Historically, talking out loud with others about the menstrual cycle has been an uncomfortable topic. Often even when talking to their healthcare provider, some may delay or avoid having a talk about what they typically experience because of feelings of embarrassment. They also may be shy about asking if what they experience during a period is “normal.” For many, the menstrual cycle has been private, and maybe even a source of shame. This lack of comfort can also result in those with painful periods to suffer in silence because they may not be aware that treatment options are available or how to start a talk about it with a provider.
We hope that this interview with Dr. Eric Schmit, an OB-GYN here at Valley offers some information about painful periods, where to go for help if you are experiencing pain during your menstrual cycle, and encouragement to start more conversations around menstruation with not only healthcare providers, but also your friends and family.
What are painful periods or dysmenorrhea?
Dysmenorrhea is lower pelvic cramping pain that is associated with the menstrual cycle. It can be broken down into primary dysmenorrhea or secondary dysmenorrhea. Primary dysmenorrhea would indicate there is no underlying cause for the symptoms, whilesecondary has identified underlying causes.
Some symptoms of a painful period may include:
| Cramping or pain in the lower belly | Diarrhea |
| Low back pain | Fatigue or weakness |
| Pain spreading down the legs | Fainting |
| Nausea | Headaches |
| Vomiting |
You mentioned that secondary dysmenorrhea indicates there is an underlying cause. What are some possible causes of secondary dysmenorrhea?
Some possible causes of dysmenorrhea may include pelvic inflammatory disease (PID), endometriosis, uterine fibroids, endometrial polyps, tumors or infection. However, experiencing painful periods does not always indicate you may have one of these diagnoses, and that’s why it’s important to see a provider so they can help you.
How do we know if there is an underlying cause?
Finding possible underlying causes of dysmenorrhea requires consulting with your provider or specialist such as an OB-GYN. They will likely discuss your health history, may complete a physical and pelvic exam or consider an ultrasound.
Why do some of us have painful periods and some do not?
Every person experiences periods differently. The menstrual cycle causes inflammation within the pelvis and uterus during a period and the amount of inflammation each person experiences may be different. Try not to compare your experiences with someone else’s, but take note if you are experiencing major changes in how your cycle typically looks, lasts and feels.
Many people have normalized pain around their periods by talking amongst friends. Some of us think we may have to “just learn to deal with it,” or “live with it.” How do you know when the pain you’re experiencing is not normal? How do you know when to seek help from a provider?
It’s time to potentially seek advice and guidance from a clinician when the pain is affecting your day-to=day activities, preoccupying your thoughts, not allowing you to work, not you allowing to exercise, or socialize with friends and family. Many people delay seeking help from a provider and we wish you’d come see us sooner so we can find ways to alleviate some of the discomfort.
If experiencing pain that distracts you, or affects you in your daily life, what is the process for getting help?
Start with your primary care provider, who often addresses many areas of women’s health. They may find it appropriate to see a women’s health specialist, or OB-GYN, about some of these issues.
Are there any lifestyle changes that you can try at home to relieve menstrual pain and support period?
As we mentioned, a painful period can often be due to the inflammation present in the pelvis. Before seeing your clinician, you can reduce inflammation through diet and exercise. During specific painful times in the cycle, heat packs are helpful and over-the-counter medications such as ibuprofen and Tylenol may provide some relief. Ibuprofen has anti-inflammatory properties which does help with pain and dysmenorrhea.
If there is a secondary dysmenorrhea and there are underlying causes, what treatment options are offered?
Beside over-the-counter options, there are a number of treatment options depending on the underlying cause. Even if there are no underlying causes that can be found, there are plenty of ways to treat dysmenorrhea with the help of your provider.
If some of us have had painful periods for a long time and feel reluctant to get help because of fear of discrimination or self-consciousness, what would you say to help those people feel heard and able to get help?
If you are experiencing dysmenorrhea or pain before, during, or after your period, we want to hear about it as your physicians. We want to find out if there is an underlying cause and help guide treatment to help make it so you can go about your day without worrying about how your period will affect your life.
Here are some tips for getting the most from a visit with your healthcare provider:
- Bring a list of your concerns and questions with you to your appointment.
- Know the approximate date of your last period and if they are regular or not.
- If you are experiencing period pain or other symptoms throughout your cycle that may be new or persistently affecting your daily life, tell your provider this directly.
- Know why any new medications are prescribed and how they will help you, along with their possible side effects.
- Know how to contact your provider if you have additional questions after your visit.
OB-GYN Eric Schmidt, DO, practices at Valley Women’s Healthcare in Renton. To learn more about Dr. Schmidt, watch his video. To learn more about gynecologic care at Valley Women’s Healthcare Clinics in Auburn, Covington and Renton, see valleymed.org/obgyn.
