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A Hidden Cause of Period Pain


Everyone has grown up listening to the rhetoric that painful periods are normal and this is just part of womanhood. This narrative has become so ingrained that women experience excruciating pain every month believing that is it normal and inevitable.


The recommended treatment is typically pain management in the form of non-steroidal anti-inflammatory drugs (NSAIDs) such as ibuprofen. These are often recommended without little regard of what long term use of NSAIDs do to the integrity of gut health and how this contributes to a woman having an imbalanced microbiome. Subsequently, an imblanaced microbiome contribute to the development of other afflictions that have recently been linked with poor microbiome health including immune functioning, digestion and auto-immune diseases. Another typical medical suggestion is managing painful periods with hormonal contraceptives, leading to an alteration of reproductive functioning. But why all the agony in the first place? Ah, right, it’s the old womanhood contract we signed up for in utero, got it.


Interestingly, what I have found when speaking to other women about their painful periods is that the potential of having pain-free periods are not often well received as many women feel it is not possible and so enthusiasm is often only superficial because of this lack of awareness. It is as if some women have indeed signed that contract that this is what is to be experienced because 'I am a woman' and there is no perceived possibility to break this contract. An unwillingness to help oneself. I am still unsure as to why this happens so frequently. Is it lack of self-worth? Lack of motivation to try something new? A refusing to believe life could be better? A commitment to a belief that bodies are fraught and prone to problems, pain and suffering no matter what? I understand most women are unaware of another way to experience menstruation but for those who are aware and choose not to engage with the possibility leaves me somewhat baffled.


What we have forgotten as a collective, and therefore never learned as individualy, is that anything more than mild discomfort for more than 30 minutes per cycle is an indication of an imbalance within the pelvis. Stress, trauma, lifestyle and nutrition certainly play a role in how we experience menstruation but these topics are not the whole picture.


Another hugely important facet to menstruation and the experience of pain pertains to the positioning and mobility of our organs. Do you know that female pelvic organs are mobile? They move around in there all the time. This is necessary considering the constantly changing sizes of the pelvic organs and of course mobility is needed for the uterus to grow during gestation. Because the organs, especially the uterus, are mobile they can be found in various positions.


Some of the common reasons behind the varying positions of the uterus include physical trauma, like falling from a horse or bicycle, postural variations such as always tucking the pelvis as commonly performed in yoga classes, digestive issues and, possibly the biggest factor, adhesions. Adhesions can develop in response to physical trauma, such as surgery or infection, and involve the proliferation of scar tissue which become fibrous and connect to tissues within the pelvic space. This acts like glue or stitching between tissues and now the effected organ is not completely mobile or able to complete it’s proper functioning. Due to the various ways adhesions can develop as well as their various locations, symptoms of adhesions vary widely and they have far reaching health consequences such as painful periods, ongoing lower back pain or infertility.


Common position of the uterus include retroverted, retroflexed and anteflexed. There is also anecdotal evidence that women have undergone surgery and were later told their uterus was found twisted, folded and completely down towards the pelvic floor.


What matters most is the mobility of the uterus rather than the positioning


Differing uterus positions do not always result in period pain and variations are normal. We do not need to pathologise the position of a uterus. What does require specific attention is whether or not the uterus is mobile. If the uterus is in an anteflexed position, is it also adhered to the bladder? Or can it move freely to adjust to the growing and shrinking size of the bladder as it fills and empties with urine? Adhesion to the bladder almost always occurs following a caesarian.

When working on restoring mobility of the organs, especially the uterus, women have reported significant improvements with period pain. This is because when the uterus is not constricted in mobility it is able to perform the contractions during menstruation without difficulty and respond effectively to the movements of its neighbouring organs, bones and muscles. There is no straining of tissues trying to compensate for the uterus being pulled or held in a particular direction.


Restoring mobility can be achieved through deep visceral manipulation of the organs, muscles, fascia and bones. It is possible to resolve adhesions, smooth out muscle trigger points, balance pelvic positioning through hands-on bodywork, like Mercier Therapy.


It is important to reiterate that a misaligned uterus is not evidence of the body’s fallibility. If you have a misaligned uterus, your body has adapted in the best possible way to external circumstances. If a woman constantly sits on her sacrum (slouched, leaning back position), the uterus will likely move backwards due to gravity and over time the ligaments may shorten and hold it there. If you have had a laparoscopy and adhesions have developed in the right side of your pelvic space pulling your uterus in that direction, this is because your body is trying to heal from the trauma of surgery. The body does not make mistakes and any imbalances or functional issues are often a result of environmental, trauma or lifestyle factors that your body is responding to.


If you experience regular period pain and are interested in bodywork that is targeted at restoring mobility of the uterus, then care at Ananda Woman offers one off sessions and recurring sessions that can support you.


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