Effective Period Cramps Relief: A Guide for Sri Lankan Women

Women experiencing period cramps need relief and for the women of Sri Lanka, access to heating pads could make all the difference. Although period cramps are a common problem affecting a large number of women during their reproductive lives at some point or another, most advice given on the topic is unrealistic. For the woman living in Sri Lanka, there is little chance of finding time to practice a 45 minute yoga session twice a day as well as scraping together money for expensive US dollar-priced medication and herbs on a local salary. In this guide we explain why you might be experiencing menstrual pain, look at some practical solutions that actually work in Sri Lanka as well as some of the medical options available and how certain types of period wear can also help alleviate discomfort. Understanding Period Cramps: Why They Happen The cramps! Period cramps or dysmenorrhea occur when the uterus contracts in order to release its lining from the previous month in preparation for a woman’s menstrual period. The hormone-like substances called prostaglandins are produced by the lining of the uterus and cause the contractions to become stronger and more painful. The prostaglandins then enter the bloodstream, which is why women can experience nausea, diarrhea, headaches, fever, or feelings of being unwell in addition to the pain in the pelvic area. Dysmenorrhea can be classified into two main clinical types. Identification of the type of dysmenorrhea and its appropriate treatment, as well as awareness of the need to seek medical advice are important for all women with dysmenorrhea. Primary dysmenorrhea is defined as pain during menstruation in the absence of other pathology. Typically symptoms begin one to two days premenstrually and last for two to three days into the menstrual period. Symptoms often begin in adolescence; however, women of all ages may have severe symptoms. Paradoxically, symptoms can improve with time and return to pre-pregnancy intensity after childbirth. Pain is prostaglandin mediated and therefore easily managed with NSAIDs and heat. Secondary or secondary excessive dysmenorrhea results from a variety of underlying causes. The most common causes include endometriosis, fibroids (uterine leiomyomas), adenomyosis, and pelvic inflammatory disease. Unlike primary dysmenorrhea, secondary dysmenorrhea tends to worsen with time, starts earlier in the menstrual cycle, and can be longer lasting. Secondary dysmenorrhea requires a medical diagnosis and appropriate management for the underlying cause. The pain relief medications used to treat primary dysmenorrhea are not adequate to treat secondary dysmenorrhea. If your cramps are getting worse over the years, start early in your cycle, or last longer, if you have pain during sex, or if you experience changes in your bleeding pattern, then you should consider secondary dysmenorrhea and discuss your symptoms with a gynaecologist. Natural Home Remedies for Period Cramps Relief For many women with primary dysmenorrhea there are established home care options that could be helpful. These evidence-based home care measures are readily applicable at home in many Sri Lankan settings. However, for women with severe dysmenorrhea, further treatment may be required to alleviate their chronic symptoms. Heat is a tried and tested non-medicine treatment for cramps. Gently warming your lower tummy with moderate heat can help the uterine muscles relax and increase blood supply to the uterus, reducing the frequency and severity of contractions. Heat can be provided by a hot water bottle covered in your clothing, a reusable heat patch or a warm, damp washcloth applied for 15-20 minutes at a time several times a day. Soaking in a warm bath can also help. Relaxation helps to reduce muscle tension and anxiety which can make pain worse. Heat is most effective if used early. It’s hard not to just sit there when you’re feeling sore and in pain, but there is a wealth of evidence which supports the use of gentle movement to alleviate menstrual cramps. Activities as simple as some light stretching, yoga or a brisk walk can increase circulation and release endorphins which are the body’s natural pain relief. There are a number of yoga postures that can help relieve menstrual discomfort, including gentle stretching of the lower back and releasing tension in the pelvic floor. Some yoga postures to try include Child’s Pose, Reclined Bound Angle Pose and gentle Supine Spinal Twists. While some people may want to do more vigorous exercise to alleviate menstrual pain, there is no need to and most women don’t feel like moving on the first day or two of their period. As long as you’re drinking plenty of fluid and eating nutritious food, it really is a case of doing what you enjoy, at a slow and gentle pace. Diet and hydration are too often left to the wayside as simple yet powerful management options. Find out how an anti-inflammatory diet can help reduce pain related to prostaglandins in the long run by incorporating these options into your daily life. Eating foods high in omega-3 fatty acids such as fish, walnuts, flaxseed may help to fight inflammation. In addition to taking magnesium supplements, incorporating magnesium-rich foods into your diet is also beneficial. Dark leafy greens, legumes, nuts and seeds