Is menstrual pain normal? Remedies to relieve period pain

By (embryologist), (gynecologist) and (embryologist).
Last Update: 04/28/2022

Many women suffer from dysmenorrhea dysmenorrheaor menstrual pain. It is a pain in the lower abdomen, which may extend to the woman's back and legs, related to the days of menstruation.

The causes of menstrual pain can be varied. For this reason, if it is an intense pain that does not stop with certain home remedies or with the usual anti-inflammatory drugs, the woman should consult a specialist in case there is an underlying pathology that is causing it.

What is menstrual pain?

Menstrual pain, also called menstrual cramps, refers to cramps or cramps in the lower abdominal area associated with menstruation or period dysmenorrheamenstrual pain, refers to cramps or cramping in the lower abdominal area associated with the period. However, the woman may also have other symptoms such as:

  • Headache.
  • Back pain
  • Diarrhea
  • Nausea and even vomiting.

Menstrual pain appears during menstruation, although these discomforts may also begin a few days before menstruation. This pain is usually more intense at the beginning of the period and usually lasts about 2-3 days.

In some cases, period pain can be so severe that it can prevent a woman from carrying out her normal routines.

Risk Factors

Generally speaking, a woman is more likely to have menstrual pain if:

  • The first period (menarche) came at an early age.
  • Her menstruation is abundant.
  • The period lasts more days than usual.
  • Menstrual cycles are irregular.

Similarly, family history of dysmenorrhea and tobacco use would also be risk factors for menstrual pain.

What is the cause of pain during menstruation?

Many women have asked themselves: Why do periods hurt? What causes menstrual discomfort?

There are two main types of pain associated with the menstrual period, each of them produced by different causes.

Primary dysmenorrhea

Primary dysmenorrhea is the most common, appears in adolescent women (between 6-12 months after menarche) and may improve with age. This type of pain is a "side effect" of the natural process of menstruation.

It is a more or less mild pain that is not associated with any other problem of the uterus or pelvic organs. In this case, period pain may be caused by prostaglandins, molecules that cause the uterus to contract and restrict blood flow, thus causing the pain.

Nevertheless, the presence of prostaglandins is normal, since uterine contractions favor the expulsion of the endometrium during menstruation. However, if prostaglandin levels are elevated, they may produce increased pain.

Secondary dysmenorrhea

This type of menstrual pain is produced by an underlying cause, generally related to a problem of the reproductive system. Among these causes, we can find:

For this reason, these menstrual cramps often appear even several years after a woman has had her first menstrual period.

In addition, secondary dysmenorrhea usually causes much more pain and discomfort than primary dysmenorrhea.

How to relieve menstrual cramps?

Menstrual cramps that are not very intense can be relieved without resorting to the use of drugs, through natural remedies. Some of these home remedies that can be performed to soothe the pain produced by menstruation are:

  • Rest.
  • Apply heat to the lower abdomen, either with a heating blanket or hot water bottle.
  • Take a shower with hot water.
  • Massage lightly on the belly.
  • Perform moderate exercise on a regular basis.
  • Avoid very heavy meals that produce difficult and slow digestion.
  • Reduce stress.

However, when menstrual pain is deep, very uncomfortable or constant, it may not go away with these home remedies. In this case, the woman should consult the specialist if she can take non-steroidal anti-inflammatory drugs such as ibuprofen.

If the pain does not go away even with nonsteroidal anti-inflammatory drugs, it is time to see your doctor so that he or she can find out what is causing your menstrual pain.

Thus, depending on the diagnosis, you will be able to indicate the most appropriate treatment. Similarly, a woman should also consult with a specialist if menstrual cramps occur:

  • They are stronger than usual.
  • They last too long.
  • They are accompanied by other symptoms, such as fever.
  • They appear at a time other than menstruation.

On the other hand, it is advisable for women to consult a gynecologist if dysmenorrhea occurs for the first time when they are over 25 years old, as it could be secondary dysmenorrhea.

Diagnosis and Treatment

When a woman presents with painful menstruation, a physical examination and ultrasound are usually performed. In addition, if PID is suspected, the woman will be given a cervical culture.

However, there are occasions when, after performing these tests, the diagnosis is not clear. At this point, it should be assessed whether other imaging tests (such as hysterosalpingography or magnetic resonance imaging) or even laparoscopy should be performed.

Finally, the most appropriate treatment for menstrual pain will depend on the causes. Therefore, this can be painkillers, hormonal contraceptives or even surgery. In any case, symptomatology should be taken into account, but also the patient's reproductive desire.

Menstrual pain in mid-cycle

A woman's menstrual cycle begins on the day she gets her period and lasts approximately 28 days. In the middle of the cycle, that is, on about day 14, ovulation, or the release of the egg from the ovary, occurs.

