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Being able to establish the cause of menstrual cramps can help you to manage better during this part of your cycle. Today we are going to take a look at what causes period pain and how working with a physiotherapist can provide you with some helpful lifestyle tips to cope better.


Different Types Of Menstrual Cramps And What Causes Period Pain

There are two types of period pain: primary and secondary dysmenorrhea. It is quite common for women of all ages to experience some pain and cramping around their period. The pain tends to be more severe when women are younger and improves with age.


Primary Dysmenorrhoea

Primary dysmenorrhoea is the most common type of period pain and occurs when there is no ostensible problem or underlying cause. It is believed to be caused by higher levels of the hormone prostaglandin, which causes more cramping of the uterine muscles. It is thought that the lining of the uterus accumulates a higher level of prostaglandins, in order to help it expel the old lining of the uterus.

The most common side effect is cramping of the uterine muscles, which may begin a day before the period starts. It may last for up to three days into the cycle.


The Risk Factors For Developing Primary Dysmenorrhoea

There are some risk factors that elevate your chances of developing primary dysmenorrhoea. These include

  • A family history of obesity
  • Periods that started before the age of 11
  • Being a smoker
  • Being a drinker
  • A family history of primary dysmenorrhoea.

One explanation for what causes period pain is that women with heavy periods tend to experience pain more often than women with lighter flow.


Secondary Dysmenorrhoea

Secondary dysmenorrhoea is caused by an underlying issue with the uterus. Some of the conditions that may cause Secondary dysmenorrhoea include

  • Pelvic inflammatory disease
  • Fibroids
  • Endometriosis
  • Adenomyosis
  • Having an intrauterine device 

Some women do not report any other changes to their menstrual cycle but may note the pain is more intense or lasts for longer than usual. Secondary dysmenorrhoea tends to affect women who are younger than 30 years of age. Treatments secondary dysmenorrhoea will address the underlying cause of the pain.

Other side effects of secondary dysmenorrhoea may include spotting or bleeding between periods, irregular periods, or pain during sex.

Women with Secondary dysmenorrhoea may experience the pain between periods as well. These symptoms should be discussed with your doctor.

Secondary Dysmenorrhoea

Tests And Diagnosis

When trying to determine what is causing your Secondary dysmenorrhoea, your doctor may employ the use of different tests



This is an examination of your uterus where a telescopic camera is inserted through your navel.



This is when a camera is inserted to have a look at your uterus


Pelvic ultrasound scan

To look for any abnormalities in your uterus.


What The Pain From Menstrual Cramps Feels Like?

The pain from menstrual cramps is generally concentrated in the lower part of your pelvis. On some occasions it may also be felt in the upper thighs or the back. The pain may be sharp or it may be dull and throbbing.

It may also cause general discomfort and body aches and be accompanied by other symptoms such as

  • Tiredness
  • Headaches
  • Nausea
  • Diarrhoea
  • Faintness
  • Dizziness

Many of the symptoms of menstrual cramps are mild and manageable using home remedies but if they are severe or get worse you should chat to your physiotherapist about alternative management techniques.


Treatments for period pain

Often some gentle lifestyle changes can make coping with period pain that much easier. Speak to your physiotherapist about changes you can make to your lifestyle to improve period pain.


Physiotherapy And Gentle Exercises

Having physiotherapy sessions to discuss yoga or pilates exercises may help you in working through period pain. Physiotherapy can improve your flexibility and circulation and help you ease through the stress of painful periods. Physiotherapy massage will also warm your muscles up and can provide temporary pain relief.


Gentle Sports Massage

Your physiotherapist may recommend heat treatment or gentle massage, particularly if the pain from your period is giving you discomfort in your back or upper thighs. Sometimes a warm bath can also bring welcome relief.



It may be possible to get pain relief with over the counter medication but if you experience pain as a result of Secondary dysmenorrhoea you may need stronger or prescription medication from your doctor.


Rest And Relaxation

While it may not be practically possible to spend a day or two in bed every month it might be possible to work rest and relaxation into your daily schedule so that your daily stressors are managed better. This translates into getting enough sleep every day, not just when you are having a period, eating a balanced and nutritious diet and ensuring your body is well hydrated. Remember that electrolyte imbalances and dehydration are among the leading causes of muscular cramps, and your uterus is a muscle.


Changes To Your Lifestyle

Quitting smoking and drinking will have benefits for your general health and wellbeing but may also be able to improve period pain.


Finding the answer to what causes period pain is a very personal journey, and while it is possible to find background information of the possibilities of what could be causing your discomfort it is important to seek professional help so you can have a personal assessment.

Please contact us for a confidential appointment and professional advice: (02) 9884 9300.

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