GuidelinesShould Periods Hurt? - Causes, Treatments, Medication You Should Know as a...

Should Periods Hurt? – Causes, Treatments, Medication You Should Know as a Nurse

Periods, also known as menstruation, is a natural biological process that most women experience on a monthly basis. However, many women suffer from painful periods, a condition known medically as dysmenorrhea. As a nurse, it’s important to understand the causes of period pain, available treatments, and when a patient should seek medical care.

What Causes Painful Periods?

There are two main types of dysmenorrhea:

Primary Dysmenorrhea

This is the most common type, affecting up to 90% of menstruating women. It occurs in the absence of any underlying medical condition. The pain is caused by contractions of the uterus as it sheds its lining during a period. These contractions are triggered by hormone-like compounds called prostaglandins. Higher levels of prostaglandins cause more intense uterine cramping and pain. Other factors that can worsen primary dysmenorrhea include:

  • Heavy bleeding during periods
  • Genetics and family history
  • Young age – symptoms tend to improve with age
  • Never having given birth

Secondary Dysmenorrhea

This type occurs due to an underlying medical condition such as:

  • Endometriosis – tissue similar to the uterine lining growing outside the uterus
  • Fibroids – noncancerous growths in the uterus
  • Pelvic inflammatory disease (PID) – infection of the female reproductive organs
  • Adenomyosis – tissue lining the uterus grows into the muscular walls
  • Cervical stenosis – narrowing of the cervical opening
  • Uterine polyps or cysts

The medical condition causes additional cramping and pain atop the usual pain associated with periods.

Symptoms of Painful Periods

Symptoms typically begin shortly before or at the start of a period and peak within the first 1-2 days. They tend to lessen in intensity thereafter.Common symptoms include:

  • Cramping pain in the lower abdomen, back, or thighs
  • Dull, constant ache
  • Pain that comes and goes in spasms
  • Pain radiating to the legs or lower back
  • Nausea, vomiting, diarrhea
  • Headache, dizziness
  • Fatigue

The pain can range from mild to severe enough to interfere with daily activities. Secondary dysmenorrhea often causes longer and more intense periods.

Risk Factors for Developing Painful Periods

Factors that increase a woman’s risk of experiencing painful periods include:

  • Being younger than 20 years old
  • Beginning to menstruate before age 12
  • Never having given birth
  • Having a family history of dysmenorrhea
  • Leading a sedentary lifestyle
  • Being overweight or obese
  • Smoking tobacco
  • Consuming excess alcohol
  • Having irregular cycles

Diagnosing Painful Periods

If a patient complains of painful periods, ask her to describe:

  • Type of pain
  • Severity
  • Timing in relation to her cycle
  • Impact on daily living
  • Other associated symptomsNursing Abroad Doctors

This symptom history can help determine if she has primary or secondary dysmenorrhea.Perform a pelvic exam to check for any abnormalities. Run tests to look for potential causes:

  • Pelvic ultrasound – checks the reproductive organs for problems
  • Pregnancy test – rules out an ectopic pregnancy
  • Complete blood count (CBC) – checks for anemia or infection
  • Thyroid tests – thyroid problems can worsen periods

If no underlying cause is found, she likely has primary dysmenorrhea. If a cause is identified, she has secondary dysmenorrhea.

Treatments for Painful Periods

Effective treatments for painful periods include:

Lifestyle Changes

Making healthy lifestyle choices can ease period cramps. Advise patients to:

  • Exercise regularly – releases endorphins to block pain
  • Reduce stress through yoga, meditation
  • Apply a heating pad to the lower abdomen
  • Get enough sleep
  • Maintain healthy body weight
  • Avoid smoking and excess alcohol

Over-the-Counter Medication

Common OTC medications that help treat dysmenorrhea include:

  • Ibuprofen – an NSAID that blocks prostaglandin release
  • Naproxen sodium – another NSAID
  • Acetaminophen – blocks pain signals to the brain

Have her take these meds at the first sign of pain or 1-2 days before her period starts.

Hormonal Birth Control

Birth control pills, patches, rings, or shots can stabilize hormone fluctuations and reduce period pain intensity. The progestin hormone helps thicken the uterine lining so less of it is shed each month. This leads to lighter, shorter periods with less cramping.

Prescription Medication

If OTC meds don’t relieve her pain, prescription options include:

  • Mefenamic acid such as Ponstel – blocks prostaglandin
  • Tranexamic acid such as Lysteda – lessens heavy bleeding
  • Low-dose antidepressants – help regulate pain pathways


This is only used for severe cases unresponsive to other therapies. Surgeries include:

  • Endometrial ablation – destroys the uterine lining
  • Hysterectomy – surgical removal of the uterus

For secondary dysmenorrhea, surgery can treat the underlying condition, such as removing uterine fibroids or endometrial tissue.

When to Seek Medical Care

Advise patients to make an appointment if:

  • Painful periods hinder daily living
  • OTC medications don’t help
  • Period pain worsens over time
  • Periods become heavier or irregular
  • New symptoms arise like fever, vomiting, fainting

Early evaluation and treatment can improve her quality of life and prevent potential complications.


Most women experience some degree of pain during their periods. As a nurse, you can educate patients on the common causes of dysmenorrhea, such as hormonal changes and uterine contractions.

Provide lifestyle measures and OTC medication recommendations for relief. However, refer patients for medical evaluation if symptoms persist or worsen. Proper diagnosis and treatment can help minimize disruption from this monthly occurrence.

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