Painful Period (dysmenorrhoea)

Our Specialists:

  • Dr Ashfaq Khan
  • Ms Scharazed A Rouabhi
  • Mr Oudai Ali

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Dysmenorrhea is uterine pain around the time of menses. Pain may occur with menses or 1 to 3 days before period starts. It is often crampy or a dull constant ache but may be sharp or throbbing; it may radiate to the back or legs.

Sometimes dysmenorrhea is accompanied by symptoms of premenstrual syndrome or heavy menstrual bleeding and passage of blood clots.

You can also experience headache, nausea, constipation or diarrhoea, lower back pain, and urinary frequency are common; vomiting occurs occasionally.

Contributing factors may include the following:

Primary dysmenorrhea typically begins within a year after menarche and occurs almost invariably in ovulatory cycles. The pain usually begins when menses start (or just before) and persists for the first 1 to 2 days; this pain, described as spasmodic, is superimposed over constant lower abdominal pain, which may radiate to the back or thigh. Patients may also have malaise, fatigue, nausea, vomiting, diarrhoea, low back pain, or headache.

 

Risk factors for Painful Periods:

Passage of menstrual tissue through the cervix

High levels of prostaglandin F2-alpha in menstrual fluid

A narrow cervical os

A malpositioned uterus

Anxiety

Early age at menarche

Long or heavy menstrual periods

Smoking

A family history of dysmenorrhea

 

Other important causes of Period pain

Endometriosis (the most common cause)

Uterine adenomyosis

Fibroids

 

Less common causes include

Congenital malformations (e.g. bicornuate uterus, subseptate uterus, transverse vaginal septum),

Ovarian cysts and tumours,

Pelvic inflammatory disease, pelvic congestion, intrauterine adhesions,

Intrauterine devices (IUDs), particularly copper IUDs.

 

Urgently go to nearest A& E (emergency) department of NHS if you have:

New or sudden-onset pain

Unremitting pain

Fever

Purulent cervical discharge

Evidence of peritonitis

 

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