Primary Dysmenorrhea: When Your Period Pain Can Be Life-Altering

Primary dysmenorrhea is your menstrual cycle playing the role of the villain in the film of your life, losing a full day dipping in and out of consciousness in overwhelming pain.

It is living your dreams studying in a foreign country and having an ‘episode’ of pain and having to be carried into a taxi home by your concerned friend.

Primary dysmenorrhea is worrying about new job opportunities or the chance of moving away because what happens if halfway through your exciting first day, you are doubled over in front of your new boss.

Primary dysmenorrhea is just knowing when an episode is about to start. You get cold sweats, your face flushes, your vision blurs, and you can’t hear properly. It is the nausea looming over you like a tsunami, and the need to leave the situation you’re in as soon as possible before the pain hits.

Primary dysmenorrhea is being investigated for inflammatory bowel disease, endometriosis, and cysts before the age of 20. Primary dysmenorrhea is having tests on all these conditions come back negative.

I am 23 years old and it has taken me over 10 years to be diagnosed with primary dysmenorrhea.

Painful periods, which are common in varying degrees, are known as dysmenorrhea, and they range from mild discomfort and nausea to painful cramps manageable with over-the-counter medication.

However, for those at the worst end of the spectrum, it is likened to a heart attack and sufferers can lose days of their life to it in bed.

When my episodes (as I like to call them) began when I was 13, the doctors waved it away as something that ‘every girl goes through’. When I was screaming in pain and blacking out every month, I was told to go on the contraceptive pill and get on with it.

As a young teenager, I frequently lost days to the pain, and had to navigate a system where I could try and get some semblance of daily life whilst on my periods (this included a string of different medications, hot water bottles and all windows open as I overheated).

Currently, I am on a course of medicine with a gynaecologist who understands my history and checks in regularly on how I’m doing. Now that I am so much better, I feel so frustrated that I lost so many days of my young life to excruciating pain. This lack of action by healthcare professionals has led to many with a uterus spending years searching for answers – years which could have been spent accessing medical help and alleviating their symptoms.

For sufferers of conditions like endometriosis, this delay in healthcare can be dangerous, with tales of people being rushed to A&E with cysts that are ready to burst, after telling their doctor continuously that they’re unwell.

The clinical process of exclusion to determine the cause of dysmenorrhea includes reviewing the patient’s medical history, which includes going over their symptoms and menstrual cycles, and then a pelvic exam. Doctors may also do an ultrasound or in some cases, a laparoscopy, which is a type of surgery that lets them look inside the pelvic region.

When it is concluded that the severe symptoms are not caused by other illnesses (known as secondary dysmenorrhea) and is instead down to the patient’s anatomy, then a diagnosis of primary dysmenorrhea is given.

Dr. Devika Chopra, a gynecologist and obstetrician at Hope Clinic in Tardeo, Mumbai, says: “Primary dysmenorrhea is the term used when the pain affects the quality of life of the patient. Normal period pain and cramps are every woman experience but she can go about her normal routine. If a woman’s normal routine is hampered and a pelvic cause for her period pain is excluded – she is termed to be suffering from primary dysmenorrhea.”

Dr Chopra urges the importance of ruling out conditions such as endometriosis, fibroids and cysts when a patient first presents with period related pain.

Professor Dharani Hapangama, researcher at Wellbeing of Women and Professor of Gynaecology and Consultant Gynaecological Surgeon at the University of Liverpool, discusses some of the ways primary dysmenorrhea can be treated, such as “pain management pathways developed by pain specialists and self-help pain management strategies”.

Professor Hapangama continues that:“Eating a healthy balanced diet and better exercise and stress reduction and trying to adapt to a healthy lifestyle will help.”

Other treatments can be anti-inflammatory medicine, contraceptive pills, and anti-spasmodic drugs. Treatments like depo-provera and the coil can be helpful, as they can completely stop periods from occurring, therefore stopping the monthly pain and symptoms affected by it.

It is only when healthcare begins to take note of the vastly different experiences of people with a uterus, that many sufferers across the world can begin to have their conditions taken seriously. We need better funding, better research, and better action plans when people first present with period related pain. As a society, we cannot have young teenagers going to the doctors in excruciating pain and not being taken seriously until we’re in our twenties. We need to do better for the generations that come after us, and make sure the pain we went through is not for nothing.

Words by Caitlin McDonald


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