Help with your pain

Endometriosis is much more than just brown/black spots in the pelvis that can be seen at a laparoscopy. There are many different problems that women with endometriosis suffer.

Some women will have painful periods, but be otherwise completely well. Others have a more complicated picture that can include:
- an irritable bowel (IBS)
- sharp, stabbing or burning pains
- an irritable bladder
- painful intercourse
- bad headaches or migraines
- fatigue and exhaustion
- pain moving around or sitting for a long time
- trouble sleeping

Not surprisingly, women with these problems feel worn down and miserable.

Because these problems cover several different areas of medicine, women often feel lost 'between the cracks' of healthcare. Each health practitioner they see cares for a small part of the whole picture, with variable success.

Surgery is helpful for some aspects of the pain, but can leave many women disappointed.

I hope that you will find this blog useful for your pain. Each week there will be a new topic covered, and your comments are welcome.


With best wishes,

Dr Susan Evans, Gynecologist and Laparoscopic surgeon

Tuesday, November 3, 2009

Is my period pain normal?

Women only know what their own period feels like. They can't compare it with their friend's period pain. Sometimes they wonder if their periods are really normal and they are just weak in some way. It's a dreadful feeling to wonder if 'its all in your head'.

Normal period pain should only last 1-2 days, and it should go away almost completely on the oral contraceptive pill and period pain medications like ibuprofen or naprosyn taken early before the pain is bad.
If your period pain lasts longer than this, or if these medications dont help you, then it is not normal period pain.
An ultrasound scan is usually normal in most women with endometriosis.


  1. I used to have severe period pain each month. I excluded dairy products from my diet for other reasons and was completely surprised to find that with my next period there was no pain. That was seven years ago and I've been dairy free and pain free ever since.

  2. Dear Judith, Its lovely to hear from you. Your situation sounds a little unusual, but its great that you have found something that stops your pain. I am sure that its a bit more trouble making sure that you have enough calcium and protein in your diet to replace the dairy products, but worth it if it works for you.
    Some women find that cutting down on lactose helps their irritable bowel symtoms too.
    Best wishes,

    1. I also have much less pain if I don't eat dairy. I know others that have reduced their pain by stopping dairy. I am not a vegan, vegetarian but heard it might make a difference. I am glad I tried it. I wonder if it only seems unusual because not many women have actually gone totally dairy free for more then a few days at a time.

  3. I have had the same experience as Judith with regards to dairy products - when I avoid them (which I have done for years at a time periodically, and for various reasons) my period pain is absolutely minimal. When I take dairy again, the pain is pretty excruciating, waking me throughout the night, only relieved by ibuprofen+codeine.

    I have read that dairy contains arachidonic acid which raises levels of prostaglandins which cause the uterus to contract and also play a role in inflammatory responses. Might this be a mechanism as to how dairy could exacerbate period pain?

    You say that Judith's situation sounds unusual, but I am wondering how many good-quality studies have been conducted to investigate a link between dairy or other foods and period pain? Such studies are notoriously difficult to do reliably are they not?

    Furthermore, according to the Harvard Nutrition website, in their summary on the subject of calcium for health and the best sources of it, although it is conventional advice, it is far from proven that milk is the best way to consume calcium in order to prevent osteoporosis, or even that consuming more calcium can even reduce fracture risk.

    My sketchy understanding is that some foods create a measurable acidic effect in our bodies which requires calcium and other base ions to be used to neutralise this in our urine - this means that if we eat more of those acidic foods, we may need to consume even more calcium in the first place in order to "break even" - and one of those foods which cause us to excrete more calcium is actually dairy!

    Since green vegetables, for example, are also relatively high in calcium but are alkaline (so should according to this theory lessen the amount of calcium we need to excrete) this may explain why a study of the bone density of vegans reported the surprising result that their bone density was perfectly normal, despite consuming less calcium than most of the population.

    I am not a medical doctor, although I have a PhD and work in the field of medical technology - I'd be very interested indeed to know your thoughts on all of these issues, and if you know of any studies which corroborate or contradict the things I've mentioned.

    Best Wishes,


  4. Dear Abi,

    There are two things in dairy products that could be making the difference for you

    1. The fat in milk.
    Eating different types of fats, certainly change the types and quantities of prostaglandins formed in our bodies, including the uterus. So, its logical that cutting down on animal fats, including milk fat could help period pain in some women. Its also a healthy eating habit for other medical conditions.
    Adding in different types of 'good' fat might also make a difference. Women with arthritis often have less pain if they take 10-15ml of liquid fish oil every day, probably by changing the type of prostaglandins their body makes. For some women, I expect it could also help period pain.
    The difficult thing is that the many different chemicals made in the uterus at period time are quite complex and variable. It seems like a new one gets discovered every year! This means that something that works for one person might not work for someone else and can take a lot of frustrating time and effort to work out what helps and what doesn't.
    One day, we will be able to do blood tests to tell women what type of diet and which medications will work for each individual woman to take the guesswork out of it.

    2. The 'sugar' in milk (lactose).
    Lactose can aggravate bladder pain in a few women (but not many) with a painful bladder. It can also aggravate bowel pain in some women with a sensitive bowel. Both of these pains can feel like period pain.

    I'm glad you have found something that helps.


  5. I've also had a similar experience - I completely cut out dairy from my diet about 10 months ago, and was surprised to find that my period pains have virtually stopped.

