What Causes Painful Periods and What To Do About It
While a small amount of discomfort during your menstrual cycle can be normal, having recurring painful periods, also known as dysmenorrhea, is not. It is estimated that dysmenorrhea affects up to 50% of menstruating women and may include severe abdominal cramping, pain in the lower back or abdomen, diarrhea, constipation, and pain that radiates down the legs.
Why Painful Periods Happen
Dysmenorrhea occurs in two forms:
Primary Dysmenorrhea, in which the painful periods are caused by chemicals in the lining of the uterus called prostaglandins. Prostaglandin levels are highest on the first day of menstruation and decrease as the lining of the uterus is shed during menstruation. As the chemicals are released, pain levels also tend to decrease. Primary dysmenorrhea can also be exacerbated by physiological factors such as hypertonic pelvic floor muscles, high intensity sports, or clenching of the lower abdomen (i.e., “sucking it in”).
Secondary Dysmenorrhea, in which a disorder of the reproductive system is causing the painful periods. Pelvic pain conditions connected with painful periods may include:
Endometriosis - a reproductive disorder in which endometrial tissue (which is normally found in the uterus) grows elsewhere in the body and can cause pain, particularly pain in the pelvic region and during menstruation.
Adenomyosis - a disorder in which tissue normally found in the uterus grows in the muscular wall of the uterus, causing chronic pelvic and abdominal pain, miscarriage, and infertility
Polycystic Ovarian Syndrome (PCOS) - a hormonal disorder during the reproductive years that can cause painful periods, infrequent periods, periods that last too many days, too much androgen, and cysts along the outer edge of the ovaries.
Chronic Pelvic Pain Syndrome (CPSS) - a disorder in which one experiences chronic pelvic and abdominal pain ranging from the bellybutton to the midthigh and in which severity and frequency of symptoms are varied.
What You Can Do About Painful Periods At Home
Stretch It Out!
For relief from painful periods, try out the following stretches:
1. Cat-Cow Pose
Get on all fours with shoulders hip-width apart and knees directly below hips. As you inhale, curve your back and bring your head up. Upon exhaling, arch your spine and bring your head down toward the ground. Repeat.
2. Child’s Pose
Sit back on your heels with your toes together. Place your knees wider than your hips and rock backward as you stretch your arms out in front of you. Hold for 5-10 breaths
3. Legs Up on the Wall
Lay on your back and place your legs up against the wall. If you find this uncomfortable, trying putting a blanket or bolster between your knees and the wall or underneath your head/neck. Lay in this position for anywhere between 2 and 20 minutes, focusing on your breath and relaxing your body.
Exercise
Although the research is not clear why, there seems to be a clear reduction in pain and symptoms of dysmenorrhea. It’s theorized that exercise decreases prostaglandins, which are the primary chemicals responsible for pain during menstruation, while also increasing endorphin levels, which improve blood flow and mood. Listen to your body and choose the type of exercise that feels good to you. Walking, stretching, running, and lifting weights are all great exercises to choose from but, remember, the important thing isn’t the intensity or type of work you do, it is the act of moving in general that will help to decrease painful symptoms!
Apply Heat
Try soaking in a warm bath or applying a gentle heating pad to the painful area. This can help promote blood flow and relaxation while decreasing pain.
Sleep
Make sure you’re getting enough sleep! Research shows the less sleep you get it, the greater your perception of pain. Sleep is almost an important factor in conserving energy, allowing our bodies to heal and devote resources to the areas that need the most help.
Relaxation Techniques
Guided meditations such as progressive muscle relaxation programs can help reduce pain by promoting physiological and psychological relaxation and calm.
How Pelvic Floor Therapy Can Help
The pelvic floor is made up of layers of muscle and other tissue stretching from public bone to the tailbone at the back. Just like any other muscles in the body, your pelvic floor can become too tight which can cause dysfunction in a number of areas, including exacerbating pain during your menstrual period. Pelvic floor PTs can help decrease such pain by providing relaxation exercises and techniques to reduce tension in the pelvic region and surrounding muscles and tissue.
Some examples of interventions we might use at pelvic floor PT in order to reduce dysmenorrhea include:
Manual therapy to release trigger points and relax muscles as well as improve lymphatic flow
Breathwork to promote relaxation and apply strategies for stress relief
Pelvic floor coordination training with exercise and proper muscle activation
While pain during periods has long been normalized, there are things we can do to help reduce pain and increase comfort during menstruation! Try out some of these tips and tricks at home and reach out for help if you’re still in pain–we can help!
