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Ask the Expert: What Causes Painful Periods?

If you don’t prefer to say the phrases “painful periods,” you possibly can simply say “dysmenorrhea”— it’s going to sound higher, maybe, however you will nonetheless be uncomfortable. So let’s speak about what’s inflicting the ache and how one can make it higher.

Let’s first talk about the distinction between main dysmenorrhea and secondary dysmenorrhea. Primary dysmenorrhea is form of your backyard selection menstrual cramps, attributable to chemical substances that the uterus makes that result in cramping. Secondary dysmenorrhea is attributable to abnormalities of the pelvic organs, which result in cramps.

So let’s dig deeper into main dysmenorrhea. The nasty chemical substances that trigger the cramps are prostaglandins, they usually’re made by the uterus across the time of our durations. Remember that the uterus is a muscle, and these prostaglandins trigger that muscle to contract. They can also trigger the sleek muscular tissues of our gastrointestinal tract to contract, so some ladies expertise nausea and diarrhea. Prostaglandins may trigger fever and achiness, though these signs are a bit much less widespread.

And importantly, we are likely to make extra prostaglandins throughout menstrual cycles during which we ovulate.

How will we assist main dysmenorrhea? We can take drugs that block the manufacturing of extra prostaglandins — and in case you’re somebody with common cycles, you possibly can even begin taking these medicines (referred to as “prostaglandin synthetase inhibitors”) the day earlier than your interval begins. Once the prostaglandins are there, they do their nasty work, so take these meds early!

And the place do you get these medicines? At your nook grocery store or pharmacy: They could have fancy names, however they embrace ibuprofen and naproxen, and even aspirin. And, perhaps you seen that I mentioned you make extra of those nasty chemical substances once you ovulate — so how do you not ovulate?

You can take a mixed hormonal contraceptive (contraception) that works by blocking ovulation, and you can too take ibuprofen with it. And don’t fear about disrupting your physique’s prostaglandin manufacturing: Next cycle, that uterus will nonetheless produce loads of prostaglandins.

Of course, common train may be very useful, too, as is consuming a nutritious diet. But if all this stuff don’t appear to be serving to sufficient, verify in together with your gynecological care supplier as a result of this might imply you’ve got secondary dysmenorrhea. Problems like endometriosis and fibroids may trigger cramping, and your supplier will work with you to analyze whether or not these points might be contributing — after which determine how you can assist.

Dr. Mary Jane Minkin is medical professor within the Department of Obstetrics, Gynecology, and Reproductive Sciences on the Yale University School of Medicine; host of the podcast “menopause:unumted”; and has been in non-public apply for greater than 35 years. She’s on a mission to destigmatize ladies’s well being points, particularly menopause.

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