Dysmenorrhoea: Why Are Periods Painful? Causes and Solutions

Dysmenorrhoea: Why Are Periods Painful? Causes and Solutions

Painful periods have a medical name: dysmenorrhoea. It affects between 50 and 90% of women of reproductive age at some point in their lives, and is one of the leading causes of absence from school and work among women. Yet it is still too often dismissed as normal or inevitable.

Understanding why periods are painful is the first step to managing them better. Here is a thorough overview of the causes, biological mechanisms, and solutions available.

What Is Dysmenorrhoea?

Dysmenorrhoea refers to pelvic pain associated with periods. It typically manifests as cramps in the lower abdomen, often accompanied by lower back pain, pain in the thighs, nausea, fatigue, and sometimes headaches.

There are two fundamentally different types, with distinct causes and treatments.

Primary Dysmenorrhoea: The Most Common Form

Primary dysmenorrhoea has no identifiable underlying gynaecological cause. It is driven by a normal — but amplified — hormonal mechanism in some women.

The Prostaglandin Mechanism

At the time of a period, the uterine lining releases prostaglandins — lipid substances that trigger the uterine contractions needed to expel menstrual blood. The higher the prostaglandin level, the more intense the contractions — and the more severe the pain.

In women with primary dysmenorrhoea, prostaglandin concentrations in the endometrium are significantly higher than average. These contractions can reduce blood supply to the uterus, creating local ischaemia that further amplifies the pain.

Aggravating Factors

  • Young age (primary dysmenorrhoea is more frequent and intense in teenagers and young adults)
  • Short cycles or heavy periods
  • Sedentary lifestyle
  • Chronic stress
  • Smoking
  • A diet high in pro-inflammatory omega-6 fatty acids
  • Family history (a documented genetic component)

Secondary Dysmenorrhoea: An Underlying Cause

Secondary dysmenorrhoea is caused by an identifiable gynaecological condition. It often occurs in women who did not previously have painful periods, or whose pain progressively worsens from cycle to cycle.

Main Causes

  • Endo (the most common): tissue similar to the uterine lining found outside the uterus, creating inflammation and adhesions
  • Adenomyosis: invasion of the uterine muscle by endometrial tissue, causing very heavy and painful periods
  • Uterine fibroids: benign tumours that distort the uterine cavity
  • Endometrial polyps: benign growths of the uterine lining
  • Copper intrauterine device (IUD), particularly in the first few months
  • Chronic pelvic inflammatory disease
  • Congenital uterine abnormalities

How to tell the two types apart:

Primary dysmenorrhoea typically begins in the first few years after the first period and tends to improve with age or after a pregnancy. Secondary dysmenorrhoea appears or worsens in an adult woman who did not previously have this problem — this is a warning sign that warrants a gynaecological consultation.

Other Factors That Amplify Menstrual Pain

Beyond biological causes, several factors can amplify the perception of pain during a period:

  • Central sensitisation: in women with chronic pain, the central nervous system becomes hyperreactive and amplifies all pain signals
  • Stress and anxiety: activate the sympathetic nervous system and increase pelvic muscle tension
  • Lack of sleep: lowers pain tolerance thresholds
  • Sedentary lifestyle: reduces natural endorphin production
  • A pro-inflammatory diet: increases prostaglandin production

When to Seek Medical Advice

Certain signs should prompt you to see a GP or gynaecologist promptly:

  • Pain that worsens from one cycle to the next
  • Pain that occurs outside of periods (mid-cycle, during sex)
  • Very heavy periods with clots
  • Pain resistant to standard anti-inflammatory drugs (ibuprofen, naproxen)
  • Digestive or urinary symptoms associated with periods

Solutions for Dysmenorrhoea

Medical Solutions

  • Non-steroidal anti-inflammatory drugs (ibuprofen, naproxen): reduce prostaglandin production
  • Hormonal contraceptives: reduce uterine lining thickness and prostaglandin production
  • Specific treatment of the underlying condition (endo, adenomyosis)

Natural and Complementary Solutions

  • Local heat (hot water bottle, heat patch): relaxes uterine muscles
  • TENS (electrical nerve stimulation): blocks pain signals at the nerve level, without medication
  • Anti-inflammatory diet rich in omega-3s
  • Gentle physical activity (yoga, walking)
  • Magnesium and curcumin supplements

The Paingone Ellune uses TENS technology specifically adapted for menstrual pain: it acts directly on the nervous mechanism of dysmenorrhoea, blocking the transmission of prostaglandin-driven signals to the brain, with no side effects and no drug interactions.

In Conclusion

Dysmenorrhoea is not something you simply have to put up with. Whether primary or secondary, effective solutions exist — provided you understand the underlying causes and choose approaches suited to your profile. If your pain is intense or worsening, don't wait: an accurate diagnosis is the key to effective management.

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