Back when she was still in university, Grace Chew, 28, will miss a day of class every other month whenever her menstrual period arrived. “The pain from my period cramps was so unbearable that sometimes even taking Panadol didn’t help. And I will get so tired,” recalls Chew. She goes on to say that there were even several occasions when her classmates would enquire worriedly about her pale complexion.
Menstruation — also known as dysmenorrhea — occurs every 21 to 35 days in a woman. There will be blood discharge which lasts about two to seven days, depending on the individual and it’s often preceded by symptoms of physical or emotional discomfort.
Known as premenstrual syndrome (or PMS), some common symptoms include, breast tenderness, stomach cramps, water retention, bloating, lethargy, insomnia, acne outbreaks and irritability.
SmartParents expert and consultant Ob-Gyn, Dr Christopher Chong, notes that up to 40 per cent of menstruating women feel some form of PMS. Some might experience symptoms too mild to take note of. Adds Dr Chong, “Often similar each month, [these symptoms] resolve spontaneously with the start of menses.”
If the severity of your PMS symptoms is affecting your normal daily activities, you may be the three to eight per cent of women who experience premenstrual dysmorphic disorder.
If the severity of your PMS symptoms is affecting your normal daily activities, you may be the three to eight per cent of women who experience premenstrual dysphoric disorder. This condition is debilitating and can result in severe depression, so it’s best to seek medical help.
Perhaps, the one good thing about PMS is that it serves as a “warning sign” for women (and everyone around them!) to brace themselves for “that time of the month”. Chew shares, “For me it was a pimple outbreak. That’s when I know it was going to happen and also when I needed to put on extra makeup.” Her husband would also receive signals in the form of a moody and irritable wife.
Other than pregnancy, where you don’t get your period at all, Dr Chong points out that prolonged breastfeeding and hormonal therapy — like contraceptive pills — are effective at preventing PMS. Some studies also show that adding more calcium to your diet can help relieve mild symptoms like headaches, mood swings, and muscle cramps.
SmartParents speaks with Dr Cynthia Kew, Ob-Gyn at Mount Elizabeth Novena Hospital who shares expert tips on how to cope with these annoying, and sometimes debilitating, symptoms.
“For me it was a pimple outbreak. That’s when I know it was going to happen and also when I needed to put on extra makeup.”
1) Over-the-counter Prescription-free Pain Medication
SUCH AS Paracetamol and Ibuprofen, sold at local pharmacies and supermarkets.
WHY Ibuprofen is a form of non-steroidal anti-inflammatory drug, which works to reduce the levels of hormones that stimulate inflammation and pain in the body. Dr Kew says, “Taking them according to the recommended dosage for short durations every month — no more than two to three consecutive days every month is likely to be safe.” On the other hand, high doses of Ibuprofen over long periods of time puts you at greater risk of stroke, heart attacks and reduced fertility. If you suffer from severe heart problems, stomach ulcers and severe liver disease, avoid Ibuprofen.
2) Dietary and Herbal Supplements
SUCH AS Fenugreek seeds, ginger, herbs like valerian and zataria, zinc sulphate, and Vitamin B1.
WHY Dr Kew notes that studies done on these supplements have shown some effectiveness in relieving pain. Ginger works to soothe inflammation, stomach discomfort and nausea, another tell-tale sign that your menses is on its way. Not a fan of ginger? Fenugreek tea should also do the trick.
3) Applying Heat
SUCH AS Heat-pads or hot water bottles to help ease and manage the cramps.
WHY Much like how you’ll apply heat-emitting muscle rubs to soothe sore arm and leg muscles after a good workout, the heat from hot water bottles helps to relax cramped stomach muscles. Dr Kew says some small-scale studies have shown this method to be helpful in reducing PMS-related pains.
4) Meds that control your hormone levels
SUCH AS Birth control pills, implants and certain types of Intrauterine Devices (IUD). They release hormones that supress ovulation and on certain months prevent your period altogether.
WHY The hormones in the meds decrease both the volume of menstrual fluids and secretion of prostaglandin – a chemical that causes menstrual cramps.
A diet with a good amount of dietary fibre is associated with less menstrual pain.
5) Omega-3 fatty acids
SUCH AS Fish Oils.
WHY Fish oils can reduce inflammation in the body and lower the production of prostaglandin, points out Dr Kew.
6) Relaxation Exercises
SUCH AS Meditation, yoga and deep-breathing techniques.
WHY Doing these exercises help you take your mind off the pain and other symptoms. Anything that can help you relax is exactly what you need when PMS strikes! Dr Kew adds, “In the event that your cramps are hampering your movement, you should avoid [yoga].”
7) Changes to your diet
SUCH AS A diet that’s rich in fish, eggs and fruit, dairy and dietary fibre.
WHY Dr Kew notes that some research has suggested a diet low in fish, eggs and fruit can aggravate menses. Another study found that dairy products can help reduce the incidence of menses. Japanese women are also known to battle menstrual pain less often and this could be due to their fibre-rich diet.
Think you know all there is to know about your “monthly friend”? Bet you didn’t know there are two types of period pain…
*Primary dysmenorrhea: Defined as cramping in the lower abdomen area occurring just before or during your menses. This is in the absence of other diseases, such as endometriosis and is commonly experienced during the teenage years or when you’re in your early 20s. It will likely continue until your 40s or 50s, until menopause sets in.
*Secondary dysmenorrhea: Defined as abnormal period pains caused by a disorder in a woman’s reproductive organs, such as endometriosis, uterine fibroids, or infection. The pain usually begins earlier in the menstrual cycle and lasts longer than normal cycles. Speak to your doctor if you’re feeling any of the following:
*Extreme intense pain that cannot be relieved by painkillers, affecting your ability to carry out normal activities. Sometimes this pain can occur outside of your menstrual cycle. You many also feel pain when moving your bowls, peeing or during sex.
*Duration of pain is longer than usual. Often occurring before your period starts and continues even after your period has ended.
*Heavy, prolonged menses and irregular cycles. Your cycle goes on for longer than the usual seven days and you are going through several heavily-soaked pads a day. Sometimes, you may even miss a period every few months, but aren’t pregnant.
*Difficulty conceiving, feeling bloated and discovering a pelvic mass. Cysts, fibroids, polyps and tumours are examples of pelvic masses that usually grow on the ovary or pelvis. They can sometimes be cancerous, so look out for symptoms such as pelvic discomfort, nausea, vaginal bleeding and abrupt weight loss.
Dr Christopher Chong is a consultant obstetrician gynaecologist at Gleneagles Hospital.
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