Period Pain

Question 1

What are 4 symptoms of period pain (dysmenorrhoea)?

Answer 1

1. Sharp, intermittent spasms of pain, usually centered in the suprapubic area.
2. Pain may radiate to the back of the legs or the lower back.
3. Systemic symptoms of nausea, vomiting, diarrhea, fatigue, fever, headache or lightheadedness are fairly common.
4. Pain usually develops within hours of the start of menstruation and peaks as the flow becomes heaviest during the first day or two of the cycle.

Question 2

Does period pain (dysmenorrhoea) require a counselling room?

Answer 2

Yes

Question 3

What are 5 red flags for referral with period pain (dysmenorrhoea)?

Answer 3

1. Abnormal uterine bleeding
2. Dyspareunia to pain before during or after sex
3. No cyclic pain
4. Changes in intensity and duration of pain
5. Suggests underlying pathology that could be due to something else (most commonly endometriosis to secondary dysmenorrhea)

Question 4

Does period pain (dysmenorrhoea) have a PSA self-care card?

Answer 4

Yes (Period Problems)

Question 5

What is the preferred treatment option for period pain (dysmenorrhoea)?

Answer 5

Ibuprofen

Question 6

What are the directions for ibuprofen in period pain (dysmenorrhoea)?

Answer 6

Adults > 12 years: Take 2 tablets STAT at onset of pain or menstrual bleeding, then 1 to 2 tablets every 4 to 6 hours as needed to a maximum of 6 tablets in 24 hours.

Question 7

What are 3 non-preferred options for period pain (dysmenorrhoea) and why?

Answer 7

1. Mefenamic Acid 250mg (Ponstan): more expensive
2. Naproxen 275mg (Naprogesic): more expensive
3. Paracetamol: inferior efficacy

Question 8

Is ibuprofen safe in pregnancy?

Answer 8

No

Question 9

Is ibuprofen safe in breastfeeding?

Answer 9

Yes

Question 10

What is the age range for ibuprofen?

Answer 10

Safe in adults and children over 12 years

Question 11

What are 7 pieces of non-pharmacological advice for period pain (dysmenorrhoea)?

Answer 11

1. Massage the lower back and buttocks.
2. Lie flat on your back and put a pillow under your knees or lie on your side and bring your knees to your chest.
3. Place a hot water bottle/heat pack on your stomach or lower back.
4. Rest and warm baths
5. Lifestyle Modifications (Reduce stress, Exercise regularly, Smoking cessation)
6. Diet: vegetarian diet low in fat, dairy products and eggs with increased vegetables, raw seeds, and nuts shown to significantly decrease pain.
7. Keep a diary of symptoms so you can plan for monthly periods.