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Getting help with managing period pain and symptoms
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  • Getting help with managing period pain and symptoms

If you concerned about your periods you can seek further help:

Talk to a school nurse or counsellor (if still at school)
Talk to a parent or carer
Look for free youth health services in your area to talk to a nurse or doctor
Make an appointment to see your GP
Access a period pain, endometriosis and pelvic pain clinic that is near you (you can refer yourself)

https://www.health.gov.au/our-work/endometriosis-and-pelvic-pain-clinics?language=en

Before seeking help:

Screenshot your period impact score (PIPPA) to take to your appointment
Print or download the 'Note for your doctor' to help your conversation with the doctor/nurse
Print or download the 'Managing period pain and symptoms with your doctor' to help you and your doctor consider actions that can be taken. It can also help you prepare for your visit with the doctor and what might be discussed.
Start tracking your pain and symptoms to help you explain symptoms (and their frequency/intensity) to the doctor or nurse. You can use a period tracker or printable guide
PIPPA Website - 4

When should you see a doctor?

You should see a doctor about your period pain and symptoms if you have:

taken the Period ImPact and Pain Assessment (PIPPA) and got a score of four or five
tried self-managing your pain and symptoms and it has not worked
concerns about your periods that you wish to discuss

To help you talk to your doctor download the ‘Managing period pain and symptoms with your doctor’ PDF. You should take it to your appointment as a checklist for things to talk about with them.

Red flags for endometriosis

Endometriosis is a disease where the tissue that is similar to the lining of the womb grows outside it, usually in the pelvis. It can be very painful and could affect your fertility.

These are symptoms that might indicate that you have endometriosis. Many of them are also symptoms for other health conditions.

They do not mean that you definitely have endometriosis, only that your doctor should be aware if you have some of these symptoms and see if first line treatments may help.

moderate to severe period pain
mid-cycle/ovulation pain
pain starting before period
sharp bowel pain before or when opening your bowels with a bowel movement (dyschezia)
premenstrual spotting not related to taking the pill or hormone therapy
bladder pain (worse with full bladder)
painful sexual intercourse (dyspareunia) (Note that lots of conditions can cause painful sex)
sharp rectal pain (‘knife like’, shoots upwards)
pain relief e.g. Nurofen or Panadol is ineffective
school or work absence or difficulty completing schoolwork due to period or pelvic pain
family history of endometriosis
multiple PMS/menstrual symptoms.

Things to review with your doctor

You should talk with your doctor about:

any painkillers you are taking and what helps manage pain
other methods you have tried to relieve your symptoms (e.g. exercise, healthy eating, hot packs, relaxation, deep breathing)
any hormone therapy that you are taking (e.g. contraceptive pill, contraceptive implant, Mirena intra-uterine device).

If you are not taking any hormonal contraception, you can talk to your doctor about whether this might help you.

Further investigations to consider

There are a number of other tests your doctor can do to see what might be causing problems. You should talk to your doctor about these and if they think any will help to understand your condition. These tests include:

a routine pelvic ultrasound scan to check for obvious pelvic conditions
advanced gynaecology ultrasound scan for endometriosis
sexual health screen if you are sexually active
blood tests to check for anemia (low iron), bleeding issues and polycystic ovarian syndrome (PCOS).

Other concerns to address

The symptoms of endometriosis can also be caused by other conditions. It is important to check if
there are other conditions that may be causing your symptoms so that you can get the right treatment.

Other conditions that you should talk to your doctor about include:

problems with your pelvic floor such as tight pelvic muscles or muscle spasm (difficulty inserting tampons, menstrual cups or with penetrative sex)
excessively heavy bleeding with periods
sexually transmitted infections (STIs)
inflamed vagina and vulva (vulvovaginitis)
anxiety, depression or other psychological disorders
gut problems such as flora imbalance or food intolerances
urological conditions such as urinary tract infections or painful bladder syndrome.

Some of these conditions may need treatment from a variety of different health professionals. This might include psychologists, dietitians and specialist pelvic pain physiotherapists.

It worked

Your pain and symptoms are adequately managed. Continue your current actions in consultation with your doctor.

It didn’t work

More help is needed to manage your pain and symptoms. Talk with your doctor about whether a referral to a specialised period pain, pelvic pain and endometriosis service is appropriate.