The ovulation process may cause pain of variable duration (from a few hours to 1-2 days) and usually on the side of the abdomen corresponding to the ovary that is expelling the egg. In addition, this pain between menses may occur along with light vaginal spotting. Although this intermenstrual pain usually subsides without any intervention, a woman can apply heat in the same way as for period pain.

However, if the pain is very intense or does not stop, or if it is accompanied by other symptoms, it is best to consult a specialist. You can read more information about intermenstrual pain in this article: Ovulation pain: Is it normal, what are the causes.

FAQs from users

By Guillermo Quea Campos M.D. (gynecologist).

Many women have painful menstrual cycles, also called Dysmenorrhea, which is usually due to the contractions that the uterus produces for the detachment of the endometrium and its expulsion through the vagina.

There are two types of dysmenorrhea:

Primary dysmenorrhea
is the most common type and there is no associated cause. This type, as mentioned above, is due to contractions of the uterine musculature by an overproduction of substances called "Prostaglandins". This pain may begin one or two days before the menstrual period and usually has a very short duration. Primary dysmenorrhea usually begins in youth, just after the first menstruation (menarche) and becomes self-limiting as age advances and even disappears in some cases after the first childbirth.
Secondary dysmenorrhea
usually starts some years later and is caused by diseases affecting the uterus, such as endometriosis or uterine myomatosis. In addition, it is common for this pain to worsen over time. Secondary dysmenorrhea could be a cause of infertility depending on the underlying diagnosis.
Imagen: menstrual-pain-fertility-dysmenorrhea-faq

What to take to get rid of menstrual pain?

By Andrea Rodrigo B.Sc., M.Sc. (embryologist).

If the pain associated with menstruation are common, that is, they always appear in the week of the period, it is important to consult with the specialist and not take anything without knowing the effects, as it could be counterproductive or aggravate the pain in the long term.

Depending on the intensity of the pain, its frequency and associated symptoms, the doctor will prescribe the most appropriate treatment.

Is it possible to have menstrual pain without menstruation?

By Andrea Rodrigo B.Sc., M.Sc. (embryologist).

Much of the pain associated with menstruation such as ovarian or breast pain is a consequence of the variation in hormone levels inherent to the female menstrual cycle.

Therefore, any punctual hormonal imbalance caused by an external factor such as stress or nerves can lead to pain or discomfort similar to those of menstruation.

Ovarian pain, menstruation or pregnancy?

By Andrea Rodrigo B.Sc., M.Sc. (embryologist).

Some women may confuse early pregnancy symptoms with menstrual symptoms. It is important to keep in mind that when pregnancy occurs menstruation does not occur and therefore the absence of menstrual bleeding may be indicative of pregnancy.

In any case, if pregnancy is suspected, it is recommended to perform a pregnancy test to determine if the pain or discomfort is caused by pregnancy or if it is a menstrual symptom.

Is it normal to have menstrual pain on the third day?

By Silvia Azaña Gutiérrez B.Sc., M.Sc. (embryologist).

Menstrual pain usually occurs when the menstrual period comes off, but it can begin to occur even before menstruation arrives. As it usually lasts about 2-3 days, it is possible for a woman to have menstrual pain on the third day of menstruation.

However, the pain usually becomes more intense with the onset of menstruation (the first day) and gradually fades away. Therefore, if the woman has prolonged and constant pain, it is advisable to consult a specialist.

Can menstrual pain be unbearable?

By Silvia Azaña Gutiérrez B.Sc., M.Sc. (embryologist).

Yes, some women have very severe menstrual pain and describe it as unbearable. On these occasions, menstrual pain is so intense that it does not allow the woman to sleep or continue with her daily activities, as it does not subside with the usual anti-inflammatory drugs.

In case of unbearable period pain, a specialist should be consulted. The gynecologist will then be able to evaluate the causes and tell the woman what she can take.

Is there any natural treatment for menstrual pain?

By Silvia Azaña Gutiérrez B.Sc., M.Sc. (embryologist).

There are some natural remedies, such as putting heat on the abdominal area and regular exercise, which can be useful and help relieve menstrual pain.

On the other hand, some supplements may have a beneficial effect on dysmenorrhea, such as ginger, vitamin B1 or E and omega-3 fatty acids. However, more studies are needed to support their effectiveness, as well as that of other herbs and natural products.

In addition, acupuncture could also reduce menstrual pain, but, likewise, more studies are needed to prove its effectiveness.

Suggested for you

In this article we have talked about menstrual pain, but if you are interested in knowing more about menstruation itself, we recommend you to visit the following link: Menstruation: symptoms and characteristics of the monthly bleeding.