are some of the best magnesium-rich foods. Always consult with your healthcare provider before increasing your intake of any food or supplement. It’s often talked about in terms of pregnancy but reducing your salt intake in the days leading up to your period may help to reduce water retention and subsequently alleviate symptoms of bloating. Drinking plenty of fluids helps to beat bloating and also ensures that muscles are functioning normally. It is best to avoid consumption of caffeine and alcohol prior to going to sleep, as these can serve to worsen the symptoms of muscle cramps and prevent adequate sleep. Ginger tea is a common remedy used to alleviate period pain in many Sri Lankan households. There is some evidence to suggest that ginger works by reducing inflammation and reducing prostaglandins. It is said to have a similar pain relieving effect to over the counter pain-relieving medications and is best taken in the first few days of menstruation. Coriander seed tea and fenugreek tea are also commonly consumed by women suffering with menstrual pain in Sri Lanka. Whilst these may be familiar remedies for women in this population and provide comfort, there is limited evidence to support their use in comparison to ginger and heat therapy. Medical Interventions for Severe Period Cramps Even if you are trying natural remedies for itchy skin and finding them insufficient, there are always appropriate and effective medical treatments that can be prescribed. Over the counter medications, in particular non-steroidal anti-inflammatory drugs (NSAIDs) are the most commonly recommended treatment for primary dysmenorrhea. All the major associations of gynaecologists world over recommend NSAIDs as the first line of treatment for dysmenorrhea. Ibuprofen and mefenamic acid are the most commonly used NSAIDs used in Sri Lanka and are available in all pharmacies. These medications work by inhibiting the production of prostaglandins that cause pain. These medications are most effective when taken at the onset of symptoms. Taking NSAIDs at a late stage of severe pain does not help. The most effective dosing schedule is from the day before menstruation starts on a daily basis until the end of the 2nd or 3rd day of bleeding. Take these medications with food, liquid, a full glass of milk, or an antacid (if liquid) to lessen stomach irritation. Follow exactly as directed on the label. Most women know when they need to see a doctor and if they are suffering from severe period pain, they should seek an investigation for underlying medical conditions. While it is true that many women experience pain during menstruation, significant, disabling pain is a clinical sign that requires investigation. You should see a gynaecologist if: These symptoms are severe enough to interfere with daily activities such as work and school. Over-the-counter pain relief provides no meaningful improvement Pain that worsens over time rather than remaining constant. Cramps begin significantly before your period arrives You experience pain during sexual intercourse Heavy bleeding or large blood clots passing. You have any other pelvic symptoms between periods Your gynaecologist can look for signs of endometriosis, fibroids or adenomyosis. These are common conditions in women that are significantly underdiagnosed. Severe period pain is often thought of as ‘normal’ in Sri Lanka, leading women to feel that they must put up with excessive pain. Early diagnosis is important so that women are not misled into suffering long-term damage from these conditions that can be easily treated if recognised early. Comfortable period wear is designed to help ease the pains of menstruation, and there are loads of styles out there to choose from. A common cramp treatment that is often overlooked is how a woman’s period clothing can affect her. The comfort level she feels in her clothing can in turn affect how she perceives her pain and in turn how she manages it. Secondary discomfort caused by current menstrual management methods stem mainly from the pad itself and the underwear worn with it. The friction created between the pad and thigh and the pull of regular underwear against a sensitive lower abdomen causes discomfort. Heat from synthetic fabrics of both the underwear and pad creates further discomfort. And always present is the fear of leakage which can add stress and create tension. Although none of these factors cause discomfort directly related to cramps, they do contribute to overall discomfort and can increase on the heaviest and most painful days of the month. Period panties and period shorts combine absorption with the garment itself, meaning you don’t need to wear extra pads that can cause so much aggravation and discomfort. Well-made period underwear will feel gentle against your skin and won’t chafe or bulge. The waistband will sit comfortably around your waist without being too tight, even when your lower abdomen is at its most sensitive. The confidence that comes from knowing your period underwear is doing the job it’s meant to do, brings yet another relief from stress and tension. With the rapid climate change prevalent in Sri Lanka, many garments are designed with breathable, natural or moisture wicking fabrics to keep us comfortable. In contrast, most imported period wear are suited to colder climates. While some local brands offer more