Painful Periods – Knowing When to Seek Help
Dr. Renuka Dangare

Dr. Renuka Dangare

Apr 20Menstrual health

Painful Periods – Knowing When to Seek Help

What are painful periods?

We all dread ‘that time of the month’. Periods can cause a lot of mood swings, cramps, bloating and body aches. But many menstruators experience periods differently with extreme bleeding followed by throbbing pain in the pelvic, buttocks and waist area.

More than half of the female population experience pain during periods. Especially during the initial 1-2 days of menstruation. This pain is usually moderate and in the form of discomfort due to cramps caused by the contraction of muscles. This kind of pain that doesn’t affect your day-to-day routine, is normal and common. However, once the pain starts becoming difficult to bear and also affects your bleeding, it’s called ‘Dysmenorrhea’ – painful periods.

There are two kinds of Dysmenorrhea

  1. Primary Dysmenorrhea – This begins when a female starts bleeding for the very first time in her life. This type of dysmenorrhea results in mild and frequent menstrual cramps followed by abnormal uterine contractions.

  2. Secondary Dysmenorrhea – This type of painful period usually starts at a later stage in life. And it is backed by some physical causes. It is usually diagnosed with other underlying medical conditions in the uterine.

Symptoms of Dysmenorrhea

In either type of condition, the symptoms usually remain the same. However, every human body is different and so is its threshold for pain. The major distinguisher to determine the seriousness of painful periods is the quantum of discomfort it brings along. Constant unbearable pain that affects your routine, requires immediate medical attention. However, the following are also some symptoms of this.

  • Heavy bleeding that requires changing of period products every 1 to 2 hours
  • Pain during urination or in the bowels
  • Constant headache with nausea and/or diarrhoea
  • Pain that stays beyond the first few days of the periods
  • Periods that last longer than 5 days

The causes of Dysmenorrhea

Primary dysmenorrhea is a cause of the general menstruation process. This pain is caused by natural chemicals called prostaglandins that are in the uterus lining. This results in muscular contractions that cause pain. Prostaglandins are very high on the first day of the period. As bleeding continues and more lining is shed their levels go down, further reducing pain in the coming days.

However, secondary dysmenorrhea could be a cause of concern and is caused due to other underlying disorders in the reproductive organs. This gets worse with time and lasts longer than usual menstrual cramps. One of the most severe causes of this pain is endometriosis. In this condition, the endometrial tissue implants outside the uterus and over the fallopian tubes. Women with this condition suffer an extremely painful period and seek constant medical attention.

There are also some other causes of secondary dysmenorrhea like -

  • Ovarian Cysts
  • Fibroids in the uterus
  • Pregnancy complications (miscarriage, abortion)
  • Pelvic Inflammatory Diseases
  • Bladder Infections

painful periods

When is it abnormal or suggestive of these underlying diseases?

Dysmenorrhoea could be a sign of something serious if -

  1. You experience menstrual cramps before or after your period.
  2. You experience pain during passing motion or while you pee
  3. You have foul-smelling vaginal discharge
  4. You experience heavy bleeding for which you need to change the period product every 1-2 hours.
  5. You pass clots of the size of a coin.
  6. You suffer from nausea and diarrhoea along with painful periods.
  7. You have had last 3-4 severely painful periods such that it hampers your normal routine

If you have painful periods, you should definitely visit and consult your gynaecologists for the same. The proper cause of dysmenorrhea can be diagnosed through different medical methods, like:

  1. Ultrasound – Your doctor uses an ultrasound probe to visualise your internal organs. It’s painless and safe for all age groups. A vaginal ultrasound can provide a deeper understanding of the overall uterine health and help in examining the ovarian conditions for any cysts or fibroids.
  2. Laparoscopy – In this procedure, a small cut is made near the belly button that lets in a thin camera that further assists in viewing the pelvic organs and determining severe ailments in the pelvic area.
  3. Physical Examination – In this form of examination, your doctor will physically check the vagina, cervix and feel the ovaries to determine any changes or complications. This method is not used for young, adolescent women.

What practices can we follow at home to minimize the pain?

Especially for primary dysmenorrhea, home remedies and treatments have proven to be relieving and partly effective. However, these are also effective in treating dysmenorrhea in general. You may try the following to ease menstrual pain:

  • Heat – The most tried and tested method for reducing menstrual cramps. When we externally press heated pads or hot water bags against the contracting muscles, heat releases the tension in the muscles and relaxes them further while reducing pain.

  • Nutrition – Periods take up a lot of your body energy. Keeping yourself well-nourished with a balanced diet consisting of healthy veggies, fruits, nuts and meat can keep your energy levels constant, further reducing the pain.

  • Exercise – Simple physical movements can relax the muscles and help in easing out the pain. Basic stretching followed by a meditation routine will also distract your mind and calm the body. Do not do any extremely rigorous workout or activity that will cause rather more discomfort and pain.

  • Hydration - Just like any other muscles in your body, your uterus is made up of muscles too and can cause painful cramps if you're not hydrating enough. Staying hydrated will definitely lower the intensity of pain.

Medical remedies that doctors may suggest

  1. Pain Medication – Over the counter medicines are extremely effective in managing pain. These medicines act by reducing the pain-producing substance in our body - prostaglandin. These should be taken at an interval of 6-8 hours depending on the severity of pain.
  2. Birth control methods - Such as the contraception pills, the patch, vaginal rings that control the estrogen and progestin levels have proven effective in the treatment of dysmenorrhea. These help in thinning the uterus lining that shall reduce contractions and result in lesser pain.
  3. Intrauterine Device (IUD) – IUD is a small T-shaped device inserted in the vagina to prevent insemination. This has the hormone levonorgestrel that is proven to reduce dysmenorrhea by half. However, this method is not recommended for young females.

While painful periods are quite common, it is suggested to always keep track of the kind of pain you experience, how long it stays and what works best as a relief. The key is to know where to draw the line when it comes to testing your physical endurance. A routine checkup of your uterine health will help in making your periods easier and healthier.

Disclaimer - This information is educational and should not be construed as medical advice. Please consult your doctor before making any dietary changes or adding supplements.

 ProactiveForHer is a digital clinic for women, offering accessible, personalised, and confidential healthcare solutions. We offer out-patient care, diagnostic services and programs for various health concerns of Indian women, across their lifetime - from puberty to pregnancy to menopause. To know more on the sexual and reproductive health of women, visit