Understanding Dysmenorrhea: The Silent Battle

For many, their first period is a sign of them blossoming into a woman but for some, it is the start of a decades long ordeal of chronic pain, despair and gaslighting.

Extreme period pain, medically known as dysmenorrhea, is a problem that has plagued generations of women and yet, many are too ashamed to come forward with their experiences out of fear of being disbelieved or past negative experiences with medical professionals. But following Spain’s creation of a new law, earlier this year, granting women the right to take ‘paid menstrual leave’ from work, many are beginning to advocate for their health, speaking up in order to get the help they need to function daily.

Characterised by severe lower abdominal cramps, back pain, headaches, nausea, and sometimes vomiting, dysmenorrhea can be debilitating. It is classified into two types: primary and secondary. Primary dysmenorrhea typically occurs in the absence of any underlying medical condition, while secondary dysmenorrhea is linked to issues such as endometriosis, fibroids, or pelvic inflammatory disease.

The impact of dysmenorrhea, for many, extends beyond physical pain. Women enduring this monthly struggle often face emotional distress and social limitations leading to anxiety, depression, and a decreased quality of life. Further to this, the stigma surrounding menstruation in many cultures often prevents open discussion about the severity of menstrual pain, leading to a lack of understanding and empathy from non-menstruating counter parts.

Journalist, Naga Munchetty has talked about feeling gaslit by the NHS when talking to doctors about extreme dysmenorrhea.

21 year old student, Aaliyah Fleming, suffers from secondary dysmenorrhea as a result of her polycystic ovary syndrome, better known as PCOS. PCOS is a condition that affects how the ovaries work, affecting around one in ten women in the UK. When asked about her experience with dysmenorrhea, Aaliyah said: “I have struggled with intense period pains since I was 13 years old but it would take another 2 years before I thought the situation was bad enough that I needed to raise concerns with my GP.

“I let my GP know that my periods were irregular and often accompanied by debilitating back pain and cramps, and the doctor advised me to lose weight instead. It would take me another 3 years to work up the confidence to see a GP about my issues again and eventually get me my diagnosis.

“I truly believe that because all my GPs have been male and lack a lived experience in this area, they have failed to diagnose my condition as they cannot conceptualise the idea of such impactful, physical pain.”

Addressing dysmenorrhea more openly requires not only effective management but also increased awareness, understanding and the normalising of conversations around menstrual health, ensuring to encourage empathy. This, and providing comprehensive education are crucial steps towards removing the stigma and shame around the discussion of period pains.  

Speaking to physiotherapist, Kieran Sheridan, she said, “Women may find it difficult to seek help or advocate for themselves harder for dysmenorrhea (severe period pains) because they often assume that these symptoms are normal or they could be wary of treatments available such as medicine, homecare or medical consultations.

“Another reason could be that they are wary that their doctor will think that dysmenorrhea is not a genuine condition. Also, women may be unaware of the side effects of other kinds of dysmenorrhea such as secondary dysmenorrhoea, which may have an impact on fertility.”

But there are ways to help alleviate the impact of dysmenorrhea, using these top tips provided by Kieran:

1.     Avoid coffee at all costs

“When it’s the time of the month, coffee isn’t exactly the wisest drink of choice as it tends to mess up your cycle. It’s best to find an alternative for a woman’s caffeine boost.

“Caffeine can actually interfere with the hormone that can make smaller blood vessels that are present in the uterus. Coffee also contributes to inflammation and bloating, adding to stomach aches.”

2.     Drink herbal teas instead

“A 2019 Study from the National Library of Medicine showed that women who consumed green or oolong teas experiences a low occurrence of menstrual cramps.

“Drinking green tea was linked with a lower prevalence of dysmenorrhea, which was stronger in moderate-to-severe dysmenorrhea than in mild cases. According to the study, those who consumed about three to five cups per day of tea were 51% less likely to suffer from mild dysmenorrhea than those who did not drink tea.

3.     Exercise

“While exercise may not be an ideal activity when a person is tired, doing light exercises such as jogging, light cardio and yoga may lessen period pains. Just don’t exercise too much or do heavy lifting as it may cause fatigue and nausea.”

4.     Use heat packs

“One of the basic measures to deal with period pains is heat packs. Applying heat or warmth on the abdomen can reduce muscle tension and relax muscles to reduce pain, according to a 2018 study.”

5.     See a doctor!

“If the pain persists, it is best to see a doctor to identify if over the counter medicines and the above tips are not helping.”