Period pain is painful menstruation i.e. the discomfort that occurs during periods or a few days preceding the periods.

What Is The Incidence And The Risk Factors?

It usually begins 2 to 3 years following the onset of menstruation. It is more common in girls from unhappy social backgrounds, who have sedentary life styles or suffer from ill health.

What Is The Mechanism?

Period pain occurs when the womb muscles go into spasm, which interferes with the blood supply of the muscles, consequently producing pain.

What Are The Causes?

It is a common gynaecological complaint. Most of the cases are functional i.e. not associated with a disease state and the physical examination is normal. However, period pain may also occur in association with abnormal conditions like endometriosis (presence of tissue which makes the lining of womb at places other than the womb), sexually transmitted diseases and others.

What Are The Symptoms?

Typical features:

• Pain is crampy in nature. It is usually felt in the lower abdomen and is referred to inner side of thighs. It generally begins several hours before the onset of a menstrual period, but may begin 1 or 2 days in advance. It lasts one or more days into the period and then subsides. Pain may be mild to severe.
•  Nausea and vomiting accompany the pain commonly. The woman usually looks pale and drawn.
• Pain may be associated with changes in bowel habits, either constipation or diarrhea.

How Is It Diagnosed?

The doctor usually differentiates between functional ones and those associated with a medical condition on the basis of history and psychical examination.

What Is The Treatment?

General measures include sex education and explanation about menstruation, describing it as a physiological phenomenon and not a disease. This helps to alleviate apprehension, particularly in functional cases.
If pain is severe, simple painkillers can be given. These include anti-inflammatory medications such as aspirin, nonsteroidal anti-inflammatory medications (NSAIDS) such as Ibuprofen. In some severe cases, and with disorders such as endometriosis, oral contraceptives can be helpful. They are used in this case to regulate the hormone levels in the body.

What Is The Expected Duration?

It usually responds well to simple analgesics. Oral contraceptives generally control severe pain. Period pain associated with a disease responds to treatment of the primary problem.

What Are The Complications?

There are no complications associated with functional cases. However, complications may develop in disease-related cases.

When To Call Your GP?

• Painful menstruation occurs.
• Pain affects life, especially if it is severe enough to cause school/work absence.
• Pain occurs frequently.
• Pain is not relieved by painkillers.