The medical term for painful periods is dysmenorrhea, and for millions of women, it turns their life upside down for several days every month.
For many, it’s an annoying inconvenience. For others, the pain develops to a point where it makes day-to-day life difficult at best. It’s more often found in women who have heavy periods.
“While periods are often uncomfortable, the pain should be manageable,” said Dr. Anne Martinelli. “If you are having menstrual cramps that are extremely painful despite taking over-the-counter medication, you should speak with us. Often, extreme menstrual pain is the result of some other complication, and it’s important that we evaluate your individual situation to find a solution.”
PMS and PMDD
PMS also complicates matters, making you even more miserable. However, some women actually have PMDD, which stands for premenstrual dysphoric disorder. This is much more severe than PMS, and can dramatically affect quality of life.
We’ll take a look at the causes of painful periods, how to relieve them, and some useful information on PMS vs. PMDD and how you can tell the difference.
Why Do Some Women Have Painful Periods?
Cramping comes from the uterus, which must expand and contract in order to shed its lining.
Hormones called prostaglandins trigger the uterine contractions. These hormones are also the same ones involved when pain and inflammation occurs.
The higher your level of prostaglandins, the more severe your menstrual cramps are likely to be.
Some women also have a headache, nausea and diarrhea when they are on their periods. Prostaglandins cause these symptoms too. Dysmenorrhea can happen as early as a woman’s first period.
Some people are more prone to menstrual issues, such as heavy periods, than others. You’re much more likely to have painful cramps if:
- You started puberty at age 11 or even younger
- You’ve had heavy periods (menorrhagia)
- You’re less than 30 years old
- You have metrorrhagia–which is irregular menstrual bleeding
- There are other women in your family who have painful periods
- You’re a smoker
“You should never hesitate to talk to us about painful periods. Even though period discomfort is annoying, it should never be so bad that it interferes with day-to-day activities,” Dr. Martinelli said. “Don’t try to ‘tough it out.’ Call us.”
Primary and Secondary Dysmenorrhea
There are two types of dysmenorrhea: primary and secondary.
Primary dysmenorrhea means that there is no underlying cause of menstrual pain outside of the normal uterine contractions.
Secondary dysmenorrhea means that the pain is caused by another condition, such as endometriosis.
The Best Ways to Ease Painful Periods
For many women, some helpful home care techniques are all that is needed to ease cramping. You may find relief in:
- Taking over-the-counter pain medications such as Motrin.
- Holding a hot water bottle over your abdomen
- Taking a hot bath
- Avoiding alcohol (alcohol can make cramps worse)
- Finding ways to reduce stress
- Taking hormonal medications such as birth control pills
Some patients get relief via therapies like acupuncture or herbal remedies. Many of these treatments are incompletely understood, and so we use caution when considering them as part of a treatment plan.
If you do decide to take herbal remedies or participate in alternative medicine, please let us know.
We respect your right to make decisions about your health care, and it is important that we know what supplements you are taking because it is possible that these could interact with other medications you may be taking.
When period pain goes beyond these treatments, we consider the pain excessive.
What Can Cause Excessively Painful Periods?
If you have cramps that interfere with your ability to function, it’s extremely important that you speak to us. This can be a sign of an underlying cause of a disease or other condition.
Some of the conditions that cause extremely painful periods include:
This occurs when your uterine lining grows outside the uterus. In these cases, the lining is most frequently found on the fallopian tubes or ovaries. However, in some cases, the lining may also grow on your bladder or other pelvic tissues.
This can lead to adhesions. As a result, your organs stick together, causing pain.
There are several non-surgical treatments available for endometriosis, and these can include:
- Contraceptives such as vaginal rings or birth control pills.
- Gonadotropin-releasing hormones (Gn-RH) – these lower your estrogen level and as a result, endometrial tissue shrinks. However, this is often taken along with a low dose of estrogen to avoid menopause-like side effects that may result from using Gn-RH
- Progestin therapy
- Aromatase inhibitors- these reduce your estrogen levels
These tumors affect between 20 to 80 percent of women, and they can be one of the causes of infertility. These growths are found in the walls of the uterus and they are almost always benign.
In this condition, your uterine tissue grows into the uterine walls.
This infection is caused by sexually transmitted bacteria.
