Pain Management Guidelines

Menstrual pain refers to abdominal pain which precedes or occurs during a woman’s menstrual period. It is sometimes referred to as menstrual cramps and usually occurs anytime from just after ovulation to the end of menstruation. Menstrual pain is mostly located in the region of the lower abdomen either centrally (suprapubic or umbilical) or on the sides and may radiate to the thighs or lower back. The pain, however, tends to subside as the menstrual flow gradually comes to an end.

In the early part of the menstrual cycle a woman’s body gradually prepares itself for hosting a pregnancy by causing a thickening of the inner lining of the womb. After ovulation, if conception does not occur, this built-up inner lining of the womb is shed and removed from the body through menstruation. During this process the broken-down tissue of the inner lining release several chemical compounds, including prostaglandins, which cause the muscular wall of the womb to contract and this contraction helps to expel the shed tissue from the womb through the vagina in form of menstrual flow. However, this contraction also tends to constrict the blood vessels of the womb, hence reducing the oxygen supply to the womb, and this results in the cramp-like pain felt during menstruation. This process happens in every woman who menstruates, hence many women usually experience some degree of pain during their menstrual periods and this is not necessarily abnormal. The good news is that menstrual pain tends to reduce with increasing age and also with increasing number of children, i.e. the older you get and the more children you have, the less the menstrual pain becomes. However, when menstrual pain becomes excessive and incapacitating, or interferes with a woman’s daily activities, then it becomes abnormal and is medically referred to as dysmenorrhea. Other symptoms which could be associated with dysmenorrhea include nausea, vomiting, change in bowel habit (diarrhea or constipation), headache, dizziness, disorientation, fainting, fatigue, and hypersensitivity to sound, light, smell and touch.

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