    For approximately 20 years I had been in severe pain every single month, with ibuprofen the only thing that helped, and even then I often had breakthrough pain. If I didn't take the tablets in time the pain would be unbearable.

    Since cutting out the dairy I have hardly any pain, and I haven't taken a single tablet of ibuprofen. It's been a really dramatic change, and I wonder how many other women could benefit from trying this?

  6. I'm only 20 yrs old, since I was 12 and started my monthly I have had enormous pain everytime! This pain I found unusual but everybody was telling me that ill have some type a pain from time to time. Like I said now being 20 I'm not convenience this pain is normal. the day, the very fist day I have my period each month I start to feel it I know I'm on it. Then an hour will pass and the pain will rise too an extream level. Lets just say on a scale of 1-10 its a HIGH 10 and it last for an exact 4 hrs long each time, this pain hurts so bad I'm force to cry. I usually need
    hot heat but heating pads don't work I have to go to extremes like putting a blow dryer to my lower stomach area, wear 40 items of clothing at once and ext ... I can't deal with. It anymore sometimes the pains so bad I'd rather be dead then to go through it! But I'm not a crazy so don't worry ill never do that .. but please someone tell me, is this type of pain natural?!

  7. my periods are always painful an stressful. when i go to the bathroom there's always clad blood coming out from my private an it hurts really bad. i don't take any meds cause it don't work at times. i had sex like 5times an it was really painful.. my nights are stressed cause i don't sleep... what do i do?

  8. Hi. I have extreme pain. I am sick and faint. It goes on for 3 - 4 days. It stops me from working. The only way i can stop it is by sleeping. I have tried everything. Tablets dont work. Hot water bottles dont work. Nothing seems to work. I have been to my doctors nurmous times and all they tell me is to take tablets. They say they cant do anything more for me. I dont know what to do anymore. Please help.

  9. I too had terrible period pain which was much better when I reduced my milk intake. I had a mild case of endometriosis which was discovered through an ultrasound scan. I was told to get on the pill, or have a baby, neither of which I could do because I'm too young to get married and was not keen on the pill, because I heard taking the pill effectively tampers with your body's natural cycle and may never come right again. I'm a very pro natural person so I tried natural remedies which I would like to share:

    The biggest pain reliever for me has been walking regularly, a lot of exercise, particularly exercises that work the muscles near the area. I drink hot water, very hot not just lukewarm. My breakfast is ussualy a porridge with a generous amount of ginger. Also I take a whole bulb of steamed garlic every night after dinner and tat has helped. It sucks but that's the best so far and most importantly I feel good.

  10. I also have crippling pain around the start of my period, but my cramps start as early as ovulation and continue on through my period. I've tried birth control pills, a variety of diet plans (lactose-free, gluten-free, nut-free, soy-free, sugar-free, name it, I've tried it), supplements, herbal teas, various painkillers. Nothing works. I eat healthy (I cook all my own foods from scratch) and exercise (run 5-6 times a week) and am well within a healthy weight range for my height. I'm nearly 30.

    I visited with several doctors about this in the past but stopped when nobody helped. However, I'm concerned that the pain seems to be getting worse over time (becoming more severe at ovulation and lasting after my period is over; period pain severe enough to make me throw up and nearly black out; pain that radiates through my entire body , etc.).

    I am wondering if it's normal for period pain to escalate over time--or if I really need to try again to find some help for this. And how do I find a doctor that specializes in this? Is there some kind of database or website that has information? Looking them up one-by-one has not been very productive. Even other doctors don't seem to know who, if anyone, truly specializes in this area.

  11. My peroid lasts for 3-4 days and is very very painful and once I have puked I can't swallow pill. My peroid dosen't come on the same date every month. I'm only twelve ( I got my peroid when I was 11) and am not sure what to do

  12. Most times my periods are extremely painful, like over the top painful (I want to die, please God help me through this pain, why can't I just die now?!) that type of pain. Some months I'm lucky and the pain is way less severe and I'm very grateful for that. Today was not one of those less severe days. It started at 6 in the morning and there was very slight cramping. I didn't think anything of it. Suddenly I realized I had the ACT today and I was worried. I didn't want to throw up in front of everyone and I didn't want to cause a scene but I had to go because the ACT is very important and I'm not going to let my period get in the way of that. I went and started the first part of the test, nothing serious but I noticed the cramps were getting a little more intense. Second part, they were much worse. I couldn't hardly concentrate and was rushing through it. Third part, I felt the need to throw up, the cramps were so bad I felt like I was going to faint, and I had to use the bathroom. And the last part before the writing section, I was so sick to my stomach. I was getting lightheaded, extremely dizzy, I had to throw up right then and there. I asked if I could use the bathroom and immediately threw up when I got there. My cramps intensified even more and I just laid on the floor crying and wishing the pain would go away. An hour later it did after I fell asleep on the floor. Nothing works for this pain, not even pain killers. They cause me to throw up. But I just think, this is all for having a child. It's worth it in the end...

  13. I had period pain for more than 15 years, very bad pain, can't sleep, can't sit, like in hell.

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  14. Many women are concerned they’re pregnant if they have cramps or spot at the end of a period or cramping a week afterward. This is a very,rare occurrence. spotting and cramping after period after your period could be your body simply readjusting out of your cycle.