Period pain caused by a health condition (secondary dysmenorrhoea)

Secondary dysmenorrhoea means period pain caused by something other than just your period being very painful. If your periods have always been painful, you may have primary dysmenorrhoea.

    Secondary dysmenorrhoea symptoms
  • Periods start to get more painful as you get older
  • Periods suddenly start being painful
  • Pain develops where there was none or only minor pain before
  • Period pain might be accompanied by suddenly heavier or irregular periods
  • Pain could be during the first or second periods of a girl’s life, indicating a blockage of some kind
  • A pelvic examination may find something unusual
  • Usually oral contraceptives and non-steroidal anti-inflammatory drugs (NSAIDs) don’t help these types of pain
  • Infertility, painful sex (dyspareunia) and vaginal discharge may be present
  • This form of period pain is most likely to be diagnosed between the ages of 30 and 45
  • Increased prostaglandins may play a role in secondary dysmenorrhoea too, but there must be another condition going on at the same time for it to be classified thus
     Secondary dysmenorrhoea may be caused by:
     Understanding and diagnosing this type of period pain

There is no one specific test for period pain, except to rule out any underlying conditions as per symptoms. Your practitioner may take blood tests, do scans, and other tests to exclude a more serious health condition causing secondary dysmenorrhoea. Figuring out what level of pain you are suffering is important to providing treatments, so your practitioner will need to know the exact nature of your pain.

Treating period pain from a known health condition/cause

The reason for your period pain varies, so finding the underlying cause is going to be key to finding the solutions that best help you relieve the pain.

About prostaglandins

Prostaglandins are little chemical messengers that cause inflammation on purpose. They are heavily implicated in period pain, and pain from inflammatory causes. Blocking prostaglandins is therefore a useful way to help relieve pain, using a few different methods.

     Painkillers that block prostaglandins

Many women deal with period pain using anti-inflammatory painkillers (drugs), but secondary dysmenorrhoea requires treatment of the underlying condition for best effect (though this isn’t always immediately available). The most effective drugs include NSAIDs like ibuprofen and aspirin, but trying a variety is likely to reveal the best drug for you.

     Birth control pills – interrupts hormones

The oral contraceptive pill is most often used medically to block period pain from many causes, as it rearranges the hormonal signals, blocking problematic hormone cascades and ultimately prostaglandins. The pill is not an option if you are wanting to get pregnant so speak to your doctor and/or naturopath about your options.

     Fish oils + vitamin B12 blocks prostaglandins

Fish oils block the action of prostaglandins. A thousand milligrams of fish oil every day for one cycle was found to be more effective than ibuprofen in managing period pain in this study1. This should be taken every day. The more severe the period pain, the higher the dose of fish oil should be. High quality fish oil is much, much better, and cost tends to reflect quality processing and product. Look up a company’s processing methods and avoid chemical extraction methods.

  • Omega-3 fatty acids (high dose fish oil, 2.5g per day with total EPA of about 1,000mg and DHA 700mg – this is high, therapeutic doses, check label for EPA and DHA quantities)
  • Vitamin B12 combined with fish oil works even better (7.5mcg per day).
     Self-massage your uterus (from the outside!) 

Massage your uterus firmly while lying down to help reduce any spasms/cramping by improving blood supply – and oxygen – to your uterus. Depending on the cause of your period pain, this may be a useful strategy, but check with your doctor.

     Herbs – uterine tonics to relax the uterus, pain relievers, prostaglandin-blockers, hormone normalisers (see list below)

Having the right herbs and supplements for your body and underlying health condition is important. Uterine tonics may support the uterus; relaxing, pain-relieving or prostaglandin-blocking herbs can reduce pain; and hormone-regulating herbs may balance out hormones. How you take each herb will depend on the reason and the herb. If you have an underlying health condition, get help from a trained herbalist when using herbs, as you need to ensure safety.

   Uterine tonic herbs
  • Aletris farinosa
  • Caulophyllum thalictroides
  • Angelica sinensis
  • Rubus idaeus
  • Combine generally with Vitex agnus-castus or Paeonia lactiflora as indicated
     Hormone-regulating herbs
  • Vitex agnus-castus
  • Paeonia lactiflora
  • Paeonia suffruticosa
  • Actaea racemosa
  • Verbena officinalis
Antispasmodic herbs (for crampy pain, vomiting, diarrhoea)
  • Viburnum opulus
  • Viburnum prunifolium
  • Caulophyllum thalictroides
  • Dioscorea villosa
  • Ligusticum wallichii
  • Paeonia lactiflora
  • Glycyrrhiza glabra
Warming herbs (works well mixed with anti-spasmodics)
  • Zingiber officinale
  • Cinnamomum zeylenicum
Relaxing herbs
  • Valeriana officinalis
  • Piscidia erythrina
  • Corydalis ambigua
  • Verbena officinalis
  • Matricaria recutita
  • Paeonia lactiflora
     Pain-relieving herbs
  • Corydalis ambigua
  • Piscidia erythrina
  • Lactuca vrisa
  • Anemone pulsatilla
  • Zingiber officinale
  • Tanacetum parthenium
  • Curcuma longa
      Other things you can do to naturally reduce your period pain
  • Acupuncture
  • Reflexology
  • Relaxation techniques for pain perception
  • Aromatherapy
  • Heat packs/hot water bottles