Periods are a pain

Few women get away with no-pain periods, but there are now effective ways to minimise discomfort, explains Barbara Lantin

Painful periods were once thought to be entirely psychological. Because doctors could find no physical abnormality in patients, they assumed that the cause was all in the mind. Fortunately, we now know better.

There are two kinds of period pain or dysmenorrhoea: spasmodic and congestive. Their symptoms vary, but both are believed to be caused by hormone imbalances. The classic cramps in the lower abdomen are spasmodic dysmenorrhoea. The pain - in some cases as intense as labour pain - starts on the first day of the period and comes in waves about 20 minutes apart, each lasting around five minutes. It may be accompanied by sickness, headache and diarrhoea. By the third or fourth day, it has usually subsided.

During a period, chemicals in the body reduce the blood supply to the muscles of the womb in order to dislodge the lining. 'It seems that spasmodic dysmenorrhoea is caused by there being insufficient oestrogen for maturing and stretching the muscles of the womb,' says Dr Katharina Dalton, a pioneer in the treatment of pre-menstrual syndrome.

'During pregnancy there is an abundance of oestrogen for a full nine months and the muscle wall of the womb is stretched by the foetus. As a result, this type of period pain usually ends after pregnancy.'

Sufferers from congestive dysmenorrhoea experience a continuous, nagging pain in the lower abdomen and back which may start a week or more before the period, increase in severity on the first day of menstruation and then gradually ease. This kind of period pain does not disappear with pregnancy and may actually get worse. Stress can also exacerbate it. It may recur until periods cease with the menopause.