Is my period pain normal?

Women of all ages are familiar with the sensation of stabbing pain that hails the monthly arrival of their period. This is often described as being stabbing, sharp or cramping pain that ranges from mild to severe. For some women, this pain can be so debilitating that it can disrupt school, work, social and family life. For others, the pain is simply a temporary simple occurrence that can be overcome with over-the-counter pain medication. 

So what’s the difference? Drs Bassem Gerges and Matthew Wilson of Norwest Obstetrics & Gynaecology are highly experienced in diagnosing the underlying conditions and causes of period pain. In this article you will discover what may be at the root of your period pain and how Norwest Obstetrics & Gynaecology can help to treat it. 

What causes period pain?

Each month, the uterus prepares itself for pregnancy by growing its thick lining called the endometrium that’s rich in blood supply. This uterine lining awaits implantation by a fertilised embryo. 

When fertilisation doesn’t occur, the body produces a period, which is actually the shedding of the endometrium. During this time, the blood vessels in the uterus open and the lining (endometrium) sheds from the uterine wall. The muscles in the uterus contract in order to expel the blood and tissue.  

dysmenorrhoea) you experience can be categorised into two types. 

Period pain: primary dysmenorrhoea

Occurs in women with normal pelvic anatomy. 90% of women in Australia who experience period pain are experiencing primary dysmenorrhoea caused by the usual prostaglandin release at the time of their period.

Period pain: secondary dysmenorrhoea

Endometriosis is when cells that are similar to the lining of the womb (endometrium) are deposited outside of the uterus, most commonly on the organs in the pelvis. The hormones in your body that trigger a period also cause bleeding at these sites of implanted endometrial tissue. This causes inflammation and pain which can last not only during your period, but at other times throughout the month. Pain is also a common experience for women with endometriosis during sex and at the time of ovulation. Endometriosis is also associated with infertility. Similarly, adenomyosis, is when endometrial-like cells are in the muscle of the uterus (myometrium), and respond to the hormones from your ovaries as with endometriosis, also causing pain and heavy menstrual bleeding.

The experience of endometriosis varies greatly for women 

The way that women interpret pain in their pelvis varies depending on the person. Some women can have severe endometriosis and have very little or no pain. Whereas other women with minimal or mild endometriosis experience severe pain.  

Many women dismiss this pain as being normal and often don’t seek treatment for it. Yet the impact of endometriosis on women’s lives is very real. Many girls and women have to take time off from work or study as a result of the pain. Endometriosis is not a fatal disease, but it does cause ongoing discomfort and pain for women and often disrupts their lives.

Treatment for endometriosis

The oral contraceptive pill can often help to manage the symptoms of endometriosis.  Also progesterone implants (Implanon) or progesterone coated intrauterine devices (Mirena)  can be helpful treatment options for reducing the pain of periods. However, these treatments don’t work for everyone.

Surgical removal of endometriosis  

Dr Bassem Gerges and Dr Mathew Wilson of Norwest Obstetrics & Gynaecology provide appropriate gynaecological treatments and surgery utilising the least invasive laparoscopic (key-hole) methods.  This includes high quality gynaecological care for women dealing with endometriosis. They regularly perform laparoscopic (key-hole) surgery and Dr Gerges routinely performs in-office deep endometriosis ultrasound scans.

Many women delay seeing a gynaecologist about their pain and therefore don’t get a proper diagnosis and treatment. This delay can bring with it a lot of anxiety and pain about how they can resolve their issue.

When you visit Norwest Obstetrics & Gynaecology, Dr Gerges and Dr Wilson will do a complete analysis of your medical history and a physical examination. If endometriosis is suspected to be the cause of your pain they will then clearly explain the medical treatment options,  the risks and benefits of laparoscopic surgery and tailor an individualised treatment plan to your health needs. 

Acyclical pelvic pain

There are several other conditions which lead to pelvic pain. Acyclical or non-cyclical pelvic pain is the kind that occurs on a regular basis (i.e. a few times per week), even when you’re not having your period. There may be many reasons for this. Some of the more common problems are: 

• Adenomyosis: where endometrial cells grow in the muscle of the uterus. 
• Uterine fibroids: where non-cancerous cells grow in the wall of the uterus. 
• Pelvic inflammatory disease: where there is an infection of a woman’s reproductive organs. 
• Vulvodynia: vulvar pain which may not have a clear cause.
• Irritable bowel syndrome: which affects the functioning of the bowel and can be related to diet and/or stress.

When should I see a gynaecologist for my pelvic pain? 

It’s worth asking for a referral to Norwest Obstetrics & Gynaecology if you have the following symptoms: 

• Regular cyclical or non-cyclical pelvic pain, pain during sex, or pain related to your bladder or bowel motions. 
• The sudden experience of severe or significant worsening, period pain.
• Changes in your menstrual cycle, such as bleeding more than normal or at unusual times throughout the month. 
• Period pain that doesn’t respond to anti-inflammatory medications (such as ibuprofen) or the pill, and you’re still in enough pain to prevent you from going to work or school.
• Pain that interferes with your ability to do normal things like go to school or work. 
• Severe pain, along with a mum or sister who has endometriosis (research suggests that endometriosis runs in families).

Also, if you just feel as though something is not right,, book an appointment with your GP who can refer you to Norwest Obstetrics & Gynaecology. Dr Gerges and Dr Wilson will be able to discuss a variety of diagnostic investigations with you, in order to find out the cause and provide you with personalised treatment options. Arrange a referral to the clinic or call us on 02 8883 5143.  

References 

Mayo Clinic (2019) Menstrual Cramps Symptoms and Causes

The American College of Obstetricians and Gynaecologists (2012) Dysmenorrhoea: Painful Periods Frequently Asked Questions 

University of Adelaide (2015) Genders experience pain differently, and women have it more. Dr Susan Evans, Gynaecologist, Pain Medicine Physician, Laparoscopic Surgeon, The Conversation 

UNSW (2017) Health Check: are painful periods normal? Dr Rebecca Deans, Paediatric and adolescent gynaecologist at Royal Hospital for Women and Sydney Children’s Hospital, UNSW 

Western Sydney University (2018) I have painful periods, could it be endometriosis? Dr Mike Armour Post-doctoral research fellow, Western Sydney University.