Painful periods: Causes and how to get rid of the cramps

Dear doctor,

From when I was around 16 years old, I have always had really bad cramps during my periods, and I also get bloated. This can be so bad such that I sometimes even miss work, which can be embarrassing because I don’t want to explain the real issue to my workmates. On two occasions, I have fainted because of the pain. I was told the pain would go away after giving birth. But even after getting a baby three years ago, I still get very painful periods. Is there a way to get rid of the pain once and for all?

Jess

Dear Jess,

Painful periods are referred to as dysmenorrhea. There are two types – primary and secondary. Primary dysmenorrhea occurs due to spasms or contraction of the uterine wall during menstruation and also due to release of some chemicals called prostaglandins and leukotrienes. It starts within the first few years after the beginning of periods, and it affects 45 to 95 per cent of women of reproductive age (15 to 49 years). It usually starts as low abdominal cramping pain shortly before or at the onset of menses and may be accompanied by headache, back ache, fatigue, changes in sleep patterns, diarrhoea or constipation; nausea and/or vomiting; appetite changes, swollen legs, bloating, body aches, breast pain, frequent urination, excessive sweating, mood changes, anxiety and irritability.

Secondary dysmenorrhea, on the other hand, is dysmenorrhea that occurs due to an underlying problem such as fibroids, endometriosis or pelvic disease. It usually starts later in a woman’s life and treatment of the underlying problem will usually get rid of the pain.

Severe dysmenorrhea may be associated with longer, heavier periods, early onset of periods, family history of severe pain during periods, smoking and obesity. Treatment involves medicines to manage the pain and reduce the uterine contractions. Other measures that may help include physical activity, warm compresses and getting enough sleep. If the discomfort is very severe, some contraceptive medications may be used under the guidance of a gynaecologist. Pregnancy and giving birth may affect the severity of the discomfort in later cycles, though this is not always the case.

Dear Doc,

My daughter is three years old and of late she has been choosy about what she eats. She used to eat very well when she was younger. What could be going on?

Maureen

Dear Maureen,

Many young children are picky eaters. They tend to have favourite foods and also refuse to eat certain foods. This is not because the food affects them in any way. By the age of three, children have their own opinions about different things and they want to exert their opinion, by saying, by throwing tantrums, refusing to eat, among others. One of those opinions is based on colour and even texture of food. Unfortunately, these preferences seem to change every few days or weeks. One reason for this is that their growth slows down from how it was in the first 18 months, so they do not need as much food as before.

To manage this, do your best to accommodate their preferences without constantly fighting so that they do not associate feeding time with fighting. At the same time, be creative in how you prepare the different foods and keep offering it in different ways to encourage the toddler to eat. Also create a conducive feeding environment and keep to a schedule. It is also advisable for them to eat at the same time as adults so that they can learn from observation. Avoid giving snacks in between meals because they may fill up the child leading to difficulty eating during meal times.

Dear Doc,

I have been feeling itchy in my vagina for several days after sexual intercourse. Is there a solution for this?

Jemimah

Dear Jemimah,

There are many possible causes of the itching. It may be due to lack of adequate lubrication or too much friction during sexual intercourse. If this is the case, then the itch will disappear after a few days if you avoid sexual intercourse. This can be prevented by use of a personal lubricant.

Persistent itching may be due to vaginal dryness that can occur due to hormonal changes in pregnancy and menopause or as a side effect of hormonal medication.

Other illnesses such as diabetes and the use of perfumed personal hygiene products in or around the vagina can also contribute to vaginal dryness and itching. The itching may also be due to an allergic reaction to condoms or a lubricant. Another possible cause is infection, especially if it is accompanied by a foul smell or an abnormal discharge.

It would be advisable for you to visit a doctor for examination and relevant tests. Treatment is given depending on the underlying cause. If there is an infection, your partner should also be treated to avoid reinfection. If you have inadequate lubrication or are experiencing vaginal dryness for whatever reason, you can use a personal lubricant, and there are hormonal creams to help address vaginal dryness due to menopause.

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