Period pain is a common problem, and when severe it can stop you from doing your usual activities. However, there are treatments available for painful periods.

Menstrual Cycle

The menstrual cycle involves a cyclical change in reproductive hormones and most women will experience some discomfort with their period. However, lots of women talk about painful periods but have you ever wondered if you experience more pain than someone else?

Before we talk about pain, below is what a normal menstrual cycle looks like.

What is a normal menstrual cycle?

The average menstrual cycle is 28 days (range 21-35 days). Day 1 is defined as starting on the first day of the menstrual bleed (day 1), through to the last day before the next menstrual bleed (day 21-35).

What is considered abnormal or heavy bleeding during your period?

If you notice any of these symptoms or are not within the normal menstrual cycle ranges above it is best to talk to your GP:

  • Prolonged bleeding: 7 days or greater
  • Heavy bleeding: normal 30-40mls, abnormal is greater than 80ml (soaking through 1 or more sanitary pads/tampons for several hours, using double sanitary protection, waking up more than once a night to change a pad)
  • Other signs – restricting activities due to menstrual flow, symptoms of anaemia, tiredness, fatigue or shortness of breath.
  • The absence of the commencement of menstrual periods by age 16, or by age 14-15 if other secondary sexual characteristics have occurred.
  • Intermenstrual bleeding: bleeding in between periods

How much period pain is normal?

Normal period pain:
1. The pain should only be there on day 1-2 of your period
2. If you use oral contraceptives or take pain relief the pain goes away

If it’s not normal, your pain could be due to:
1. Pain in the womb (uterus), this occurs on the first 1-2 days of bleeding
2. Pain caused by endometriosis, especially if it lasts longer than 1-2 days and doesn’t get better with the pill.

What can you do to help reduce period pain?

1. Over the counter pain relief medication; talk to your pharmacist to see which medications you are allowed to take
2. Talk to your GP about options such as being on the contraceptive pill or having a uterine device inserted.
3. Complementary therapies that can help include acupuncture, Vitex Agnus Castus (1000mg daily) and magnesium (100-200mg every 2 hours during your period for 2 days only) (Dr Susan Evans, Introduction to Pelvic Pain, 2019)

If these strategies don’t relieve your pain, talk to your GP to see if you may have endometriosis. Endometriosis is where tissue like the lining of your uterus grows in places outside the uterus and around the pelvis.

A GP may recommend a laproscopy to diagnose and remove endometriosis if possible.

How can a Women’s Health Physiotherapist help?

Our number one priority is to help you reach your goals, so with painful periods and endometriosis for many women, it’s to help reduce pain. How we do this, is to have a very holistic approach, looking at all aspects of your life. This includes:

  • Assessing pelvic floor activity – is it overactive and contributing to pain
  • Looking at bladder and bowel habits
  • Treating any symptoms of painful intercourse in conjunction with your painful period/endometriosis.
  • Assessing your body’s protective response to pain and changing the input into your system to relieve pain.
  • Introducing exercise and stretches which will help your body relax during painful periods or management of endometriosis
  • Trigger point release or acupuncture to reduce muscle tension around painful areas
  • Work in conjunction with your specialist who may be managing your endometriosis

To make an appointment with Amy Tinetti our Women’s Health Physiotherapist, call (08) 6389 2947 or click here to make an appointment online.