suitable designs and fabrics for period wear within Sri Lanka, we should particularly pay attention to the choice of fabric for our innerwear. Fabrics that draw heat away from skin and have a breathable outer fabric are much more suited to our hot and humid climate than many imported designs. At Period.lk we have a few local brands like Fabpad, Healthfab, Mahina and Nushy Care who offer breathable fabrics that are gentle to skin. When you have cramps and are not feeling well, the fabric you choose can make a big difference in how your day is going to be. The choice of period wear fabric is not just about style and appearance but can make you feel miserable or more comfortable. Holistic Wellness Approaches for Menstrual Health Treatments for relieving menstrual cramps often revolve around temporary relief; in the form of pain relievers, warm baths, and massages to ease immediate discomfort. However, certain lifestyle habits can be introduced on a monthly basis, or incorporated into your daily routine year round, to decrease the severity of cramps in the long run. Stress relief is key in managing menstrual pain. Stress can affect hormones and elevate cortisol levels in the body, and over time, create hormonal imbalances that can affect a woman’s monthly cycle. Many women report feeling more stressed before their period, which can cause more severe cramps. Managing stress in the moment can help to alleviate period cramps, but incorporating stress-reducing activities into your daily routine can also have long-term positive effects on your body’s hormonal balance. Activities such as mindfulness meditation, yoga, breathing, or sitting in a quiet space for 30 minutes a day can also reduce menstrual cramps. Sleep quality can affect menstrual pain (Migneault 2012) – and also be affected by it. When a woman is in pain, it can make her more sensitive to other pain, making what is usually manageable cramps seem unbearable. Yet, cramps can also keep a woman awake at night. To manage menstrual pain better, incorporating healthy sleep habits into daily routine can increase pain tolerance. Going to bed and waking up at the same time every day, sleeping in a cool, dark space, and not being on screens or devices before bed can help a woman get the quality sleep that she needs. Furthermore, wearing comfortable period wear to bed can prevent further discomfort that can be caused by irritation and worry of leakage. Managing irregular pain on a long-term basis can be really challenging, but there are lots of approaches you can try. An anti-inflammatory diet, moderate exercise (try to do this on the non-period days) and having a good knowledge of your cycle can all be helpful. There’s some fantastic cycle tracking technology out there that allows you to prepare for your period with heat, diet, NSAIBs or other approaches before pain has built up. However, whilst these approaches can help reduce the frequency and severity of your pain, it is vital that your primary approach is that which your specialist has prescribed to treat the underlying condition. Where can I find products that provide relief from Period Cramps for Sri Lankan Women? At Period.lk you can find a range of comfortable period care products. We stock a wide variety of Indian brands of period underwear from Healthfab, Mahina, Fabpad, Nushu Care and Carmesi. These brands were chosen as they use great material, have good absorbency and stylish designs. Check out our advice on choosing your period products based on your flow and lifestyle. We also deliver all over the island for women outside of Colombo who may not find these products in retail outlets around Colombo. For immediate pain relief products that contain ingredients like ibuprofen and mefenamic acid can be purchased over the counter at pharmacies across the country without a prescription. Heat patches and reusable hot water bottles can be found to be sold at pharmacies and other household goods stores in many towns. Many herbal teas contain ginger for relieving pain and these can be found at supermarkets and other grocery stores. period.lk is also a good starting point for products related to menstruation that are focused on comfort. You can browse products, read their descriptions, and see images of the products without having to try them out first. Key Takeaways Menstrual pain could be relieved by a number of treatments and techniques such as using heat, pain relieving medications like NSAIDs, dietary modifications and combinations of methods. In most cases, the type of pain experienced by a woman is primary dysmenorrhea for which treatments can be carried out through home remedies and over-the-counter medications and in most cases a medical evaluation is not necessary. Secondary dysmenorrhea can be due to a multitude of reasons and most require medical evaluation and treatment for underlying causes like endometriosis, fibroids and other surgical causes of abdominal pain. Methods such as application of heat, consuming ginger tea, intake of anti-inflammatory foods and practice of moderate exercises are widely used practices in Sri Lankan households to manage menstrual pain and comfortable period wear helps to reduce secondary sources of discomfort such as discomfort caused by friction, heat, constriction and leakage anxiety which may or may not be related to pain experienced by women during