Painful Periods: Dysmenorrhea

Painful periods, also known as dysmenorrhea, are caused by chemicals called “prostaglandins”. A woman’s body produces these chemicals which cause the uterus to contract and expel its contents. During menstruation, these prostaglandins will shed the tissues lining the uterus causing menstrual bleeding while during child birth, to expel the foetus. While contractions during a woman’s period are completely normal, they can cause much pain.


Other conditions that worsen dysmenorrhea

While painful periods may be normal, there are certain medical conditions that may worsen the pain. One such condition is known as endometriosis whereby tissues that typically form the lining of uterus grow outside of uterus. Another condition is the pelvic inflammatory disease where there is an infection of the organs of a woman’s reproductive system.


What the pain feels like

Typically, the pain starts just before or during the period. It feels like the lower part of the belly is cramping and the pain may extend to the back or even down to the thighs. Depending on individuals, the cramps may be mild to severe.


Other symptoms

Some women may also experience other symptoms such as:

  • Nausea
  • Diarrhoea
  • Bloating (a feeling of fullness in the belly)
  • Tiredness
  • Headache



There are several things a woman can do to relieve or alleviate herself of the pain and discomfort:

  • Using a hot water bottle or heating pad on the lower belly will reduce the pain and make it more bearable.
  • Exercising regularly has been shown in certain studies to reduce the pain during dysmenorrhea. It is worth pointing out that the size of these studies is relatively small, hence the evidence is inconclusive. Nevertheless, exercise is known to confer many other health benefits. So why not?
  • Pain medications such as ibuprofen, mefenamic acid, and naproxen are very useful in reducing pain during periods. They are widely available in pharmacies, so make sure you speak to your pharmacists before taking them as people with certain conditions such as asthma should not take them. Also, do note that some of these medications do reduce the duration and flow of periods.


When to see a doctor?

Although dysmenorrhea is mostly benign (do not cause any harm to your health), some of the underlying conditions mentioned above may require active treatment. Hence it is prudent to make a trip to your family doctor or gynaecologist when:

  • The pain is severe or unbearable
  • The pain is getting worse than what your normally experience
  • Pain medications are not providing relief
  • The pain starts well before menstruation or extends beyond that


Other treatment options

If there are other underlying causes of the period pain, the doctor may choose to treat those causes first. Otherwise, apart from pain medications, the doctor may prescribe hormonal birth control pills to reduce the pain.



  1. Schorge J, Hoffman B, Bradshaw K, Halvorson L, Schaffer J, Corton M. Williams gynecology. 3rd ed. McGraw Hill; 2008.
  2. Kasper D, Harrison T. Harrison’s Principles of internal medicine. 18th ed. New York: McGraw-Hill Education; 2015.
  3. Brown J, Brown S. Exercise for dysmenorrhoea. Cochrane Database of Systematic Reviews. 2010;17(2):CD004142.
  4. Image credit:–azO2pZc2–/c_fill,fl_progressive,g_center,h_450,q_80,w_800/cgohsmwtvz1idz8w7tpm.jpg
Pou Wee Gan
Pou Wee Gan

M.Pharm, MBBS, BCPS, R.Ph

A pharmacist first, then a medical doctor. An avid tea drinker and an occasional poet.

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