health

A definitive answer to the question: is period pain ever normal?

'Period pain' is a phrase we're used to hearing regarding a woman's menstrual cycle. 

There are countless products, vitamins, and pain relief inventions cashing in on this very phenomenon.

While some women might experience a dull ache at the start of their period that quickly subsides after a round of painkillers, others describe it as the worst pain imaginable. 

"The pain itself is so intense and it changes sometimes. So you get everything from the aching and dragging feeling inside your vagina that feels like you've got ten bricks tied to you. You get the pain inside your ovaries. Or you might feel like you've got 10 people inside of you all with dull knives and they're shoving them in and twisting them around and around and around. It's so intense and makes you not want to be here anymore. You wonder how you can live through it," radio host Kristel Dally explained to Mamamia's news podcast The Quicky. 

LISTEN: Is period pain ever normal? Post continues after podcast.


But no matter how much or how little pain you get during that time of the month, we've got news for you: none of it is normal. 

One in five women experience pelvic pain here in Australia. That's a high number. It's very common. 

But according to Dr Jane Chalmers, a senior lecturer in pain sciences at the University of South Australia, "pelvic pain is really anything from the level of our belly button to the level of our inner thighs, and none of it is normal."

"It's a common thing women get told, unfortunately," she said. "But it's important to think about when we should worry and when we should not be worried. For me the time not to be worried is when it happens every now and then."

Dr Chalmers says psychological factors, like stress and anxiety, can influence pain so while the "odd painful period" isn't normal, it's not something to be too concerned about. 

But if you're experiencing pain during most of your menstrual cycles, and it's bad enough to stop you from going to work or school or from playing sport, that's when you need to be concerned and seek help. 

What causes period pain? 

Period pain is a diagnosis in and of itself. 

Dysmenorrhea is the most commonly reported menstrual disorder, and is caused by natural chemicals called prostaglandins which are made in the lining of the uterus.

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According to the American College of Obstetricians and Gynecologists (ACOG), pain usually occurs right before menstruation starts, as the level of prostaglandins increases in the lining of the uterus. As the lining of the uterus is shed, the levels decrease, as does the pain.

No period pain is "normal" despite how common it is. Image: Getty.

But period pain can also be a symptom of other types of pelvic pain like endometriosis, vulvodynia, fibroids, pelvic inflammatory disease (PID), adenomyosis, or cervical stenosis. 

In lots of cases, unfortunately, "there actually isn't always a cause that can be found in the pelvis," Dr Chalmers explains. 

For conditions like vulvodynia, the name simply refers to 'unexplained pain' in the vulva region.

"It's really common... we see it in around one in 10 women. But we don't know enough about it," said Dr Chalmers. 

Endometriosis is found in one in nine women, amounting to around 830,000 Australian women. It’s a condition where the lining of the uterus – the sheath of cells that is shed during a period – grows outside of the uterus.

While this often debilitating condition has received more attention and funding in recent years, we still don't know what causes it. 

As Donna Ciccia, founder and director of Endometriosis Australia, told The Quicky, "there is no cure or prevention, and we need more investment to find out what is hindering those with endometriosis from reaching their potential."

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WATCH: Women explaining what endometriosis feels like. Post continues after video.


Video via Mamamia

Right now, it takes on average between seven and 10 years for someone to be diagnosed with endometriosis, in part because of the taboo that remains around this area of women's health and because of the difficulty in diagnosis. 

"There's no way to know if you have endometriosis unless you have a thorough medical investigation. It's diagnosed by a laparoscopy which is where there are small incisions made into your pelvis and a small camera is inserted to have a look for endometrial legions. But the signs and symptoms to look out for are period pain, bloating, infertility, pain during sex, irregular bleeding, pain with bowel movements and chronic migraines," Dr Chalmers said.   

Can you grow out of period pain?

Yes. A lot of teenagers will simply grow out of bad period pain. 

"In teens that are raging with fluctuating hormones prostaglandins can be quite high, so we see cramping can be quite bad in teenagers," said Dr Chalmers. 

As ACOG explains, primary dysmenorrhea - which is caused by prostaglandins - can also improve after you've given birth.

Secondary dysmenorrhea, however, which can be caused by endometriosis, can begin much later in life, and tends to get worse rather than better over time.

What should you do if your doctor doesn't believe your period pain is real?

Step one: Find a new doctor. 

If that's not an option, Dr Chalmers suggests keeping a period diary that documents when you get your period, when the pain starts and ends, and how bad it is. 

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"If you can go to the doctor equipt with some evidence, they will be more likely to take notice," said Dr Chalmers. 

How can you fix period pain?

Seeing your GP and getting a referral to a gynecologist is the right start if your pain is interfering in your daily life. 

If the pain is more of the "every now and then" variety, there are medications your doctor can prescribe or advise to help you monitor it. Lifestyle interventions - like sleeping eight hours a night, eating a healthy diet and exercising - can also make a huge difference.

"A lot of my research has looked at the role of exercise in reducing period pain and we found that the fitter or more engaged in exercise women tend to be, the better their period pain becomes," Dr Chalmers told The Quicky. 

Research has found exercise can improve period pain. Image: Getty.

"It can be really tough to motivate yourself to exercise when the pain is there, but the more you can move around the better period pain will be," she added. 

What if you get no period pain at all?

It's completely normal and is what all women should be aiming for. 

You shouldn't be experiencing pain during your period. It's a sign that something is either temporarily off-balance, or that you've got something a bit more serious going on that needs to be investigated. 

Feature image: Getty.

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