menstruation. However in a tropical country like Sri Lanka comfort period wear could go a long way in managing discomfort caused by menstrual cramps. Long-term pain relief can be gained by continuing these practices and incorporating them in to women’s day-to-day life and lifestyle through dietary, physical activity, stress management and sleep strategies. For most women with primary dysmenorrhea NSAIDs are a safe and effective treatment. It appears that NSAIDs are most effective when used before pain has reached its most severe stage. If a woman finds that her disability and pain intensity has increased over time or has any of the warning signs for secondary dysmenorrhaea she should seek gynaecological assessment and not delay in seeking the advice of her gynaecologist. Frequently Asked Questions There is no known limit for which a person can take ibuprofen for relief of symptoms of headaches, fever, and minor aches and pains. Typically, no problems are anticipated as long as large doses are not taken for extended periods of time. For most women with primary dysmenorrhea taking ibuprofen or mefenamic acid for 2 to 3 days each month during menstruation is safe. These medications are considered safe for long-term use by experts and are recommended by the major gynaecological guidelines for the treatment of dysmenorrhea. Patients with a history of stomach ulcers or other medical conditions such as kidney disease or who take other medications should discuss their use of NSAIDs with their doctor to ensure safe use. A woman who takes NSAIDs on a regular basis for her dysmenorrhea who continues to experience severe symptoms should also be evaluated by a healthcare professional to rule out other causes of symptoms. Period cramps affect every woman but some are worse than others. I’ve suffered terrible nights when even taking double doses of pain-relievers hasn’t worked. Variation exists among women in the severity of muscle cramping. The severity of muscle cramping between women can be affected by several factors, including the level of prostaglandins, the shape of the uterus, hormonal levels, stress, and sleep as well as by underlying medical conditions such as endometriosis. Some women have occasional moderate muscle cramping that does not interfere with their daily activities, while others have severe pain that interferes with her daily activities. Both scenarios are real and valid. Women with persistent severe cramping or a change in cramping, should be evaluated by her physician. It is very difficult to compare comfort during cramps of period underwear and regular pads or tampon applicators because period underwear is meant to be worn as replacement of regular pads and also in different ways. While some ladies have reported comfort while wearing Yoni Washable Panties during their time, they say that comfort hits a new high when they pair their period underwear with other products meant to soothe cramps. Most disposable pads are uncomfortable in one way or another: they have to be worn with separate undergarments and can move around, bunch up or cause irritating rubbing on the thighs. In contrast, Period underwear is designed with soft absorbency and a snug fit to cause NO FRCTION at all! The gentler waistline of period pants means there is less discomfort in an area that is already sensitive on your lower abdomen. And did you know that breathable period underwear is also cooler than products with plastic back sheets for girls in Sri Lanka? Home remedy question: What cures everything around here? Of the many folk remedies that are used in South Asia to treat pain of the woman’s illness (dhat in Hindi), pain relief with ginger tea has the best evidence. It is thought to work by preventing the synthesis of prostaglandins. Ginger is safe in tea form in normal dietary amounts. Warm compression and immersion in a warm bath or shower are also used widely in South Asia and have good evidence. Fenugreek and coriander are also used to treat pain of the woman’s illness in South Asia, but there is limited evidence. These foods are unlikely to cause harm at normal eating amounts, but should not be relied upon as the only means of pain relief for period pain. Please consult with your doctor before taking any herbal remedy if you have any medical conditions or are on any medication. Here’s where you can find them in Sri Lanka (it’s a tiny market still, so I’m listing anywhere I can find them You can find a variety of period underwear at Period.lk from established Indian brands such as Healthfab, Mahina, Fabpad, Nushu Care and Carmesi. All our products are delivered island wide and have great fabric quality and comfort. Please see the details of our products and select the one that fits your type of flow and lifestyle. Severe pain around the navel and presence of other symptoms such as fever, unusual sickness or feeling unwell may be symptoms of appendicitis. If these symptoms are present it is recommended to call a doctor. Same Symptoms? These symptoms same as endometriosis, fibroids and adenomyosis? If you have these symptoms, but they don't let you get on with your life, get worse over months or years, over the counter pain medication not sufficient to control your pain, pain during sex, abnormal bleeding or other symptoms that don't seem right for you, you may have endometriosis, fibroids or adenomyosis.