The All Too Common ‘Period Pain’, and Menopause

For some women, menopause has a certain appeal. It means the absence of the female hormones that are too often causing pain, moods, dysphoria and a repetitive amount of inconvenience. For 88% of us Australian women, your monthly period means a level of pain that is either uncomfortable or lifestyle changing[1].

88%.

Of that 88%, over half are using pain medication for their monthly periods, and about a quarter have had to take time off work or study because of the pain (for a few days, every month?). That’s staggering, and that’s Australian statistics.

To top it off, a greater proportion of those who experienced period pain also reported depression.

Suddenly, menopause looks appealing as it can be thought of as a retirement from the monthly pain, disruption and depression.

Right?

Painful periods can occur as a result of a hormonal issue like endometriosis, fibroids, or adenomas, or unfortunately they can occur ‘just because’.

Unless you have an obvious reason for menstrual pain (endometriosis, fibroids etc.) it is not fully understood why it occurs. It is known that the natural chemicals produced within the body (prostaglandins) collect in the uterus lining and help the uterus shed the endometrial wall by making it contract (causing a bleed). It is theorised that excessive prostaglandins can increase contractions, and thus increase the intensity of contractions from ‘no pain’ to ‘severe pain’. This theory may have developed from the research done by Willman et al showing that those who had period pain had significantly more prostaglandins than those who didn’t get the pain[2].

Separate to this theory, but staying in the same direction, Ham et al’s observations suggest that prostaglandins increase in a manner related to oestrogen levels[3]. Whilst this is only an observation, it is interesting to note that the ‘other reasons’ for period pain (endometriosis, fibroids etc.) are all high oestrogen conditions.

Oestrogen may be the key to period pain.

Menopause, a low oestrogen state, sounds like an end to menstrual pain. And it may be. But due to the nature of the menopause transition (perimenopause), period pain may get worse before it gets better.

The team at the Australian Menopause Centre may be able to help you by assessing your oestrogen response and if needed, balance your hormones. In the meantime, try these tips to reduce pain, and reduce the recurrence of period pain.

• Exercise – try stretching and yoga
  • A series of stretching exercises were shown to significantly decrease the duration and severity of pain [4]^,[5]
• Heat – dust off the old hot water bottle
  • A 40-degree heat wrap, worn for 8 hours on day 1 of your cycle was shown to be more effective than paracetamol[6]^,[7]
• Acupressure – see the professionals
  • Various acupressure techniques were shown to significantly improve severity of pain.[8]^,[9] One study found acupressure significantly more effective than ibuprofen.[10]
• Fish oil and vitamin E supplement
  • 300mg of fish oil (180mg EPA and 120mg DHA) with 200IU of vitamin E had a considerable effect on menstrual pain[11].

For more information, speak with our doctors and clinical team, or our nutritionists and naturopaths.

If period pain is so bad that it interferes with your daily living, or stops you from going about your daily routine, please talk to a health professional.

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[1] Subasinghe, A. K., et al. (2016). “Prevalence and severity of dysmenorrhoea, and management options reported by young Australian women.” Aust Fam Physician 45(11): 829-834.

[2] Willman, E. A., et al. (1976). “Studies in the involvement of prostaglandins in uterine symptomatology and pathology.” Br J Obstet Gynaecol 83(5): 337-341.

[3] Ham, E. A., Cirillo, V. J., Zanetti, M. E., & Kuehl, F. A. (1975). Estrogen-directed synthesis of specific prostaglandins in uterus. Proceedings of the National Academy of Sciences of the United States of America, 72(4), 1420-4.

[4] Abbaspour Z, Rostami M, Najjar S. The effect of exercise on primary dysmenorrhea. J Res Health Sci. 2006;6(1):26–31.

[5] Yang, N. Y. and S. D. Kim (2016). “Effects of a Yoga Program on Menstrual Cramps and Menstrual Distress in Undergraduate Students with Primary Dysmenorrhea: A Single-Blind, Randomized Controlled Trial.” J Altern Complement Med 22(9): 732-738.

[6] Akin, M., et al. (2004). “Continuous, low-level, topical heat wrap therapy as compared to acetaminophen for primary dysmenorrhea.” J Reprod Med 49(9): 739-745.

[7] Potur, D. C., et al. (2014). “Prevalence of dysmenorrhea in university students in Turkey: effect on daily activities and evaluation of different pain management methods.” Pain Manag Nurs 15(4): 768-777.

[8] Aghamiri ZB, Vigeh M, Latifnezhead R, Nabavi S. Study of effect of acupressure methods on pain in primary dysmenorrhea. Hayat. 2005;11(4):19–28.

[9] Bazarganipour, F., et al. (2010). “A randomized clinical trial of the efficacy of applying a simple acupressure protocol to the Taichong point in relieving dysmenorrhea.” Int J Gynaecol Obstet 111(2): 105-109.

[10] Charandabi, S. M., et al. (2011). “The effect of acupressure at the Sanyinjiao point (SP6) on primary dysmenorrhea in students resident in dormitories of Tabriz.” Iran J Nurs Midwifery Res 16(4): 309-317.

[11] Sadeghi, N., et al. (2018). “Vitamin E and fish oil, separately or in combination, on treatment of primary dysmenorrhea: a double-blind, randomized clinical trial.” Gynecol Endocrinol 34(9): 804-808.