Are you one of the 85% of women who experience aches and pains associated with your menstrual cycle? Period pain happens when the muscles in the uterus contract or tighten, and is also known as dysmenorrhea.
There is a huge variety in the severity of period pain. For some it is just a bit of an ache throughout the day; whereas for others it interferes with their daily living, and may stop them from going to school or work. It can move around - from the back, to the stomach, legs and hips; and can also affect your bladder and bowels. If it is this debilitating I always recommend speaking to your medical professional to make sure you are receiving the best care possible.
Many people are not aware that physiotherapists can help relieve period pain! Pelvic Health Physiotherapists have specialised knowledge in the pelvic region - anywhere from the waist down to between your legs. As well as helping period pain, they can assist in differential diagnosis (endo, adenomyosis), concurrent symptoms (painful sex or bowel movements) and link you in with specialists.
What are my top tips for period pain management as a physiotherapist?
Our body's first response to pain is to tense up and protect itself. The more severe the pain, the more we tense up! This can mean that during period pains the surrounding tissues, such as the hips or pelvic floor become tight as well. This tension can contribute to your pain experience. Gentle stretching exercises will promote blood flow and feel good hormones in the body.
My favourite stretches are
- Pigeon stretch
- Puppy stretch
- Child’s pose with wide knees
- Figure 4 glute stretch
2. Focus on your breath and do body scans to regularly check in.
As I mentioned above, we know that it is instinctive to tense your body when you are in pain and trying to protect yourself. When you tense your stomach you are also changing the way you breathe.
Belly breathing is the style of breath that promotes relaxation in the body. In this style of breathing all your muscles are relaxed, except for your diaphragm, which pumps up and down. This pumping action has science behind it - it actually stimulates the vagus nerve which promotes the “rest and digest” nervous system in our body.
To learn how to belly breathe I get my patients to lie on their back with pillows, as relaxed as possible. Place one hand on your chest, and another on your stomach. INHALE through the nose for a count of 4-5, allowing the stomach to passively rise (the diaphragm is descending). The hand on the chest should not move at all. EXHALE slowly through the mouth for a count of 4-5, as if you are fogging up a mirror, letting the stomach lower. Do this slowly for 5 - 10 minutes.
I do not expect this to be easy because it is a skill! Skills take time and practice to learn. I like to tell my patients to do regular body scans to check in with their breath - Are you breathing deep into your belly, or shallow into your chest? Set a reminder to do a few times throughout the day.
3. Use heat therapy such as The Spoonie Society heat packs
I haven’t met a patient who hasn’t thought that heat therapy wasn’t amazing for period pain - think heat packs or hot baths. There is evidence to suggest that heat therapy can significantly reduce period pain, so considering heat packs and baths are cost-effective and readily available - why not!
My favourite is the wrap around heat pack which you can wear, hands free.
4. Use a TENS machine
A tens machine is a device that transmits an electrical current and can be used for pain relief. The electrical impulses can reduce the pain signals going to the spinal cord and brain, which may help relieve pain and relax muscles. They may also stimulate the production of endorphins, which are the body's natural painkillers.
TENS machines are affordable, and can eliminate the need for medication. These days they are small enough to wear around discretely underneath your clothes too. They’re definitely worth trying before considering heavier pain relief options.
5. See a women’s health physiotherapist to assess and treat you individually!
Given the close proximity of your bladder, bowels, uterus, hips, lower back and vulva it is likely that concurrent issues are also going on. Seeking help from a physiotherapist will help address all your different symptoms for maximal benefits.