Sometimes, it may not produce any symptoms, but other times it may cause pelvic pain and abnormal bleeding, particularly after sex.
This occurs when the cervical opening is so small that it blocks menstrual flow. The increased pressure inside the uterus causes excessive pain.
We Offer Care and Treatment for Painful and Heavy Periods
Your menstrual cycle is an indicator of your overall reproductive health.
If you have heavy periods, irregular bleeding or other problems, we want to know. We encourage you to speak with us about your periods so we can help you find relief. Contact us for more information.
What’s the Difference Between PMS and PMDD?
Almost all women are familiar with the symptoms of PMS, which causes cramps, bloating and tender breasts. However, an estimated 3 to 5 percent of menstruating women have PMDD (premenstrual dysphoric disorder). Those with a family history of disorders such as depression and postpartum depression are at a greater risk.
What is Premenstrual Dysphoric Disorder (PMDD)?
This is an often-debilitating condition that you could think of as an extreme case of PMS. While there are several similarities between PMS and PMDD, there are some dramatic differences, and understanding these differences is the key to receiving effective, timely treatment.
PMDD includes emotional symptoms such as:
- Extreme anxiety
- Extensive moodiness
- Marked sadness
PMDD involves having at least one of the above in addition to the symptoms of PMS. (Mayo Clinic).
“Some women may think that they are just having a really bad case of PMS when there are actually more extensive underlying causes. We’ve successfully treated patients for PMDD, and it’s important for women to realize they do have options, and they do not have to endure the discomfort and anxiety of this condition.”
– Dr. Joshua Hardison
What is the Difference Between PMS and PMDD?
The main difference between PMS and PMDD is that PMDD involves much more extreme symptoms which can include extensive mood swings, hopelessness and even serious depression. Women with PMDD not only have extreme versions of PMS symptoms, but they also demonstrate extensive behavioral and emotional issues that make it difficult for them to function in day-to-day life.
What Causes PMDD?
It’s not clear what the exact cause of PMDD is, but researchers believe that the hormonal changes involved in menstruation may contribute to the symptoms of mood disorders. In some people, these hormone changes can cause a deficiency in serotonin, a substance found in the brain that affects mood. In addition, PMDD tends to run in families, so there may be a genetic component.
How Can I Tell If I Have PMS or PMDD?
Ask yourself the following questions:
Is my period so bad that it interferes with my daily life?
Do I have depression severe enough that it makes it difficult to accomplish everyday tasks?
Am I more argumentative than usual?
Am I so irritable that it causes extensive conflict with my friends, family or partner?
Do these symptoms tend to get worse when I consume alcohol or caffeine?
If you answered yes to any of these, it’s important for you to schedule an appointment to speak with us so we can help you find answers and provide the quality treatment you need.
How is PMDD Treated?
Before we diagnose you with PMDD, it’s important to make sure these symptoms are caused by the hormonal fluctuations of the period and not by an underlying condition such as depression. We’ll also evaluate you to ensure that your symptoms aren’t caused by other issues such as fibroids or endometriosis.
If you’re diagnosed with PMDD, there are several treatment options, including:
- Regulating emotional symptoms with antidepressants. A class of antidepressants called selective serotonin reuptake inhibitors (SSRIs) can be particularly effective in treating PMDD symptoms. Examples of SSRIs include Zoloft and Prozac.
- Taking birth control pills
- Limiting caffeine
- Avoiding alcohol
- Participating in stress management techniques
- Getting regular exercise
- Practicing meditation and yoga
While herbal remedies may help, we want to provide a word of caution: Herbal remedies are not regulated by the FDA. In addition, they may interact with other medicines you’re already taking. Before you start any herbal remedy, please speak with us.
PMDD Can Dramatically Affect Your Quality of Life
PMDD may be more common than you realize. The good news is we can help you. We’ve served thousands of patients of all ages and at all stages of their lives, helping them find solutions carefully tailored to fit their health care needs. Contact us today to schedule an appointment.
For more than 40 years, Chapel Hill OBGYN has served patients in the Triangle area, sharing the joy of little miracles and supporting them during challenges. Our board-certified physicians and certified nurse midwives bring together the personal experience and convenience of a private practice with the state-of-the-art resources found at larger organizations. To schedule an appointment, please contact us for more information.