About period pain or dysmenorrhea
Period pain is lower stomach ache or cramping that happens around the time of a period.
Period pain is common. Most people who have periods also have period pain. But not many have pain that affects quality of life and stops them going to school, doing sport or socialising.
We don’t know why some people have more pain than others, but it might have to do with the chemicals their bodies produce during periods and the heaviness of their bleeding. Stress levels, past pain, traumatic experiences, sleep, diet and physical activity might also play a part.
The medical term for period pain is dysmenorrhea.
It’s good to talk with your child about periods. This prepares your child and lets them know what to expect. It’s also a good opportunity to encourage your child to tell you if their periods are painful or heavy or worry them in any way.
Symptoms related to period pain
Period pain often starts a few days before a period.
It’s usually worst:
- just before the bleeding starts
- on the first few days of bleeding
- on the days of heaviest bleeding.
If your child has heavy periods, period pain might also be worse when they’re passing clots.
Your child might have other symptoms at the same time as period pain, including:
- nausea or vomiting
- diarrhoea
- headaches
- pain when urinating or doing a poo
- low back pain or pain radiating down the legs
- general aches
- dizziness or faint feelings
- mood changes
- lethargy.
Managing painful periods
These strategies can help your child manage painful periods.
Practical strategies
Your child can try these ideas to help with the pain:
- Put a heat pack or hot water bottle on their lower stomach.
- Rest and relax, particularly with their legs elevated or lying on one side with knees bent.
- Lightly massage their lower stomach.
- Have warm drinks like hot milk or herbal tea.
Wellbeing strategies
These ideas might help your child feel better physically and emotionally:
- Eat a healthy diet.
- Get enough sleep.
- Do some physical activity.
- Manage stress.
- Do stretching and breathing exercises.
Medicines
Over-the-counter non-steroidal anti-inflammatory medicines like ibuprofen or naproxen can help. It’s best for your child to start taking these as soon as they notice the first signs that they’re about to have a period – for example, when mild pain or nausea starts.
Medical help: when to get it for period pain
Your child should see their GP if they have painful periods that stop them from doing everyday activities and the strategies above haven’t helped.
They should also see the GP if:
- The pain is getting worse from one period to the next.
- The pain extends beyond the end of the period.
- The bleeding is very heavy.
Period pain diagnosis and tests
Your child might not need tests if their period pain happens just before and on the first few days and they also have nausea, vomiting, diarrhoea, aches, pains and dizziness.
But if your GP thinks there might be an underlying cause for the period pain, one or more of these tests might help with diagnosis:
- An abdominal examination – this can help the GP work out whether the pain has a muscular cause.
- A pelvic examination – the GP might suggest this if your child is in a lot of pain and has a fever.
- An ultrasound – the GP might suggest this if the pain continues beyond the end of your child’s periods or painkillers don’t help with the pain. An ultrasound can check for an ovarian cyst and some other abdominal conditions.
- An MRI – the GP might suggest this if they think there might be a problem with the kidneys or skeleton or another anatomical problem. MRIs are rarely used.
- A laparoscopy – the GP might suggest this if an ultrasound has shown something that needs surgery. This rarely happens.
Treatment for period pain
The GP will talk with your child about which treatment is best for them. Period pain treatment includes the following:
- Tranexamic acid – this is a non-hormonal medicine that your child can use if their periods are heavy as well as painful. It can reduce bleeding a lot.
- Hormonal medicine like the combined oral contraceptive pill, which contains both oestrogen and progesterone, or a progesterone-only pill – these medicines can reduce pain, reduce bleeding or stop periods altogether.
- A hormonal levonorgestrel-releasing intrauterine device (IUD), like Mirena – these devices can reduce bleeding or stop periods altogether.
- Medroxyprogesterone acetate injections every 3 months – this can stop periods.
It’s best for your child to avoid strong painkillers like codeine, unless it’s just for short-term use. These painkillers can make pain worse in the long term.
Causes of period pain
Primary period pain
Most period pain is primary pain. This is pain that results from normal body processes. These processes involve chemicals that make the uterus shed its lining during a period and that also cause pain.
Sometimes the pain can be caused by blood flow from the uterus back through the fallopian tubes, which happens in almost all people who have periods.
Secondary period pain
Secondary period pain is when there’s an underlying condition causing the pain. Many of these conditions occur only very rarely in pre-teens and teenagers. They include:
- adenomyosis
- endometrial polyps
- endometriosis
- fibroids
- pelvic inflammatory disease
- variation in the shape of the uterus.
