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The Global Library of Women’s Medicine
Enhancing the Welfare of Women
Expert Health Information for Women
Painful periods and heavy menstrual bleeding
Women and girls can have pain and heavy bleeding during their monthly periods. This is a very common problem which can be treated.
The pain usually comes from the uterus (womb) tightening and squeezing, often because of chemicals the body produces called prostaglandins.
Most pain can be treated with simple painkillers (such as paracetamol and ibuprofen) and heat pads.
A normal period should last no more than 8 days and come roughly every month. Some women may feel sick, tired or tearful but, again, this should not be severe.
If you are unable to go to school or work because of your periods, or you have bleeding after sex or in between periods
you should see a doctor who may offer an internal examination and tests to check whether other problems are causing the pain or heavy bleeding.
Your healthcare worker may check the neck of the womb (cervix) with a plastic tube, called a speculum, or feel the womb with an internal examination through the vagina.
The examination should not be painful and you should always give consent before an examination happens. Sometimes an examination is recommended, but sometimes it is not needed.
Other tests may include blood tests, urine tests, swabs and scans, which can be done internally or externally.
Causes of heavy bleeding can include growths in the womb muscle or in the lining of the womb, or womb-lining cells growing in the wrong place.
If tests show that your blood count is low, iron tablets can be used to treat anemia and increase your blood count.
Different forms of contraception which contain hormones, such as the pill, implant, injections and hormone coil are often used.
They can reduce pain and lessen bleeding but may take a few months to work.
For some women, an operation may be needed
Sometimes operations can be used to look inside your womb or abdomen to diagnose and treat the problem or to remove growths.
As women get older, in severe cases, the womb can be removed if needed.
Remember, you do not need to suffer with heavy bleeding or pain during your period.
There are many treatment options that you can discuss with your healthcare worker.
The authors of this PAINFUL PERIODS AND HEAVY MENSTRUAL BLEEDING programme are:
- Dr Winnie Mwebia
Obstetrician Gynecologist/Assistant Principal Clinical Research Scientist, KEMRI Centre for Global Health Research, Kenya - Dr Dorcus Muchiri
Consultant Obstetrician Gynaecologist/Reproductive Medicine Specialist/Women's Health Researcher and Educator, The George Institute for Global Health, Imperial College London NHS Hospitals Trust, London, UK; and Bonita Centre for Women's Health, Nairobi, Kenya
The Welfare of Women programme has been created under the General Editorship of Dr Kate Lightly, University of Liverpool, UK and is overseen by an expert International Editorial Board