Eight different ways to manage painful periods.

By Dr. Greta

The question on everyone’s lips is: “How can I manage my pesky painful periods?” Well, the good news is, there are actually a fair few things out there that may be worth a try. Up to 95% of women will experience period pain at some stage, and it’s one of the most common problems that women will present to the doctor with. 

So, I have put together a list of eight different options that may help ease period pain. With my medical background, I lean towards scientific-based treatments that have been rigorously tested and proven to be safe. BUT… I am also open to women sharing their experiences with me about what has worked for them, outside of those guidelines. We are all different, and we have different beliefs and ideas about what is best for our bodies. So the list hopefully has a bit of something for everyone.  

In order to be able to understand how various treatments will help to manage painful periods, it’s really important that first, you understand what causes period pain. Once you have a rough idea of the process then you can understand how each remedy works. 

We also need to remember that there are two types of period pain — primary period pain which is the pain caused by an otherwise ‘normal’ period, and secondary period pain, which is where the pain is caused by an underlying condition such as endometriosis. You can learn about the difference between primary and secondary period pain here, and see which characteristics fit with you and your period. 

As you will remember from my post that talks you through the cascade of events that causes period pain, you will understand that in order to STOP period pain, we need to be able to STOP one or more of these events from happening. As a quick summary, (also pictured below), these are the steps that lead to pain during menstruation:

  • a drop in progesterone levels trigger the body to start menstruating
  • the endometrium releases prostaglandins
  • the prostaglandins trigger the uterus to start contracting
  • the contractions of the uterus cause the blood supply to be momentarily cut-off
  • the decreased blood supply to the uterus causes pain 
cycle of events causing painful periods.

If we look at the different treatment options for period pain we can link it back to stopping or interrupting one of these steps. All methods of pain relief aim to do one or more of the following:

– stop menstruation completely

– stop the release of prostaglandin from the endometrium

– block pain

– stimulate blood flow to the uterus

– target the underlying medical condition that is driving the pain (which happens with secondary period pain)

To make it easy, I am going to list the different types of pain relief and describe how it works in relation to the above list of color-coded processes.  So let’s go ahead and launch into the eight different ways to manage painful periods.

1. Pain relief

– stops the release of prostaglandin from the endometrium

– blocks pain

Pain relief is the obvious place to start. It is probably the most commonly used method to manage painful periods. Generally, I recommend simple pain relief like paracetamol as a first step in managing pain. The family of medication that can be really helpful for period pain is the anti-inflammatory medications (such as Ibuprofen). Anti-inflammatory medications work by reducing inflammation and they STOP those pesky prostaglandins from being released (and what’s more – this is not harmful to the body).

2. Contraception

– stops menstruation completely

– targets the underlying medical condition that is driving the pain (which happens with secondary period pain)

There are a few contraception options that can help reduce or completely stop period pain. Having contraception that doubles as pain relief can be a win-win situation for some women. The Depo Provera injection is commonly used as it works by switching off menstruation in most women. If there is no period, then generally there is no pain. The Mirena intrauterine device which sits inside the uterus is often also used to help women with painful periods. It works by releasing a small amount of progesterone hormone to the endometrium every day. This stops the endometrium from growing and thereby stops menstruation. In some cases where the pain is due to an underlying medical condition such as endometriosis, a certain type of contraception such as the combined hormone contraceptive tablet or the Mirena IUS can help control symptoms as well as ease pain by stopping menstruation. 

3. Heat

– blocks pain

A hot water bottle or a wheat pack can help ease period pains. It sounds pretty basic but lots of studies have shown that heat can help with period cramping! Up to 50% of women with period pain use heat to help manage their pain. By applying heat over the lower pelvis it can help relax the abdominal muscles, reduce spasms and ease discomfort. Plus there is something pretty comforting about curling up with a hot water bottle isn’t there?  

4. TENs machines

– blocks pain

Have you heard of a TENs machine before? TENs stands for Transcutaneous Electrical Nerve Stimulation. You can see one in action here (from the beautiful team at Ovira). Sounds pretty sci-fi but it has been proven to really help ease period pain and it’s drug-free. A TENs consists of little pads you place on your skin which release little electric currents and works by interrupting pain messages to and from the brain. It may also help stimulate the release of your natural pain-relieving hormones such as endorphins. Studies show that it works really well as a stand-alone treatment for period pain, but when coupled with some basic pain relief it’s even more effective! 

5. Supplements / vitamins

– unknown mechanism of action

The jury is still out on whether supplements or vitamins help ease period pain. There are quite a few studies that show some benefit, but remember, not all studies are good studies (some studies do not go through the right processes to prove their results are significant!!). There is certainly a role for a good diet in helping us to stay well and healthy. Aside from that, a few things that have shown an improvement in some women are the following:

  • Magnesium may help ease period pain. It is also a helpful supplement for easing muscular tension and anxiety, so potentially worth a try. Just be aware that too much magnesium can cause stomach upset and loose stools.
  • Ginger: some studies comparing ginger to anti-inflammatory medication found that ginger may be just as effective in helping manage pain (a good excuse to chow down on some gingerbread biscuits I think!).
  • Zinc: some studies say zinc helps ease period pain, although there is a lack of understanding of how this actually helps.
  • Vitamin B: there are also some studies showing vitamin B may help ease pain, but we aren’t exactly sure how. 

6. Exercise

– stimulates blood flow to the uterus

I’ve had some patients tell me that exercise helps their period pain and others swear that it makes things worse. However, a big meta-analysis (where someone smart looks at heaps of different studies and summarises the jist of all the results) recently showed that exercise likely improves period cramping by increasing the blood flow to the abdomen. It may also have a role in helping to ease your stress (particularly exercise such as yoga and pilates). You often get a kick of endorphins after exercise and these are natural pain relievers for the body. Either way, if exercise doesn’t help you, then maybe opt for cuddling that hot water bottle on the couch instead.

7. Lifestyle

– increases blood flow to the uterus

Two words: quit smoking. Smoking has been proven to cause increased pain during periods. The bad news is, the longer you smoke, the worse the pain gets. It is thought that smoking may constrict those blood vessels that supply blood to the uterus, so this can worsen that pain when the uterus contracts as even less blood supply will get to the uterus   — ouch! So by quitting smoking, you are effectively helping to increase blood flow to the uterus. 

Also, as mentioned above, supplements may have a role in helping to alleviate period pain. The natural sources of these vitamins are even better, so upping the fruit and vegetable content in your diet should be a priority if you have painful periods. 

8. Self-care

I know everyone loves to say it but stress actually has an impact on SO many things in your body. For a start, people with high levels of stress have been found (in studies) to have a lower threshold for pain. So basically the more stressed you are, the worse your period pain feels.   

As far as I see it, you should always PRIORITISE self-care. The female body is complex and clever, but due to our hormones and the way our cycles work, we may find some days we feel less than amazing. If you are troubled by period pain, make sure you concentrate on filling that time with rest and listen to what your body needs (if that’s chocolate, then give your body the chocolate). 

So that completes the list of eight different ways to manage painful periods. You may require a bit of time to experiment with what suits you best. I often remind women that they can try and combine a few different methods at a time, as they stand to get better relief. Remember that period pain is really common, but it shouldn’t be impacting your life. If you aren’t getting any relief from these suggestions or if you are finding that you’re unable to function during your period, I urge you to book an appointment to discuss your pain with your doctor. 

Written and illustrated by Dr. Greta

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