish oil, and vitamin B1 in the easing of period pain. However, other proposed ‘pain alleviators’ such as cinnamon, fennel seeds, dill, Damask rose and chamomile tea, have not, to date, been well validated.

Despite this, it is probably worth noting that herbs such as chamomile have been used in traditional medicine for thousands of years. Chamomile has been used in various formulations, as a tea, as a lotion and as an essential oil, for a multitude of human ailments. Many people have derived comfort from it, dating as far back as the ancient times. So if having a daily cup of chamomile tea relaxes and soothes you, it is probably a habit worth continuing with, including during your period.

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Sources:

• Bavil, Dina Abadi, et al. “Comparison of Lifestyles of Young Women with and without Primary Dysmenorrhea.” Electronic Physician, vol. 8, no. 3, 25 Mar. 2016, pp. 2107–2114., doi:10.19082/2107.
• Guimarães, Inês, and Ana Margarida Póvoa. “Primary Dysmenorrhea: Assessment and Treatment.” Revista Brasileira De Ginecologia e Obstetrícia / RBGO Gynecology and Obstetrics, 19 June 2020, doi:10.1055/s-0040-1712131.
• “Menstrual Cramps.” Mayo Clinic, Mayo Foundation for Medical Education and Research, 8 Apr. 2020, www.mayoclinic.org/diseases-conditions/menstrual-cramps/diagnosis-treatment/drc-20374944.
• Pattanittum, Porjai, et al. “Dietary Supplements for Dysmenorrhoea.” Cochrane Database of Systematic Reviews, no. 3, 22 Mar. 2016, doi:10.1002/14651858.cd002124.pub2.
• “Period Pain.” NHS Choices, NHS, www.nhs.uk/conditions/period-pain/.
• Srivastava, J K, et al. “Chamomile: A Herbal Medicine of the Past with a Bright Future (Review).” Molecular Medicine Reports, vol. 3, no. 6, 27 Sept. 2010, pp. 895–901., doi:10.3892/mmr.2010.377.