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Why are my periods so painful?

Dr Freeman Osonuga



Most women have their regular monthly flow without any pain or difficulty but in some this physiologic process has been associated with pain, sadness and tears.
Painful menstruation also known as dysmenorrhea is a common complaint among women of reproductive age with about 45 to 95 percent of women in this category experiencing painful menstruation at one point or the other.
So, what is painful menstruation? What causes it? And how can it be managed? This post aims to answer some of these pertinent questions. Painful menstruation are cramps in the lower abdomen or supra pubic region which starts with the onset of menstrual blood flow and usually last for up to 3 days. Painful menstruation can be mild but can also be very severe to the extent that it interferes with normal daily activities in some women.


There are basically of two types of Painful menstruation:

The primary and secondary dysmenorrhea. Primary dysmenorrhea is more common than secondary dysmenorrhea.

Primary dysmenorrhea usually seen in females aged 15 to 25 years, is the type of painful menstruation that is commonly experienced by virgins. These painful periods start from just few months after commencement of the monthly menstrual flow to few years after. This type of painful menstruation is found in menstrual cycle within which ovulation occurs (ovulatory cycles).
The pain is intermittent and spasmodic in nature and is attributed to prostaglandin activity (prostaglandins are hormone-like substances in the body that participate in a wide range of body functions) leading to uterine myometrial hypercontractility (excessive contractions of the muscles of the womb). Sometimes, there is associated nausea, vomiting, diarrhoea and headache.
Painful menstruation is likely to occur more frequently in females whose menstrual flow occurs for more than 5 days, those who smoke cigarette, and ladies who started menstruation at a relatively younger age. Primary dysmenorrhea usually improves after childbirth and also with increasing age.
Drugs that prevent the formation or action of prostaglandins have been found to be helpful in relieving the pain. Oral contraception has also been found to be useful due to prevention of ovulation.
However, Secondary dysmenorrhea is not as common as primary dysmenorrhea. Secondary dysmenorrhea is seen in older women. Typically, the pain starts about 5 days before menstruation and is relieved after 4 to 5 days of the menstrual flow. Importantly, secondary dysmenorrhea is usually associated with an underlying medical problem and treatment is aimed at the gynecological disorder.
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Dr Freeman Osonuga is a multi-award winning Humanitarian, Social Enterprise Consultant, International Public Speaker and Medical Professional. An Associate Fellow of the Royal Commonwealth Society, a One Young World Ambassador, a WIRED 2015 Innovation Fellow, 2014 TIME Magazine Person of the Year and One of the 2013 Ten Outstanding Young Persons in Nigeria. He is also a recipient of Meritorious Service Award from President Bai Ernest Koroma of Sierra Leone and One of the Fabulous and Inspiring People of Colour of the Year 2015. Dr Freeman advocates for health care services to be fully accessible and affordable by all. He can be reached on the following social media platforms. Instagram: freemanosonuga, Twitter: @freeman_osonuga, Facebook: Freeman Osonuga, Website: