Period Pain & Lifestyle

Understanding the causes and drivers behind cramping

What is period pain: primary and secondary dysmenorrhea

Period pain, medically known as dysmenorrhea, can be divided into two different subtypes: primary and secondary.

Primary period pain is pain that has existed since the onset of our periods and comes during our period. The pain is attributed to an increase in inflammatory markers called prostaglandins. These prostaglandins are behind the contractions of our uterus to help expel our uterine lining. This can lead to the commonly experienced symptoms: abdominal cramping, abdominal pain, weakness, digestive upset, back pain, or pain in the back of the leg.

Secondary dysmenorrhea is when the cause of this period pain is actually due to an underlying pelvic condition. This might be due to fibroids, endometriosis, an infection or an abnormal pregnancy. It is important to work with health care providers if you suspect your period pain is beyond normal, and to be worked up for any of these causes.

What can I do for my primary period pain?

If your period pain isn’t due to a secondary cause, there are a few strategies to help manage the pain.

Adequate vitamin D levels

Vitamin D is an important hormone involved in a variety of processes in our body. Vitamin D plays an important role in our immune system functioning and inflammatory processes. Studies have shown that supplementation with vitamin D can support the reduction of symptoms of period pain. Vitamin D is a hormone that can be tested in the blood and supplemented accordingly!

Always work with a practitioner when supplementing - especially fat soluble vitamins.

Reduce smoking and alcohol consumption

Smoking and alcohol consumption can both cause an increase and worsening of menstrual cramps. Alcohol does this by increasing prostaglandins - those inflammatory compounds that contribute to the contractions of the uterus.

Smoking worsens period cramps by worsening vasoconstriction throughout the body. Reduced blood flow or, ischemia, at the level of the uterus can lead to increased pain during our period.

Reducing our alcohol consumption and smoking are also generally health promoting changes that would be good to consider in any case!

Add in some movement!

Historically, exercise was thought to help decrease pain by pumping blood out of the uterus. Although we now know that’s not the case, there are recent studies showing benefits of exercise for menstrual pain. ⁠

This is likely from a combination of reducing stress, pain perception and prostaglandin levels. Exercise can help reduce symptoms but also support mental health and quality of life.⁠

Now, the hard part is getting up and going when you are already in pain. Short duration with moderate intensity - even a brisk walk! - seems to be helpful for some women.

What if it’s something more?

If your period pain has been established to be due to secondary concerns, or you suspect it might be - there are still options for you. Working with a great team of professionals ensures that you have access to the testing, medication and supplementation that can support how you feel!

Fiona Callender