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Menstrual (period) pain is felt as cramps in the abdomen and pelvic area and may or may not be associated with a heavy period. Menstrual pain is not the same as the discomfort felt during premenstrual syndrome (PMS), although the symptoms can sometimes be the same. Many women suffer from both PMS and menstrual pain.

Mild menstrual pain may be barely noticeable – sometimes just a heavy or dragging feeling in the lower abdomen. But severe menstrual cramps can be so painful that they interfere with regular activities for several days.



What causes menstrual pain?

After ovulation each month, if the egg is not fertilised by a sperm, hormone-like substances called prostaglandins are released to break down the lining of the uterus. During menstruation, uterine contractions expel the dead tissue through the cervix and out of the body by way of the vagina.

Menstrual pain is caused by these uterine contractions, which are similar to the contractions felt during labour – although not as intense. It is thought that the intensity of menstrual pain in some women may be related to higher levels of prostaglandins in the lining of their uterus, compared to women who do not experience cramps.



What is the treatment?

If you experience pain with every period, you will probably have some pain relief strategies already. These may include lying down when the pain is bad, moderate exercise such as walking, abdominal massage, yoga, and applying a heated pad or hot water bottle to the abdominal area.

Many women find over-the-counter pain-relievers very effective as they not only relieve pain but prevent the menstrual cramps themselves. For mild cramps, paracetamol may be sufficient. More painful periods can be managed with non-steroidal anti-inflammatory drugs (NSAIDs), which lower the production of prostaglandins and lessen their effect. The NSAIDs that do not require a prescription include low dose ibuprofen, naproxen and diclofenac, and a combination of Paracetamol 500mg + Ibuprofen 150mg.

If you experience severe period pain every month, you should see your doctor, who may want to rule out underlying conditions like endometriosis, fibroids and pelvic inflammatory disease. If nothing more serious is going on, your doctor might prescribe low dose oral contraceptives to prevent ovulation and reduce the production of prostaglandins which, in turn, reduces the pain and the menstrual flow.




More information

Endometriosis New Zealand

EMedicine Health

enter “menstrual pain” or “period pain” both will bring up list of relevant links



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