We spoke to Dr Bheena Vyshali, Consultant Gynaecologist at Columbia Asia Hospital Petaling Jaya to clear the air around menstruation. Read on to find out all you need to know about menstrual pain.
GetDoc: Why does menstrual pain occur?
Dr Bheena: Painful menstruation is called dysmenorrhea. There are two types of dysmenorrhea which is primary and secondary.Primary dysmenorrhea occurs in women who experience pain before and during menstruation since early menarche .Women who have had normal periods that become painful later in life may have secondary dysmenorrhea. In primary dysmenorrhea, prostaglandin is a chemical that forms in the lining of the womb during menstruation.This causes the muscles of the womb to contract and cramp during menstruation leading to pain. Several medical conditions can also cause cramps such as endometriosis, uterine fibroids and adenomyosis which is the main cause for seconday dysmenorrhea.
GetDoc: Why is it that some women experience more pain than others?
Dr Bheena: It is not known why contractions of the womb muscle is more painful in some while not in others.It is most like related to the production of too much prostaglandin or a increased sensitivity to them.
GetDoc: Can some medication be taken to alleviate the menstrual pain?
Dr Bheena: Non steroidal anti-inflamatory medication such as mefenamic acid and ibuprofen can be used.They work as anti- prostaglandins to reduce cramping and relieve discomfort. Hormonal treatment such as birth control pills and patches can be prescribed by your doctor as well.This thins out the lining of the uterus which lessens the blood flow and cramping.
GetDoc: What about food habits – does food play a role in worsening the pain/other symptoms such as feeling bloated, headache. What must be eaten, what must be avoided during menstruation?
Dr Bheena: Anything that increases inflammation in your body can worsen the cramps and symptoms.Try reducing sugar, dairy products, alcohol, caffeine and salt. Eat plenty of whole grains, vegetables, legumes and fruits.
GetDoc: How long will the menstrual pain last, does it start from PMS?
Dr Bheena: Menstrual cramps are not the same as PMS. Symptoms of PMS can occur from ovulation but gets a lot better when a woman's period starts.On the other hand with dysmenorrhea, pain usually worsens during the first few days of a woman's period.
GetDoc: In some cultures earlier on women, they were asked to stay away from certain chores indirectly giving them rest during this time. Is rest much needed during menstruation?
Dr Bheena: As odd as it may sound, exercise is one way to relieve menstrual cramps.It helps your muscles to relax and releases feel-good endorphins from your brains. Take rest as well as indulge in some exercise. You can also take a leisurely and relaxing 30 minute walk but remember to get plenty of sleep at night as well.
GetDoc: On the same note, some countries in Asia such as Taiwan, have something called a Menstrual Leave. Do you think it must be implemented all over the world?
Dr Bheena: This is debatable. Some may consider menses an excuse for anything while some legally enshrine it as a right for women. In this day and age when we are moving towards gender equality then introducing leave policy may spread the notion that women are weak.
We hope this article answered at least few of your queries about menstrual pain. Do you need further advice? Make an appointment with your doctor using GetDoc, whether you are in Singapore or Malaysia.
by Hridya Anand
A biochemist by education who could never put what she studied to good use, finally found GetDoc as a medium to do what she loved - bring information to people using a forum that is dedicated to all things medical. View all articles by Hridya Anand.