Dealing with period pain

Period pain (also known as dysmenorrhoea) is a common PMS symptom associated with the menstrual cycle which often occurs around two days before your period commences.

Different people can experience period pain in different ways, with pain ranging from mild to severe. Common symptoms of period pain include aching, cramping or heaviness, particularly within the lower part of the abdomen, lower back and legs.

There are two types of period pain: Primary dysmenorrhoea and Secondary dysmenorrhoea.

Primary dysmenorrhoea

Primary dysmenorrhoea is the most common type of period pain. Typically, the pain has a regular pattern, begins just before or as the period begins and usually lasts one to three days.

This is caused by natural compounds called ‘prostaglandins’ are the cause of primary dysmenorrhoea. Prostaglandins play an active role in regulating the menstrual cycle, with the most notable role being triggering the muscles in the uterus to contract and expel the uterus lining causing your menstrual period. If your levels of prostaglandins are too high, you may experience excessive abdominal cramping which is stronger and more painful than normal menstrual cramping, and/or excessive menstrual bleeding.

Secondary dysmenorrhoea

Secondary dysmenorrhoea is caused by an underlying reproductive disorder such as endometriosis, adenomyosis, pelvic inflammatory disease, or fibroids.

• Endometriosis is a condition in which the cells that normally line the uterus (the endometrium) throughout the body in areas outside of the uterus
• Adenomyosis is a condition in which the cells that normally line the uterus (the endometrium) also grow in the muscle wall of the uterus
• Pelvic Inflammatory disease occurs when an infection spreads from the vagina to the upper reproductive organs
• Fibroids are non-cancerous lumps or growths of muscle tissue that form within the walls of the uterus

Unfortunately, there is no easy way of discerning which type of dysmenorrhoea you may be experiencing immediately without reviewing your symptoms and medical history. This may be completed with a specialised women’s health general practitioner (GP). If you would to explore this further, please contact Ignite Athlete.

While exercise has been linked to reducing painful periods, the symptoms associated with period pain may make participating in training and competition more difficult. Your estrogen and progesterone levels are also at their lowest throughout your period so you may feel less energetic and more tired than usual. Some strategies to manage these implications include ensuring your diet remains balanced, prioritising hydration and sleep in your schedule to improve recovery and addressing any stressors where possible.

Once again, the treatment of your period pain will be dependent upon the type of period pain you are experiencing.

If you are experiencing primary dysmenorrhoea there are a range of treatments that you can try to self-manage your period pain including medication, hormonal treatment and other strategies.

Medication

Anti-inflammatory medicines (e.g., ibuprofen, naproxen, mefenamic acid) stop your body from producing prostaglandins. They are the most effective when taken 48 hours before you expect to get your period, or as soon as your period starts.

Paracetamol can also help for mild cramping.

Please note, it is important that all athletes should discuss that they are starting medication with their support staff or medical team to ensure medications are approved by their sporting body.

Hormonal treatment

Hormonal management strategies can also be implemented as a longer-term strategy to manage period pain. Your doctor may try using the contraceptive pill (‘The Pill’), Depo Provera injection, and Mirena to reduce pain and period flow. Seek advice from a women’s health general practitioner (GP) to help you manage these treatments.

Other management strategies

Other strategies that you may like to try to reduce your period pain include:

• Heat pack
• Meditation to reduce stress
• Transcutaneous electrical nerve stimulation (TENS)

Secondary dysmenorrhoea is best treated by treating the underlying cause so make sure you seek appropriate advice if symptoms are prolonged and not managed by the above.

If the techniques outlined above do not help in reducing your pain, or your period pain is impacting your ability to participate in your daily activities, we recommend you seek the advice of a specialised women’s health GP.

We also recommend seeking the advice of your doctor if you experience the following:

• You get pain in your pelvic area when you don’t have a period
• Any significant changes in the pattern of your period
• The absence of a period
• Heavy bleeding (e.g., flooding of pads, changing pad/tampon every hour etc.)
• Large clots present during your period
• Severe pain that impacts on your daily activities
• Vomiting or nausea
• Blood in urine or bowel motion
• Urinary incontinence

They will assess your symptoms, and where relevant, refer you onto a gynaecologist for further investigation. If you track your menstrual cycle, this log will be beneficial to bring to your appointment.

We have a network of specialised General Practitioners, gynaecologists and fertility specialists across Australia who will be more than happy to speak with you and discuss your individual circumstances.

With over 50 dedicated specialists across 70 consulting locations throughout the country, our friendly staff can help you choose the right medical professional to guide you and help you achieve your sporting goals.

AIS Female Performance and Health Initiative – Dysmenorrhoea