Period Pain 

Written By: Dr. Lisa Kachaniwsky, ND

Let’s bust some common myths about period pain AKA dysmenorrhea! 

Period pain is very normalized and often brushed off or minimized by health care providers. 

Women are thought to believe that period pain is expected and comes with having a uterus. 

This is not true! 

Period pain can be a sign of an underlying health condition, and should be assessed and treated appropriately. 

Typically, we’re given two options at the doctor’s office for painful periods without a full assessment – hormonal birth control and/or prescription pain medication.  There’s definitely a time and place for both birth control and pain medication when treating period pain.  BUT they’re band aid fixes that don’t identify or address the route cause of your pain.

What’s normal?

Normal variations of menstrual discomfort includes:

(1) No pain or discomfort

(2) A sensation of heaviness or pressure in the lower abdomen

(3) Very mild cramping or low back pain that doesn’t affect your ability to function and doesn’t require painkiller use

What’s NOT normal?

Period pain that needs to be further investigated includes:

(1) Taking painkillers multiple times per day throughout your period

(2) Missing work, school, or social activities due to your pain

(3) Vomiting or fainting due to your pain.

Potential diagnoses involving period pain

Period pain is classified into primary dysmenorrhea or secondary dysmenorrhea.  

Primary dysmenorrhea is the most common type of period pain.  This means the pain is not caused by an underlying condition.  The painful cramps in primary dysmenorrhea are caused by higher levels of prostaglandins in the uterus before/during menses.  Prostaglandins are hormone-like compounds that help the uterus contract to shed its lining, which can result in pain.

Secondary dysmenorrhea is caused by an underlying condition.  Some examples include endometriosis, uterine fibroids, adenomyosis, and pelvic inflammatory disease.   

Endometriosis is the most common cause of secondary dysmenorrhea.  It is the growth of endometrial-like tissue outside of the uterus.  In addition to severe period pain, it can cause painful bowel movements or urination, painful intercourse, heavy periods, and infertility.  Endometriosis affects 1 in 10 females of reproductive age, but it takes 6-10 years on average to receive a diagnosis of endometriosis. 

That means, most people with endometriosis are suffering for YEARS before anyone takes their pain seriously. 

What can you start doing today for period pain? 

#1 Track your menstrual cycle and period pain 

Use an app to make it easier!  There are tons to pick from, choose ONE and stick to it.  I often see people using different apps to track different things – this makes tracking much more complicated, so don’t do it!  

Track your pain severity, pain frequency, pain duration, and your use of painkillers.  If you get pain outside of your period, make sure to track that as well.  Tracking other symptoms that might come with the pain can be helpful too.  For example, very heavy bleeding or clots. 

#2 Get assessed by your healthcare provider

Bring up your concern with your healthcare provider!  If you don’t, they might not ask about period pain, and your diagnosis will be delayed.  An assessment may include details about your symptoms, lab work, ultrasounds, and/or laparoscopic surgery (in severe cases). 

If your period pain is affecting your quality of life and your healthcare provider dismisses your concerns, get a second opinion!

#3 Start with the basics – Optimize your lifestyle

The best treatment plan for you will depend on your individual symptoms and root cause of your period pain.  Leading an overall healthy lifestyle can be quite helpful for period pain.  This includes a diet high in vegetables, fruits, and healthy fats, regular physical activity, stress management, and targeted supplementation. 

Book an appointment with Dr. Lisa for an assessment and individualized treatment plan to manage your period pain by clicking HERE