Complaints & connections · borters.ch
Dysmenorrhoe
Pain is not a self-evident part of periods — severe pain deserves assessment.
Also known as: menstrual cramps · period pain
Open in the tool — with search and all the links →This compilation is for information and replaces neither medical diagnosis nor treatment. If you have symptoms, see a doctor.
Period pain is very common and a regular companion of menstruation for many. It arises because the uterus contracts to shed its lining — driven by messengers (prostaglandins). The most common form is primary dysmenorrhea: cramping lower-abdominal pain, often radiating to the back, without an underlying disease; it usually starts in youth and often eases over the years. A secondary form is when a cause such as endometriosis or fibroids is involved. Much can be well relieved. Pay attention if the pain is suddenly new, very severe or increasing, occurs outside the period, or comes with very heavy bleeding — that deserves a calm check.
A hot-water bottle, a warm bath and gentle movement often ease the cramp.
Proven pain relievers work best taken early, at the start.
A cycle/pain diary helps notice changes early.
With severe, increasing pain or suspected endometriosis.
If the pain costs a whole day despite the usual medicines, lasts beyond the bleeding, or is already this strong soon after the first period.
Hot water bottle or heat patch on the lower abdomen, 20 to 30 minutes, as often as needed.
Calm walking, cycling or stretching, 20 to 30 minutes, also on the heavier days.
Ibuprofen and naproxen act on the prostaglandins that contract the womb — they work distinctly better started the day before or with the first pain and taken regularly for two to three days, rather than at the peak. The pill thins the lining and so reduces the amount of these messengers. Heat on the lower belly has matched a dose of ibuprofen in studies; magnesium is used traditionally.
The pain usually begins with the bleeding or a few hours before and lasts one to three days. About one in two women is affected, one in five strongly enough to interrupt daily life. Anti-inflammatories work distinctly better started before the peak and taken regularly for two to three days. Pain that begins years after the first period, continues beyond the bleeding, or increases, leads to investigation towards endometriosis.
The uterus contracts — hence the cramping lower-belly pain.
Common, usually starts young, often eases over the years.
If a cause is behind it (e.g. endometriosis, fibroids) → secondary, see endometriosis.
Sudden, very severe or increasing pain, pain outside the period or heavy bleeding → get checked.
Not because of the pain but because of the bleeding: heavy periods empty the iron store over years. That often explains the tiredness alongside.
Falls only late — the store is empty long before. Ferritin therefore says more here.
Every bleed costs iron. With heavy or long periods the store empties faster than it fills — ferritin shows this earlier than the haemoglobin.
Often used for cramps of the womb muscle. The studies are small and inconsistent; it is well tolerated, and the belly shows the upper limit.
Acts on ovary and womb lining. Low values are common; correcting them is worthwhile for bone and muscle regardless of the cycle.
Often named for complaints before the period and defensible in a moderate dose. At a high dose over months it harms the nerves — that is the limit that counts.
Studied in several small trials: 300 mg a day, started a few days before the period and continued through the first days. The effect is smaller than with anti-inflammatory painkillers.
750–2000 mg a day over the first 3 days of the period was as effective as ibuprofen in several studies. It inhibits the same messengers — which is why it works, and why the same caution applies with a sensitive stomach.
1–2 g EPA+DHA a day over 2–3 months showed less pain and less need for painkillers in studies. It works preventively across cycles, not on the day itself.
A large Indian study at 100 mg a day over 90 days reported no more pain in a majority of the girls. The study is old and was never repeated — that is the honest state of things.
Clearly effective with proven deficiency, useless without. Take only with a documented deficiency — excess is harmful.
Clearly worthwhile and well studied when deficient; fewer data for the wider uses. Fat-soluble — check blood levels at high doses.
Its fall before the bleed releases the messengers that make the womb contract.
In small studies 300–1800 mg EPA and DHA a day over 2–3 cycles reduced pain intensity and painkiller use. Two portions of oily fish a week sit at the lower end of that.
Studied at 200–400 mg a day, started a few days before the period. Through food: pumpkin seeds, almonds, wholegrain and dark chocolate.
The classic women’s plant of folk medicine, drunk in the days before the period.
Traditionally for belly massage before and during the period; not in pregnancy.