Three women share how they manage their dysmenorrhea
“I remember I was once at a business event and the paracetamol wore off,” says 29-year-old Carly Thompsett who runs Anaphase Store, an online clothing company. “I started feeling faint as I was driving home.” On arriving home, all she could do was roll on the floor. She told her boyfriend she thought she was going to die. “He was worried,” she says. “He’d never seen me like that, he’d never seen me in so much pain.”
Carly experiences terrible dysmenorrhea, or period pain as it is commonly known. If she doesn’t catch it just before it starts, she soon finds herself in agony, unable to do anything except lie down crying. When the pain had subsided Carly recalls telling her boyfriend that “that’s just what it’s like”.
Period pain isn’t rare; as many as nine in ten menstruating women experience it. The pain is caused by the contracting muscles in the womb as they shed the lining that has built up each month. As the muscles contract, they constrict the blood vessels in the womb, cutting off the blood supply, causing the tissue to release pain stimulating chemicals.
“I felt like someone was going to burst out of me, I would roll on the floor crying.”
Alongside these chemicals, the body also produces prostaglandins, which encourage the womb muscles to contract even more, increasing the pain. We don’t know why some women experience period pain worse than others, and the duration of the pain varies between women, usually lasting between 48 and 72 hours.
For women who get pain badly, they develop coping mechanisms to prevent it, or make it manageable. In Carly’s case, she developed these mechanisms pretty quickly. “I first started experiencing period pain when I was in school,” she says. “I felt like someone was going to burst out of me, I would roll on the floor crying.” She used to beg her mum not to send her to school; when it was at its worst the pain would render her unable to stand, eat, or do anything at all.
When period pain has no underlying cause, it is known as ‘primary dysmenorrhea’, but certain conditions can make it worse, or cause it in the first place. If this is the case, your period pain is classed as ‘secondary dysmenorrhea’, and treating the underlying condition is an important part of pain management. For a while, Carly thought her pain was normal, until someone suggested she get checked for endometriosis, which has extremely bad period pain (and pain at other times of the month) as one of its symptoms.
”As soon as I feel a twinge I will take tablets, because I just can’t deal with the period pain itself.”
Nonetheless, Carly didn’t show signs of endometriosis after investigation, and she was diagnosed with primary dysmenorrhea, advised instead to use painkillers to control the pain. “I have an underactive thyroid though,” she says, “so the painkillers I can take are limited.” Her only real options are paracetamol and ibuprofen and her biggest trick at managing her pain is to catch it before it begins.
“My period always comes on the tenth of every month, so I have loads of ibuprofen ready,” she says. “As soon as I feel a twinge I will take tablets, because I just can’t deal with the period pain itself and do anything to catch it early.” Her strategy works well for her and she has only experienced the crippling pain she got as a teen two or three times in the past 13 years or so. Despite this, she still fears it happening again, and tries not to take painkillers for any other ailment in the hope that this will mean they work optimally when she needs them for period pain.
Like Carly, 25-year-old Ella is also badly affected by period pain. While she has always had it, she was recently diagnosed with endometriosis, which may explain why she gets it so badly. “It is often so bad that I can’t move,” she says. “Sometimes it comes on gradually, sometimes it is sudden, but the crux is I can’t move. My ovaries will just ache and I will get cramps to the point where I can’t think of anything except the pain.”
“I’ve been working at festivals where I’ve just had to fill a water bottle with hot water and lie on the floor of the makeshift office.”
Ella also gets aching legs and describes the sensation as if “all the bloody from all the parts of my body is rushing out of me”. “I know that sounds disgusting,” she grins, “but that’s how it feels!” Similarly to Carly, she can’t go to work when it’s bad, and in situations where she has been at work, she has had to manage the situation best she can. “I’ve been working at festivals where I’ve just had to fill a water bottle with hot water and lie on the floor of the makeshift office.”
Again, Ella is also entirely dependent on painkillers for managing the pain, and says she wouldn’t be able to cope without them. For her, paracetamol doesn’t tend to work, so instead she takes ibuprofen for the duration, occasionally taking codeine instead if the pain is particularly bad.
While the NHS, and other medical sites, often recommend light exercise to help, those who get period pain extremely badly will know exercise is an absolute impossibility when you’re immobile in agony on the floor. For this reason, controlling pain with painkillers and learning to anticipate when it’s coming is crucial for many women.
If i take naproxen at the first sign of trouble, I find the pain is reduced to barely noticeable levels.
Alongside paracetamol and ibuprofen, doctors can prescribe Naproxen, a drug similar to ibuprofen. For my own situation, Naproxen has proved a lifesaver. Period pain would have me fainting, throwing up, and lying on the floor screaming, and on more than one occasion people have tried to call me ambulances. When it’s bad period pain is quite literally unbearable, and, like Carly, even though I’ve had it before, when it hits I’m convinced I am dying.
Paracetamol does nothing, ibuprofen does little, but if i take naproxen at the first sign of trouble, I find the pain is reduced to barely noticeable levels. This can be prescribed by the doctor, although it should not be taken alongside ibuprofen, and the NHS recommends that no more than three tablets are taken within 24 hours for period pain. Nonetheless, I generally find that taking two on the first day is enough to ride out the worst of it – now I don’t know how I coped before I discovered it.
If your period pain is becoming too much to handle on your own, go and visit your doctor. While it’s not uncommon to get it really badly, occasionally it can be a sign of an underlying cause, so it’s always worth getting checked out. In the meantime, experiment with painkillers to find out which combination works best for you (although check the packets first and stick to dosage guidelines), and try to plan ahead as much as possible – even if this means carrying a small pharmacy around with you at all times just in case.