Learn about the 3 causes of period pain and what you can do about them.
Period pain affects up to 91% of women in the UK at some point in their lives and for 1 in 10 women, it interferes with their daily lives. While period pain is common, it’s not normal and should be investigated.
What is Period Pain?
The medical term for period pain is primary dysmenorrhea. This is the term for painful periods caused by uterine contractions rather than other underlying conditions such as endometriosis.
When Do Women Typically Experience Period Pain?
Painful periods impact nearly all women at some stage in their lives. Typically period pains are worse in puberty and again during perimenopause due to the hormonal fluctuations and a tendency towards higher estrogen and lower progesterone at these times.
On average, period pain can last 1-2 days, usually starting the day before or first day of bleeding. For others, it can last their entire period.
The experience of painful periods can be very mild and experienced as small twinges, but can also be debilitating pain that impacts the normal functioning of daily life. In some cases, period pain can be accompanied by nausea, vomiting, bowel changes, headaches and dizziness or fainting.
Period pain can have a great impact on work and school performance. One study found that more than 80% of women said they had continued to work or study while feeling unwell with period pain, and were less productive as a result.
Let’s look at the 3 causes of period pain next.
3 Causes of Period Pain
1. Hormone Imbalances
A. Low progesterone
A common cause of period pain is low progesterone.
Progesterone is one of your most important sex hormones alongside estrogen. It is anti-inflammatory and when we have adequate levels of progesterone in the luteal phase (second half) of our cycles it can affect the regulation and synthesis of prostaglandins. To put this simply, progesterone can reduce prostaglandin levels in the body, which as we’ll see below is another driver of period pains.
Having adequate progesterone levels will also lessen other PMS symptoms such as mood changes, poor sleep and heavy periods too. That’s because progesterone keeps its sister hormone estrogen in check: while estrogen thickens the uterine lining, progesterone thins it; while estrogen stimulates the brain, progesterone calms the brain and so on. So having an adequate balance of these two hormones in the luteal phase (the second half of your cycle) is key.
It’s important to note that progesterone is only made after ovulation, so without ovulation you can’t make progesterone.
You can test progesterone in our Advanced Hormone Test which comes with a personalised plan to address your symptoms. We recommend testing progesterone 5-7 days after ovulation as this is when levels peak.
Signs and symptoms of low progesterone
Signs you may have low progesterone include:
- Heavy or painful periods
- Anxiety
- Spotting in between periods
- Irregular periods
- Poor sleep
- Bad PMS
B. High or unopposed estrogen
A second common hormone imbalance is high or unopposed estrogen. High estrogen levels can increase both prostaglandins and histamine. Estrogen also thickens the lining of the womb, meaning there is more to shed during our period.
It’s also vitally important also to understand your estrogen detoxification: once our estrogen has been used it needs to be removed safely and efficiently from the body via the liver, kidneys and gut. If we struggle with any phase of estrogen detoxification, they we are more likely to get symptoms associated with high estrogen such as period pains, even when estrogen levels are normal.
Read more about estrogen detoxification.
You can test both estrogen and estrogen metabolism in our Advanced Hormone Test. It’s important to note that a typical hormone blood test is not able to detect hormone metabolism. This is why we test in urine.
Signs of high or unopposed estrogen
Some common signs of high, unopposed estrogen or poor estrogen metabolism include:
- Period pain
- PMS
- Tender breasts
- Weight gain
- Mood swings
- Histamine symptoms
- Heavy periods
2. High histamine
Histamine is a chemical that is released in the body, also as part of the immune response. High histamine is a common cause of painful periods, as well as heavier periods and hormone imbalance too.
Signs of high histamine
As well as suffering from period pain, you may also suffer from symptoms such as:
- Itchy eyes
- Nausea
- Skin rashes
- Irritability
- Anxiety
- Food sensitivities
- Loose stools
Possible causes of high histamine
It is important to figure out the root cause of high histamine – there can be many. Possible causes include:
- High histamine intake in the diet
- Excess estrogen (which proliferates histamine)
- A genetic tendency to have poor clearance of histamine from the body (such as a SNP on the DAO or HNMT genes).
Once we know where the problem lies for you, we can target this with supplementation and nutrition in your personalised healthplan that accompanies the Advanced Hormone Test.
Learn more about the connection between histamine and hormones.
3. High Prostaglandins
The most common cause of primary dysmenorrhea is a chemical in the body called a prostaglandin.
Prostaglandins are hormone-like chemicals released in all tissues of the body. When released from the tissues, they cause muscles of the uterus and blood vessels to contract – this muscle contraction and inflammation caused by the prostaglandins is what causes period pain.
We actually need prostaglandins. This is because they are a natural part of our immune system and play important roles in both stimulating our periods and promoting ovulation.
Prostaglandins are released 3 times around ovulation. First to help with follicular maturation, second to help with the rupture of the follicle and egg release and third to help the formation of the corpus luteum. So they are are very important for our hormone health.
The problem lies in high levels of prostaglandins.
Signs of high prostaglandins
One of the signs of high prostaglandins is getting loose stool before and during your period! This is because prostaglandins cause other muscle contractions too, including inside your intestines.
If high prostaglandins are an issue for you, you are more likely to have high markers for inflammation and oxidative stress: we test for both of these in our Advanced Hormone Test.
3 Key Takeaways for Period Pains
- The main causes of period pain are low progesterone, high or unopposed estrogen, poor estrogen metabolism, high prostaglandins and high histamine.
- Testing is key to understand the root drivers of your period pain: every woman is different. We recommend the Advanced Hormone Test. This test looks at not only reproductive hormones like estrogen and progesterone, but also estrogen metabolism, inflammation markers and more.
- Working with an experienced practitioner can help you identify strategies to eliminate period pain – all our tests come with. a personalised plan to address the root drivers of your symptoms. These include recommendations for supplement, diet and lifestyle changes.
References
Barcikowska, Z., Rajkowska-Labon, E., Grzybowska, M. E., Hansdorfer-Korzon, R., & Zorena, K. (2020). Inflammatory Markers in Dysmenorrhea and Therapeutic Options. International journal of environmental research and public health, 17(4), 1191. https://doi.org/10.3390/ijerph17041191
Ferries-Rowe, E., Corey, E., & Archer, J. S. (2020). Primary Dysmenorrhea: Diagnosis and Therapy. Obstetrics and gynecology, 136(5), 1047–1058. https://doi.org/10.1097/AOG.0000000000004096
Sadeghi, N., Paknezhad, F., Rashidi Nooshabadi, M., Kavianpour, M., Jafari Rad, S., & Khadem Haghighian, H. (2018). Vitamin E and fish oil, separately or in combination, on treatment of primary dysmenorrhea: a double-blind, randomized clinical trial. Gynecological endocrinology : the official journal of the International Society of Gynecological Endocrinology, 34(9), 804–808. https://doi.org/10.1080/09513590.2018.1450377
