Menstrual pain or dysmenorrhea is the pain that accompanies menstrual periods that can begin even before menstrual bleeding and last for the first 2-3 days. More than half of all women have experienced it, especially during their youth. It can be felt in the pelvis, lower back or thighs. Sometimes it is associated with nausea, vomiting or diarrhea.
The period can hurt due to added gynecological pathologies, such as endometriosis, but it can also occur in completely healthy women, and it is due to the fact that during a normal cycle in which ovulation has occurred, substances called prostaglandins accumulate in the endometrial tissue, which when we remove them during the bleeding cause uterine contractions and therefore pain.
So we can conclude that the period only hurts if the cycle is ovulatory. This is why girls do not usually have period pains during the first-second year of menstruation, because their cycles are not ovulatory, and neither do hormonal contraceptive users, because these treatments inhibit ovulation and secondarily the production of prostaglandins and pain.
Therefore, to alleviate dysmenorrhea we have to focus on relaxing uterine contractions, decreasing the production of prostaglandins or inhibiting ovulation. When a woman has painful periods, the first thing to do is to rule out that there is no underlying pathology that causes them, so we should consult a gynecologist. If everything is fine, it is considered a primary dysmenorrhea (without organic cause) and if a therapeutic guideline is necessary, the treatments that have demonstrated effectiveness are:
- Nonsteroidal anti-inflammatory drugs, such as ibuprofen, diclofenac, dexquetoprofen… as they inhibit the synthesis of prostaglandins.
- Hormonal contraceptives, because as we have mentioned, as they prevent ovulation, they also prevent the synthesis of prostaglandins and therefore pain. They are really effective in 90% of patients
- Transcutaneous electro nerve stimulation, which by applying electric shocks through electrodes in the pelvic area can reduce the intensity of pain.
- Acupuncture or acupressure has shown some benefits in these patients.
And alternatively, without sufficient scientific evidence, it has been proposed as a possible attenuation of these problems:
- Regular physical exercise, because it increases the synthesis of natural endorphins and decreases the production of prostaglandins, and acts as a muscle relaxant.
- Local heat in the pelvis or lumbar area or massages can also alleviate by its relaxing effect.
- There are some products in the pharmaceutical market that stimulate the cellular cannabinoid receptors and can act as alternative analgesics to the classic ones.
- Certain diets, rich in Omega 3 fatty acids, present in fish oils, which decrease the synthesis of prostaglandins, magnesium, a mineral present in green leafy vegetables, nuts, seeds and whole grains, zinc, vitamin B or infusions of ginger, valerian, cinnamon can help to cope better with those days if we do not want to resort to medical treatment.
Dr. Natàlia Garcia Montaner