When is period pain not normal?
Period pain is common, but that doesn’t mean severe pain is something you simply have to put up with.
For some women, period pain is relatively mild and manageable. For others, it can interfere with work, exercise, sleep, relationships and everyday life.
So how do you know when period pain is worth investigating?
What is considered normal period pain?
Some cramping or discomfort around the start of your period can be normal. This is caused by the uterus contracting as it sheds its lining.
For many women, this discomfort can be managed with simple measures such as heat, rest or over-the-counter pain relief and doesn’t significantly interfere with daily life.
It’s when pain becomes severe, persistent or starts affecting what you can do that it deserves a closer look.
Signs your period pain may need investigating
It’s worth speaking with your GP or a gynaecologist if your period pain:
regularly stops you from going to work, school or participating in normal activities
isn’t adequately controlled with standard pain relief
is becoming progressively worse
occurs at other times during your menstrual cycle
is associated with very heavy or irregular bleeding
is accompanied by pain during or after sex
is associated with pain when opening your bowels or urinating, particularly around your period
is affecting your quality of life
A change in your usual periods is also worth discussing, particularly if symptoms have appeared suddenly or are becoming more noticeable.
What can cause painful periods?
There are a number of possible causes of pelvic and period pain.
One is endometriosis, where tissue similar to the lining of the uterus grows outside the uterus. Endometriosis can cause significant period pain, pelvic pain, pain during sex and, for some women, fertility difficulties.
Other possible causes can include adenomyosis, fibroids, ovarian cysts and other gynaecological conditions.
Importantly, the severity of your symptoms doesn’t always tell us how extensive an underlying condition may be. This is why investigating persistent symptoms can be important.
What happens when you see a gynaecologist?
Your first appointment is a chance to talk through what you’ve been experiencing.
I’ll ask about your periods, the type and location of your pain, how long you’ve experienced it and whether there are other symptoms occurring alongside it.
We’ll also discuss your medical history, any previous investigations or treatment, and whether your symptoms are affecting other areas of your life.
Depending on your circumstances, further investigation may be recommended. This could include an ultrasound or other testing.
From there, we can discuss what may be causing your symptoms and the treatment options available.
Treatment doesn't always mean surgery
Seeing a gynaecologist for period pain doesn’t automatically mean you’ll need surgery.
Treatment depends on the likely cause of your symptoms, their severity and what’s appropriate for you.
For some women, medication or hormonal treatment may help manage symptoms. In other circumstances, further investigation or surgery may be appropriate.
The important thing is having a clear understanding of your options so that we can decide on the most appropriate approach for you.
You don't have to simply put up with painful periods
One of the difficulties with period pain is that many women have lived with their symptoms for years before seeking help.
If your periods are regularly disrupting your life, your pain is becoming worse or something simply doesn’t feel right, it’s worth having the conversation.
Severe period pain shouldn’t automatically be dismissed as just part of having a period.
Dr Michael Allen is a Specialist Obstetrician, Gynaecologist and Fertility Specialist consulting in Subiaco, Perth, and Clinical Director of IVF Australia WA.
To make an appointment, contact Dr Allen's rooms on (08) 9381 2400 or please fill in a contact form.
