Menstruation is a fact of life and something women have to deal with approximately 450 times in their lives, alongside bloating, cramping and irritability. We lose between two and three tablespoons of blood with each period, relying on some a plethora of products to get us through with minimal disruption to our lives. Unlike previous generations who were told their time of the month brought with it a need to stay close to home and minimise their daily activity, modern women refuse to let their monthly crimson wave get in the way of what they have to do - that is, until the onset of heavy bleeding and downright debilitating pain plays havoc. We all experience some level of discomfort at certain times of the month, but living in a constant haze of pain is not normal. Your heavy period and crippling cramps may be the result of something more serious and not necessarily something you just have to put up with until you hit menopause. Although the root cause behind excessive discomfort could be one of many things, there are five main diagnosis that may be worth discussing with your doctor if your monthly gift is more like monthly torture.
1. Endometriosis is a gynecological condition in which the lining of the uterus is found on other structures throughout the pelvis (including the ovaries, fallopian tubes, bladder and pelvic floor.) It’s not known exactly why endometriosis causes menstrual pain, but it’s thought it may be to do with where lining of the uterus is located and how it’s formed. Displaced endometrium can cause chronic inflammation, chocolate cysts and internal bleeding – all of which can prompt excruciating pelvic pain.
2. Adenomyosis is similar to endometriosis - except instead of the lining implanting itself outside of the uterus, it is found embedded deep within the muscle. Symptoms can include painful cramping and painful intercourse, but it’s usually seen in women over the age of 30 who have already had children.
3. Uterine Fibroids will develop in as many as 75% of women, but their size determines whether or not they’ll present any symptoms. Although many are microscopic, some are large enough to distort the shape of the uterus and can increase not only the amount of bleeding, but the severity of menstrual pain - as the uterus must contract to expel the large blood clots that often result.
4. Pelvic Inflammatory Disease is an infection of the female reproductive tract, most commonly caused by untreated sexually transmitted infections. Left untreated, PID can cause inflammation, scarring, painful menstruation and infertility thanks to the scar tissue left behind. During menstruation, hormones influence the uterus and surrounding structures which can increase inflammation, bleeding and pain. PID can be treated with antibiotics, but antibiotics unfortunately won’t undo any structural damage caused by the infection.
5. Primary Dysmenorrhea occurs at some point in almost half of all menstruating women. According to the American College of Obstetricians and Gynecologists, this cramping is caused by increased or imbalanced levels of prostaglandins – hormone-like fatty acids that stimulate the uterus to contract. Changes in prostaglandin levels can cause more intense and frequent contractions, leading to the compression of nearby blood vessels and cutting off oxygen to the uterine muscle; the result of this is painful cramping and discomfort.
2. Adenomyosis is similar to endometriosis - except instead of the lining implanting itself outside of the uterus, it is found embedded deep within the muscle. Symptoms can include painful cramping and painful intercourse, but it’s usually seen in women over the age of 30 who have already had children.
3. Uterine Fibroids will develop in as many as 75% of women, but their size determines whether or not they’ll present any symptoms. Although many are microscopic, some are large enough to distort the shape of the uterus and can increase not only the amount of bleeding, but the severity of menstrual pain - as the uterus must contract to expel the large blood clots that often result.
4. Pelvic Inflammatory Disease is an infection of the female reproductive tract, most commonly caused by untreated sexually transmitted infections. Left untreated, PID can cause inflammation, scarring, painful menstruation and infertility thanks to the scar tissue left behind. During menstruation, hormones influence the uterus and surrounding structures which can increase inflammation, bleeding and pain. PID can be treated with antibiotics, but antibiotics unfortunately won’t undo any structural damage caused by the infection.
5. Primary Dysmenorrhea occurs at some point in almost half of all menstruating women. According to the American College of Obstetricians and Gynecologists, this cramping is caused by increased or imbalanced levels of prostaglandins – hormone-like fatty acids that stimulate the uterus to contract. Changes in prostaglandin levels can cause more intense and frequent contractions, leading to the compression of nearby blood vessels and cutting off oxygen to the uterine muscle; the result of this is painful cramping and discomfort.
This is by no means an exhaustive list (nor does period pain necessarily equate to any kind of condition or abnormality,) but if you feel like your day to day life is being negatively impacted due to monthly intolerable discomfort, please speak to your doctor or gynocologist. They'll be able to tell you whether what you're experiencing is normal, or whether it needs to be investigated further. Regardless, there are a number of things you can do to minimise the pain and discomfort - even temporarily. These quick, easy and totally free methods of pain control are suitable for all.
HEAT: Heat helps to relax the contracting muscles in your uterus, which is the root cause of pain. Using a heat pad on your pelvic area or tummy can help to soothe the muscles and reduce the tension, as can a hot water bottle; massaging the abdomen area gently or taking a warm bath can also help to restore pain levels to a tolerable amount.
RELAXATION: Practising yoga, meditation and relaxation techniques can help wash away symptoms associated with cramping, while taking an anti-inflammatory medication (such as ibuprofen) several days before your expected period can help to tackle symptoms associated with inflammation. It's all about relaxing those muscles and learning to control how tense you are - both in body and mind.
DIET: If you're into supplements, omega-3 fatty acids, calcium and magnesium has been known to help prevent bloating and discomfort, while reducing your intake of salt, alcohol, caffeine will have a positive impact overall. Eating lighter meals (even though we all want to gauge on pizza) will also keep your body working at its best, while reducing the pressure on your abdomen.
EXERCISE: When you're doing any type of aerobic exercise, your body is pumping more blood; this helps to release endorphins to counteract the prostaglandins and reduce your cramps. A light walk, a jog or even a little dance can help to counteract a painful patch - even when you'd rather curl up in a ball and hibernate for the next three days.
Our monthly periods simply aren't fun, but they are a fact of life. Although without certain contraceptives you can't rid yourself of them entirely, there are ways to manage the pain and discomfort so it doesn't impact on your life in a negative way. I really believe we need to discuss period pain and heavy bleeding more openly, so we can share experiences and tips for managing it effectively. We collectively have a tendency to shy away from such discussions as if it was something to be ashamed of, when a monthly period is actually a sign of a healthy body operating in the way it was intended - so technically, we should celebrate our menstruation cycle. Perhaps with cake.
Do you have any advice for managing pain and discomfort, or any experience with one of the aforementioned conditions that may help others? Remember, continue the conversation on Twitter using the hashtag: #LetsTalkAboutIt
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