Women have been menstruating – having periods – for as long as history. In many cultures, a girl’s first period is an important rite of passage and marks her transition to womanhood. For centuries, what girls and women knew about menstruation and their own reproductive health, they learned from other women.¹ This is still the case in many poor and rural communities where traditional stigmas and taboos stop young women – and men – from learning about menstruation.² Also, and for as long as women have been menstruating, some dread that time of the month. For these women, having their monthly period is painful and debilitating. With so many women working, many of whom are single mothers and breadwinners, this can have a huge impact on their working lives and productivity.³

Women who experience painful menstrual periods can get help.

What is the Menstrual Cycle?

When women reach sexual maturity, also known as puberty, they become fertile and menstruate – bleed from their vaginas – each month. This cycle of monthly bleeding is known as the menstrual cycle and is governed by hormones. Women’s levels of oestrogen and progesterone change during the cycle which begins on the first day of your period, i.e. when you start bleeding. Healthy women who are not pregnant have regular periods from puberty – usually 2 to 3 years after their breasts start to grow – until they reach menopause which is usually in their mid-to late 40s.

The menstrual cycle prepares women’s bodies for pregnancy. In the time between periods, the lining of the uterus thickens to prepare for a fertilised egg to settle in her womb. If the egg is not fertilised, her body reabsorbs it and produces prostaglandins, which are hormones that encourage the womb to contract. These muscle contractions help the uterus to shed the lining that has built up and she expels it as part of her monthly period.^4,5

Dysmenorrhea or painful periods

We have already noted that some women suffer from painful periods, also known as dysmenorrhea. It is the uterus contracting that causes this pain. Medical professionals have identified two categories of dysmenorrhea: primary and secondary.

Primary dysmenorrhea is when a woman or girl’s period is always painful: usually from the time her periods begin. Secondary dysmenorrhea, however, usually indicates that there is something else wrong.

Although both categories of painful menstruation can be treated, there are some risk factors that are thought to cause painful periods.

Possibly the most obvious cause of primary dysmenorrhea, is a family history of painful periods. Primary dysmenorrhea is also not uncommon in women under the age of 20 and/or who reached puberty before they were 11 years old. In addition, heavy periods are often associated with pain. Sometimes the actual causes of painful periods can’t be pinpointed and might be linked to having irregular periods, never having had a baby, and/or smoking.

Secondary dysmenorrhea, on the other hand, is generally caused by an underlying medical condition like premenstrual syndrome (PMS), endometriosis, fibroids, pelvic inflammatory disease (PID) among others, and which are explained here.⁶

How can I relieve menstrual cramps?

We’ve already noted that both types of dysmenorrhea can be treated. Women who regularly suffer from mild to moderate pain with their periods can take Cipladon 1000, an effervescent paracetamol tablet that you dissolve in water, and which is quickly absorbed.⁷ Alternatively, you could consider non-steroidal anti-inflammatory drugs (NSAID) like ibuprofen which reduces prostaglandins.

Other, non-medical ways to get more comfortable when you have period pain

Many women who suffer from period pains will tell you that a hot water bottle, or heating pad over your tummy or lower back, helps to ease the pain. Getting a massage and enough rest before, during, and after your period is also thought to help manage period pain. At the same time, as much as it might be tempting, avoid caffeine, smoking, and drinking alcohol.

When should you go to the doctor or clinic?

If you or your daughter has severe menstrual cramps which are not helped with over-the-counter medication, you should consult a health professional. In addition, if your usual monthly pattern changes, you should go to the clinic. For example, if your period pain is more severe and/or if your periods become irregular. Similarly, if you bleed more heavily and for more days than is “normal” for you, consult your health care practitioner.

Disclaimer: The information on this site should not be used as a substitute for professional medical care or advice. Contact a health care provider if you have questions about your health.

Sources:

1. Cawthorne, A history of menstruation extracted from an interview with Mary E Fissell, professor of the History of Medicine, Johns Hopkins University. HistoryExtra podcast [Online] Available from <https://www.historyextra.com/period/general-history/history-menstruation-periods-how-people-women-cope-deal-periods-past-health > 29/06/2022
2. Lufadeju, Y., 2018:  FAST FACTS: Nine things you didn’t know about menstruation Unicef [Online] Available from <https://www.unicef.org/press-releases/fast-facts-nine-things-you-didnt-know-about-menstruation> 29/06/2022
3. Schoep ME, Adang EMM, Maas JWM, et al. 2019. Productivity loss due to menstruation-related symptoms: a nationwide cross-sectional survey among 32 748 women. British Medical Journal Open doi: 10.1136/bmjopen-2018-026186 Overview [Online] Available from <https://bmjopen.bmj.com/content/9/6/e026186> 29/06/2022
4. The Johns Hopkins University Menstrual Cycle: An Overview [Online] Available from <https://www.hopkinsmedicine.org/health/wellness-and-prevention/menstrual-cycle-an-overview > 29/06/2022
5. Periods and fertility in the menstrual cycle – Periods National Health Service, UK [Online] Available from <https://www.nhs.uk/conditions/periods/fertility-in-the-menstrual-cycle/> 29/06/2022
6. What is Primary Dysmenorrhea & What is Secondary Dysmenorrhea: Painful Periods. Acog.org [online] Available at: <https://www.acog.org/womens-health/faqs/dysmenorrhea-painful-periods/> 29/06/2022
7. Rygnestad, T. et al. 2000. Absorption of effervescent paracetamol tablets relative to ordinary paracetamol tablets in healthy volunteer.  European Journal of Clinical Pharmacology. 56, 141–143. [Online] Available from <https://pubmed.ncbi.nlm.nih.gov/10877008/>  26/04/2022