If you want to learn more about this topic, you can read the following article: Why do blood clots occur during menstruation?

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References

Armour M, Smith CA, Steel KA, Macmillan F. The effectiveness of self-care and lifestyle interventions in primary dysmenorrhea: a systematic review and meta-analysis. BMC Complement Altern Med. 2019 Jan 17;19(1):22. (See)

Barcikowska Z, Rajkowska-Labon E, Grzybowska ME, Hansdorfer-Korzon R, Zorena K. Inflammatory Markers in Dysmenorrhea and Therapeutic Options. Int J Environ Res Public Health. 2020 Feb 13;17(4):1191. (See)

Chen CX, Barrett B, Kwekkeboom KL. Efficacy of Oral Ginger (Zingiber officinale) for Dysmenorrhea: A Systematic Review and Meta-Analysis. Evid Based Complement Alternat Med. 2016;2016:6295737. (See)

Daily JW, Zhang X, Kim DS, Park S. Efficacy of Ginger for Alleviating the Symptoms of Primary Dysmenorrhea: A Systematic Review and Meta-analysis of Randomized Clinical Trials. Pain Med. 2015 Dec;16(12):2243-55. (See)

Guimarães I, Póvoa AM. Primary Dysmenorrhea: Assessment and Treatment. Rev Bras Ginecol Obstet. 2020 Aug;42(8):501-507. English. (See)

Harel Z. Dysmenorrhea in adolescents and young adults: an update on pharmacological treatments and management strategies. Expert Opin Pharmacother. 2012 Oct;13(15):2157-70. (See)

Igwea SE, Tabansi-Ochuogu CS, Abaraogu UO. TENS and heat therapy for pain relief and quality of life improvement in individuals with primary dysmenorrhea: A systematic review. Complement Ther Clin Pract. 2016 Aug;24:86-91. (See)

Jo J, Lee SH. Heat therapy for primary dysmenorrhea: A systematic review and meta-analysis of its effects on pain relief and quality of life. Sci Rep. 2018 Nov 2;8(1):16252. (See)

Marjoribanks J, Ayeleke RO, Farquhar C, Proctor M. Nonsteroidal anti-inflammatory drugs for dysmenorrhoea. Cochrane Database Syst Rev. 2015 Jul 30;2015(7):CD001751. (See)

Matthewman G, Lee A, Kaur JG, Daley AJ. Physical activity for primary dysmenorrhea: a systematic review and meta-analysis of randomized controlled trials. Am J Obstet Gynecol. 2018 Sep;219(3):255.e1-255.e20. (See)

Pattanittum P, Kunyanone N, Brown J, Sangkomkamhang US, Barnes J, Seyfoddin V, Marjoribanks J. Dietary supplements for dysmenorrhoea. Cochrane Database Syst Rev. 2016 Mar 22;3(3):CD002124. (See)

Woo HL, Ji HR, Pak YK, Lee H, Heo SJ, Lee JM, Park KS. The efficacy and safety of acupuncture in women with primary dysmenorrhea: A systematic review and meta-analysis. Medicine (Baltimore). 2018 Jun;97(23):e11007. (See)

FAQs from users: 'Is menstrual pain related to fertility?', 'What to take to get rid of menstrual pain?', 'Is it possible to have menstrual pain without menstruation?', 'Ovarian pain, menstruation or pregnancy?', 'Is it normal to have menstrual pain on the third day?', 'Can menstrual pain be unbearable?' and 'Is there any natural treatment for menstrual pain?'.

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Authors and contributors

 Andrea Rodrigo
Andrea Rodrigo
B.Sc., M.Sc.
Embryologist
Bachelor's Degree in Biotechnology from the Polytechnic University of Valencia. Master's Degree in Biotechnology of Human Assisted Reproduction from the University of Valencia along with the Valencian Infertility Institute (IVI). Postgraduate course in Medical Genetics. More information about Andrea Rodrigo
 Guillermo Quea Campos
Guillermo Quea Campos
M.D.
Gynecologist
Guillermo Quea, MD has a degree in Medicine and Surgery from the University of San Martin de Porres. He also has a Master's Degree in Human Reproduction from the Universidad Rey Juan Carlos and another in Public Health and Preventive Medicine from the Universidad del País Vasco. More information about Guillermo Quea Campos
Member number: 282860962
 Silvia Azaña Gutiérrez
Silvia Azaña Gutiérrez
B.Sc., M.Sc.
Embryologist
Graduate in Health Biology from the University of Alcalá and specialized in Clinical Genetics from the same university. Master in Assisted Reproduction by the University of Valencia in collaboration with IVI clinics. More information about Silvia Azaña Gutiérrez
License: 3435-CV

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